Pharmacy Practice During the Pandemic

UTILIZING PROFESSIONAL JUDGMENT

Pharmacists and pharmacy technicians are relied upon to use their knowledge, skills and judgment to make decisions that positively enhance health outcomes for patients and provide patient-focused care. This professional judgment is founded on always having the best interests of patients in mind, taking into consideration the unique circumstances of each situation.

The College often receives questions from registrants asking for a solution to a specific scenario. Pharmacists and pharmacy technicians know their patient and the situation best and must ultimately use the resources they have, including the Standards of Practice, the Code of Ethics, policies and guidance, and consultations with colleagues, to make an informed decision that they feel optimizes the health outcomes of their patient. One helpful resource for this is the Framework for Ethical Decision Making.

When providing patient care throughout the pandemic, pharmacy professionals are encouraged to use their professional judgment within the overall intent of the legislation, standard or policy. For example, where delivery of a prescription directly to a patient and obtaining a signature is not possible due to a health status (such as being COVID-positive), pharmacy professionals can use their professional judgment to ensure that the prescription has been dispensed to the right patient and that opportunity for loss/theft is minimized. This could occur through a phone call or virtual check-in.

During public health emergencies, pharmacy professionals may also be more likely to encounter situations where patients require emergency care in order to prevent or reduce risk of imminent severe harm. In such circumstances, pharmacists may apply professional judgement to address the patient’s immediate needs and provide care, such as prescribing a rescue/reliever inhaler for a patient suffering from an acute asthmatic reaction or rendering other temporary assistance, in addition to what is currently permitted within the current scope of practice related to adapting and renewing prescriptions (see the College’s Initiating, Adapting and Renewing Prescriptions guideline).

Additional examples, such as receiving prescriptions by email, managing drug shortages and dispensing limits, establishing virtual care, enabling access to opioid agonist treatment and avoiding close contact with COVID-patients, have been significant challenges for pharmacy professionals. While the College has provided guidance and resources where possible on the COVID-19 for Pharmacy Professionals webpage, it is fundamentally up to the registrant to use their professional judgment to determine the best course of action, while ensuring that the patient’s best interest comes first.

THE IMPORTANCE OF DOCUMENTATION

Appropriate documentation of actions and decisions throughout the pandemic is important, especially where they may vary from established processes, such as making modifications to sterile compounding due to PPE shortages or not obtaining a signature for a prescription delivery.

Depending on the situation, documentation should include, but is not limited to, decisions made, the rationale for doing so and what, if anything, has been done to mitigate any risk to patients and staff. This documentation can demonstrate accountability for decisions and actions, address questions or concerns that may be raised later, enable collaboration and consistency among colleagues at the pharmacy and support continuity of care for patients.

For more resources related to documentation, visit the Documentation Practice Tool on the OCP website.

RESOURCES FOR PHARMACISTS AND PHARMACY TECHNICIANS

The College has received many questions from registrants throughout the pandemic. Many of these have been addressed on the COVID-19 for Pharmacy Professionals webpage, including:

What can I do under the CDSA Section 56 exemption?
How do I safely serve COVID-positive patients?
Can I receive emailed prescriptions from a prescriber?
Can I deliver prescriptions without getting a signature from the patient?
Can I compound hand sanitizer?
How do I receive post-consumer returns?
How do I temporarily close my pharmacy?

The College has also created and updated many fact sheets, guidance documents and policies to support registrants in providing patient care during COVID. These include: