Standards of Practice

Exploring NAPRA’s New Standards: Knowledge and Expertise

Domain 2 - Knowledge with lightbulb icon
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The College is exploring whether to adopt or adapt new Model Standards of Practice for Pharmacists and Pharmacy Technicians in Canada. These new standards were approved by the National Association of Pharmacy Regulatory Authorities (NAPRA) in November 2021 and, if adopted or adapted by the College for Ontario registrants, would replace the existing separate standards for pharmacists and pharmacy technicians. This is the second in a series of five articles to help registrants, pharmacy stakeholders and patients understand each domain in the new model standards.

Most of the new Model Standards of Practice are well-aligned with existing practice standards. And in a few instances where changes have been made, they remain consistent with expectations already articulated in the College’s Code of Ethics and Standards of Operation. This means that putting these new model standards into practice should be relatively straightforward for pharmacists and pharmacy technicians. For now, Ontario’s current practice standards remain in effect.

Overview of Domain 2 – Knowledge and Expertise

Pharmacy professionals keep their knowledge and skills up to date and provide quality care based on best available evidence and the application of professional judgment.

Domain 2 includes two standards:

  • 2.1: Pharmacy professionals develop and maintain their professional knowledge and skills and practise within their own scope of practice;
  • 2.2: Pharmacy professionals incorporate evidence-informed practice in all aspects of professional care.

What’s New

Standard 2.2.1 focuses on critically analyzing information to ensure best available evidence is used to make all decisions or recommendations. This differs from the existing standards for pharmacists (1.5 and 1.6) by referring to all decisions and recommendations related to healthcare, not just those that are medication related. For pharmacy technicians, this standard of practice requires the use of professional judgment to ensure best available evidence and other valid information sources are used to make all decisions or recommendations within their scope of practice.

Standard 2.2.2 reinforces professional judgment and applying evidence-based information to each patient’s unique circumstances and goals, to provide optimal, evidence-informed care. While new to the standards, using professional judgment is not new for pharmacy professionals. A Pharmacy Connection article explored this very topic and provides some relevant examples of professional judgment in practice.

DOMAIN 2: Requirements for domain 2

DOMAIN 2: Circular graphic displaying the requirements for domain 2: knowledge, professional judgment, skills, scope of practice, lifelong learning, best available evidence and expertise.

This Domain in Action

To illustrate how pharmacists and pharmacy technicians work together within their scopes of practice and demonstrate professional judgment, let’s look at a practical, everyday example.

A patient asks a pharmacy technician to refill a prescription that is a year old. This raises a concern, and the pharmacy technician uses their professional judgment to refer the refill to the pharmacist. The pharmacist consults best available evidence, draws on their expertise and therapeutic knowledge, and uses their professional judgment to determine that it would be inappropriate and result in adverse health outcomes for the patient to restart the prescription at the original strength. The pharmacist, practicing within their scope, documents their evidence-based findings and rationale, and then provides a recommendation and professional opinion on restarting therapy with the prescriber.

In this example, the standards were able to support optimal patient care by ensuring that pharmacists draw on best available evidence and apply their professional judgment based on the unique circumstances of the patient.

Learn more

This article provides a high-level overview of Domain 2 of the new model standards of practice and does not cover all aspects of the standards and indicators included within the domain. For more information, refer to NAPRA’s Model Standards of Practice for Pharmacists and Pharmacy Technicians in Canada.

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