Keeping the Environment Safe for Patients and Professionals: Infection Prevention and Control at Community Pharmacies

Infection prevention and control (IPAC) is an important way to prevent or reduce the risk of transmission of infections to healthcare providers and patients. IPAC involves evidence-based practices and procedures that must be applied consistently in healthcare settings.

Why Is IPAC Important for Community Pharmacies?

• Ensure proper sanitary conditions for drug preparation and storage.
• Support effective and safe administration of substances by injection or inhalation and other pharmacy services (e.g., performing a point-of-care test).
• Support appropriate environment for non-sterile and sterile compounding.
• Maintain a healthy environment for patients.
• Protect pharmacy staff from disease transmission and other threats to health and safety.

Requirements for Pharmacies

Under the Standards of Operations for Pharmacies, which apply to both community and hospital pharmacies, all pharmacies are required to have a program to ensure the regular cleaning of the pharmacy, including all premises, furniture, equipment and appliances, and automated pharmacy systems.

Any pharmacy staff involved in dispensing, compounding or the administration of substances by injection or inhalation must engage in evidence-based infection control practices, including appropriate hand hygiene and wearing suitable protective equipment as needed.

Community pharmacies should:

• Have a policy in place to address IPAC procedures at the pharmacy
• Ensure staff are trained and understand the policy and can demonstrate how to apply it
• Know the resources available from Public Health Ontario and their local public health unit
• Plan for what to do in the case of an IPAC breach and when/how to report to public health

Public health units have been using the IPAC Checklist for Clinical Office Practice to inspect pharmacies. Designated Managers are encouraged to review the checklist for potential gaps in their IPAC policies and procedures.

IPAC Issues Commonly Identified at Community Pharmacies

Lack of established cleaning schedules and/or insufficient cleaning. The pharmacy should not look visibly unclean or have clutter that makes cleaning difficult. Cleaning procedures should occur regularly and be based on best practices.

Vaccination areas that are not maintained appropriately. A consultation room being used for vaccination or other pharmacy services should not be cluttered and should be regularly cleaned. Avoid multiple uses of the room, such as an eating area. Do not store food and drinks in vaccine fridges.

Lack of adherence to PPE use and hygiene techniques. Use proper hygiene and aseptic technique.

Improper waste disposal. Sharps containers should be managed in line with manufacturer guidelines, including ensuring that they are not overfilled. Pharmacies should also have appropriate materials and procedures in place to manage any hazardous waste and bodily fluids.

Furnishings that do not allow for proper cleaning. Furnishings in the pharmacy, especially where vaccinations are being given, should be smooth, non-porous and cleanable. For example, fabric chairs are hard to clean and are often visibly stained.