Public Health Ontario describes Infection Prevention and Control (IPAC) as “evidence-based practices and procedures that, when applied consistently in health care settings, can prevent or reduce the risk of transmission of microorganisms to health care providers, clients, patients, residents and visitors.”
Pharmacy professionals have an ethical obligation to act in the best interest of their patients by placing their well-being first and foremost and, whenever possible, preventing harm from occurring. Under the Standards of Operation, pharmacies should be designed to mitigate risk and maintain safe drug distribution practices. To effectively safeguard the health of the public, infection prevention measures must be considered by registrants in all practice settings. The nature and extent of these measures will depend on several factors, such as applicable legislation, the professional services provided and the characteristics of the patient population.
The Standards of Operation require all accredited pharmacy premises to be designed and maintained to ensure the safe and appropriate storage of all drugs and medications, including the proper conditions of sanitation. The pharmacy must ensure regular cleaning of the premises the pharmacy is operated from including all furniture, equipment and appliances. Personnel engaged in dispensing or compounding activities must adhere to appropriate hygienic behaviour including using appropriate hand washing techniques and wearing suitable protective equipment as needed in accordance with the College’s Guidance on Accreditation and Operation of a Pharmacy (see the College’s Community Pharmacy Assessment Criteria for specific guidance.)
Regulations under the Public Hospitals Act require hospitals to establish a committee to oversee an infection control program. Keeping the hospital’s medication supply free of potential contamination requires collaboration between Pharmacy and other departments, in consultation with the IPAC committee, when developing policies and procedures (see the Hospital Pharmacy Assessment Criteria for specific guidance). In the community setting, Designated Managers are responsible for implementing procedures and quality assurance mechanisms to meet the standards.
Ontario Regulation 202/94 under the Pharmacy Act stipulates that a pharmacist may only administer a substance by injection in an environment that is clean and safe for the patient and with appropriate infection control procedures in place. Injection-trained pharmacists must have completed training according to the Public Health Agency of Canada’s Canadian Immunization Guide (see the Key Immunization Information and Infection Prevention and Control sections of the guide).
As scope of practice continues to expand and pharmacy professionals become increasingly engaged in patient care activities – especially those involving piercing the dermis – the need for effective infection prevention measures is heightened. Ontario’s Public Health Units also have a responsibility to investigate IPAC complaints related to the administration of a substance by injection or performing of a procedure beneath the dermis, as outlined in the Infection Prevention and Control Complaint Protocol.
In the event of a communicable and/or infectious disease transmission risk related to the professional conduct of a regulated pharmacy professional, the regional board of health will involve the College on the matter, per the protocol.
INFECTION PREVENTION AND CONTROL RESOURCES FOR PHARMACY PROFESSIONALS
The following list is by no means exhaustive. Additional resources are available from other government ministries, professional associations and jurisdictions.
Ministry of Health and Long Term Care (Public Health Standards)
- Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings, 3rd edition (May 2012)
- Routine Practices and Additional Precautions In All Health Care Settings, 3rd edition (Nov 2012)
- Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings (April 2018)
- Best Practices for Hand Hygiene in All Health Care Settings, 4th Edition (April 2014)
- Infection Prevention and Control for Clinical Office Practice (April 2015)
- Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings (2013)