C O L L E G E O F P H A R M AC I S T S O F M A N I T O BA

N E W S L E T T E RFALL 2016

IN THIS ISSUE...

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Canadian Patient Safety Week

Dr. John Wade Patient Safety Initiatives Grant

CancerCare Manitoba Checklist for Oral Chemotherapy

Office Use Only Rxs

PHIA and Confidentiality

Another Successful Day on the Course

Pharmacy Compounding Standards

President’s Message

Professional Development

Practice Advisories for Patient SafetyFocus on Patient Safety

College Updates

In Every Issue....

This year’s Canadian Patient Safety Week will be held October 24th – 28th. The Canadian Patient Safety Institute (CPSI) is answering the three biggest questions in patient safety:

1. How do I take an active role in preventing harm?, 2. How can I respond when harm does happen?, and, 3. How I can learn from harm that has already happened?

The answer is CPSI’s new initiative SHIFT to Safety, offering tools and resources for patient safety in Canada.

With a focus on empowering patients, practitioners and leaders, this innovative initiative promotes positive, safe healthcare experiences for everyone while navigating the healthcare system.

“We want to help patients and their families advocate for their healthcare safety, we want to help providers prioritize safety when caring for their patients, and we want leaders in healthcare organizations to be able to create a positive patient safety culture. Most importantly, we want everyone working together as a team. After all, improving patient care safety and quality in Canada requires everyone’s involvement.”

CPSI SHIFT to Safety News Release

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Features

Canadian PatientSafety Week

The College is interested to learn of your pharmacy’s plans

for the upcoming Canadian Patient Safety Week. Feel free

to let the College know at info@cphm.ca.

SHIFT to advocate for healthcare safety. Empower yourself with information and tools to help you ask good questions, connect with the right people, and learn as much as you can to keep you or a family member safe while receiving healthcare.

SHIFT to prioritize safety when caring for patients. Get information and tools to help you answer critical questions, work together as a healthcare “team,” respond effectively to safety incidents, and reduce the risk of patient injury.

SHIFT to a positive patient safety culture. Discover tools and resources to help you inspire a lasting, positive patient safety culture by capitalizing on learning opportunities, team performance, organizational change readiness, and safety incident management.

The College of Pharmacists of Manitoba (College) is pleased to support this impressive initiative and we encourage members to review the many resources available on the CPSI website at SHIFTtoSafety.com.

On September 30th, the College received notice that amendments to the Pharmaceutical Regulation, had been approved by government and are now in effect.

The amendments include adding the tetanus and diphtheria (Td) booster in Schedule 2 of the Regulations (Vaccines that a member may administer as part of the provincial program) and to allow authorized pharmacists to prescribe clindamycin combinations for the treatment of acne vulgaris by including this listing in Schedule 3 of the Regulations.

Vaccines that a member may administer as part of a provincial program now include:

• human papillomavirus (HPV) vaccine• influenza vaccine• pneumococcal polysaccharide (Pneu-P-23) vaccine• tetanus-diphtheria-acellular pertussis (Tdap) vaccine• tetanus-diphtheria (Td) vaccine

The amendment and additional details can be found on the College website.

CPhM Fall 2016 issue2

200 Taché avenue, Winnipeg, MB | phone: (204) 233-1411 Fax: (204) 237-3468 | eMail: inFo@cphM.ca

www.cphM.ca

THIS NEWSLETTER is published by the College of Pharmacists of Manitoba and is forwarded to every licenced pharmacist in the Province of Manitoba. Decisions of the College of Pharmacists of Manitoba regarding all matters such as regulations, drug-related incidents, etc. are published in the newsletter. The College therefore assumes that all pharmacists are aware of these matters.

OFFICERSJennifer Ludwig, President, BrandonKevin Hamilton, Vice President, WinklerPetr Prochazka, Executive Treasurer, WinnipegGlenda Marsh, Past President, Brandon

COUNCILLORSWendy Clark, CarmanDr. Xiaochen Gu, Interim DeanDonna Forbes, Public RepresentativeTravis Giavedoni, Public RepresentativeGeoff Namaka, WinnipegRik Panciera, Public RepresentativeSonal Purohit, WinnipegDerrick Sanderson, The PasDinah Santos, WinnipegAudra Taylor, Public Representative Cheryl Zelenitsky, Public Representative LIAISON MEMBERSDr. Patricia Caetano, Manitoba Government LiaisonBrittany Kessler, University of Manitoba – Student Dr. Brenna Shearer, Pharmacists ManitobaAshley Walus, C.S.H.P. (MB. Branch)

COLLEGE STAFFSusan Lessard-Friesen, RegistrarTodd Mereniuk, Deputy RegistrarJill Hardy, Assistant RegistrarRonda Eros, Practice ConsultantKathy Hunter, Quality Assurance & Field OfficerKathy Wright, Executive Assistant to the RegistrarStacey Hjorleifson, Senior Administrative AssistantBev Robinson, Administrative AssistantChantal MacDonald, Administrative AssistantRachel Carlson, Communications & Quality Assurance Coordinator

VISIONLeader in patient safety by creating the framework for collaborative and

innovative patient-centred pharmacy practice.

MISSIONTo protect the health and well-being of the public by ensuring and promoting safe, patient-centred and progressive pharmacy practice in collaboration with

other health-care providers.

VALUESThe College activities are based on the following values and are the foundation

of what we do: Integrity~Respect~Excellence~Accountability~Collaboration~Life Long Learning

Regulation Amendment

P r e s i d e n t ’ s M e s s a g e

CPhM Fall 2016 issue 3

Dear Members,

This past August, I was pleased to represent the College of Pharmacists of Manitoba (College) as the National Association of Boards of Pharmacy (NABP) and the American Association of Colleges of Pharmacy’s (AACP) hosted the 2016 District V Meeting, in Lincoln, Nebraska. It was my first opportunity to attend these meetings on behalf of the College and in my capacity as President. The experience was indeed a worthwhile one, which allowed me the opportunity to meet and collaborate with like-minded members from the US and Canada. The meetings covered a range of topics from sterile compounding, to stakeholder consultation and feedback, and collaborative practice, which reflects much of what the College and the practice of pharmacy in Manitoba has been focusing on recently.

Back on Canadian soil, the National Association of Pharmacy Regulatory Authorities (NAPRA) recently expanded its development of the Model Standards for Pharmacy Compounding of Non-hazardous Sterile Preparations and the Model Standards for Pharmacy Compounding of Hazardous Sterile Preparations. After having attended the District V meetings, I am convinced this process is a positive step for pharmacists in Manitoba and will prove to aid the practice of pharmacy.

One of my greatest takeaways from these meetings was the presentation by the speaker and pharmacist Fergus Hoban on the value of collaboration across healthcare professions. Mr. Hoban introduced the audience to a novel concept of collaborative practice which saw greater communication and solidarity among physicians, nurses and pharmacists; a stride that the Colleges here in Manitoba have already been making with recent partnerships on important matters such as opioid replacement therapy training and recent improvements to the Joint Statements on Electronic and Fax Prescriptions. I am convinced that such efforts further reinforce just how valuable cooperation among regulatory bodies can be and how much more effective initiatives can be in strengthening delivery of healthcare services.

The College has been fortunate to participate in meetings with the new Minister of Health, Seniors and Active Living, The Honourable Mr. Kelvin Goertzen, and Deputy Minister of Health, Seniors and Active Living, Ms. Karen Herd, who both graciously engaged with us and were receptive to the our discussion regarding our concerns and goals for the future of pharmacy. We certainly look forward to forums that allow for further dialogue with government as we all strive to improve healthcare in Manitoba.

I cannot conclude this message without mentioning our annual golf tournament, held on September 1st at the Selkirk Golf & Country Club. While I, by no means can claim to have the greatest swing on the golf course, I certainly can admit to a wonderful day spent among colleagues in the profession and friends of the College! The College wishes to thank everyone who participated in this year’s event whether through sponsorship or team spirit. We look forward to other opportunities such as these in the future!

Sincerely,Jennifer Ludwig, BSc. (Pharm.) President, College of Pharmacists of Manitoba

Licence renewal will be upon us shortly, and with this in mind, practicing pharmacists are reminded that in order to be eligible for licence renewal, they are required to participate in a minimum of 25 hours of professional development (PD) learning activities from November 1, 2015, to October 31, 2016.

Of the 25 hours, a minimum of 15 hours must be from accredited learning activities with a balance of 10 hours of participation in either accredited or non-accredited learning activities. Members must enter their learning activities in the online Professional Development Log on the College website by logging in to their accounts and accessing the PD section. All relevant links can be found under the “My Professional Development” tab, including a guide to using the online PD Log.

Members are reminded that programs which have been accredited for pharmacy technicians may not be claimed as accredited learning for pharmacists, but may be claimed as non-accredited learning activities.

Pharmacists authorized to administer drugs by injection are further reminded that they are required to maintain current certification in CPR Level C or HCP and Standard or Emergency First Aid in order to remain authorized. Please see the College website for more information on the CPR and First Aid requirements.

All pharmacists are required to enter their PD learning activities and complete the online licence renewal application by November 30, 2016. Should PD learning activities not be entered by this date, the fee for licence renewal will increase by 50%.

In late October, Council will determine this year’s licence renewal fees and this information will be announced in an upcoming issue of the Friday Five.

Should you have any questions regarding the PD requirement or online PD Log, please call the office at 204-233-1411.

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CPhM Fall 2016 issue

PROFESSIONAL DEVELOPMENT REQUIREMENT DEADLINES...

Don’t get left behind!

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P r o f e s s i o n a l d e v e l o P M e n t

CPhM Fall 2016 issue

Commitment to Professional Development Certificate in 2016

New Multidisciplinary Approach to Opioid Replacement Therapy Training

The College of Pharmacists of Manitoba’s “Commitment to Professional Development Certificate”, formerly known as the “Life Long Learning Certificate”, is issued to recognize a pharmacist’s strong commitment to involvement in continuing professional development within the professional development year.

All pharmacists who participate in a minimum of 50 hours of professional development activities during the 2015-2016 PD year, of which a minimum of 30 hours are from accredited learning activities, will receive a College of Pharmacists of Manitoba “Commitment to Professional Development Certificate in 2016” and will also be recognized in the upcoming Annual Report for their accomplishment.

For pharmacists who go above and beyond the required 25-hour professional development requirement, additional learning activities can be entered in the online PD Log on the College website until January 31, 2017.

PROFESSIONAL DEVELOPMENT REQUIREMENT DEADLINES...

Don’t get left behind!

The College of Pharmacists of Manitoba (CPhM), in partnership with the College of Physicians and Surgeons of Manitoba (CPSM) and the College of Registered Nurses of Manitoba (CRNM), is excited to launch a new multi-disciplinary training course for healthcare providers who wish to become involved in treating those with opioid use disorder. This collaborative approach will enrich discussions during the two day training sessions. It will ensure that all physicians, nurse practitioners and pharmacists successfully complete training with the same high standard of knowledge and insight into the collaborative approach to treatment that best serves this complex patient population. Training together will hopefully translate into stronger and more frequent interdisciplinary collaboration in clinical practice.

The new training course 'Opioid Replacement Therapy 101: An introduction to clinical practice' will consist of two days packed with practical knowledge and skill building exercises, including opportunities to practice interviewing patients with opioid use disorder in a supportive environment. The first joint CPSM / CPhM / CRNM training course is being planned for November 24th and 25th, 2016, in Winnipeg.

'Opioid Replacement Therapy 101: An introduction to clinical practice' joint training program replaces the "Principles for the Provision of Opioid Dependence Treatment by Manitoba Pharmacists" Certificate Program previously offered by CPhM as the required specialized opioid dependence treatment training program for pharmacists dispensing methadone. Those who previously completed the Principles for the "Provision of Opioid Dependence Treatment by Manitoba Pharmacists" Certificate Program are encouraged to complete the new, updated program, although it is not required.

The updated "Principles for the Provision of Opioid Dependence Treatment by Manitoba Pharmacists" guideline document is available on the CPhM website.

Please see the CPhM website for more information on the Opioid Replacement Therapy 101 course including information on the pre-requisites and how to register for the November 24-25th program.

f o c u s o n P a t i e n t s a f e t y

6 CPhM Fall 2016 issue

The Institute for Safe Medication Practices Canada is an independent national not-for-profit organization committed to the advancement of medication safety in all healthcare settings. ISMP Canada works collaboratively with the healthcare community, regulatory agencies and policy makers, provincial, national and international patient safety organizations, the pharmaceutical industry and the public to promote safe medication practices. ISMP Canada’s mandate includes analyzing medication incidents, making recommendations for the prevention of harmful medication incidents, and facilitating quality improvement initiatives.

ISMP Newsletter SubscriptionsISMP Canada Safety Bulletins are designed to disseminate timely, targeted information to reduce the risk of medication incidents. The purpose of the bulletins is to confidentially share the information received about medication incidents which have occurred and to suggest medication system improvement strategies for enhancing patient safety. The bulletins will also share alerts and warnings specific to the Canadian market place.

The following ISMP Canada Safety Bulletins have been issued since the last issue of the Newsletter:

ISMP Canada Safety Bulletins for Practitioners2016 - Volume 16

• Accidental Intravenous Infusion of a Heparinized Irrigation in the Operating Room - Issue 6

• Understanding Human Over-reliance on Technology - Issue 5

SafeMedicationUse.ca Newsletters and Alerts for Consumers

2016 - Volume 7:

• Beat the Heat: How to Prevent, Recognize, and Manage Heat-Related Illnesses

• 5 Questions to Ask about Your Medications

All issues of the ISMP Canada Safety Bulletins, including those issued in previous years, are freely downloadable from the ISMP Canada website www.ismp-canada.org. ISMP Canada is pleased to distribute The Medication Safety Alert! (US) newsletters along with ISMP Canada Safety Bulletins to Canadian practitioners and corporations. To subscribe and for more information on all ISMP Canada’s publications, events and services visit the ISMP Canada website at www.ismp-canada.org.

The Canadian Medication Incident Reporting and Prevention System (CMIRPS) is a collaborative pan-Canadian program of Health Canada, the Canadian Institute for Health Information (CIHI), the Institute for Safe Medication Practices Canada (ISMP Canada) and the Canadian Patient Safety Institute (CPSI). The goal of CMIRPS is to reduce and prevent harmful medication incidents in Canada.

Report medication incidents (Including near misses)Online: www.ismp-canada.org/err_index.htmPhone: 1-866-544-7672ISMP Canada strives to ensure confidentiality and security of information received, and respects the wishes of the reporter as to the level of detail to be included in publications.

Sign up:To receive this publication or other medication safety publications sign up at: www.ismp-canada.org/subscription.htm

Visit CMIRPS, call 1-866-544-7672, or email cmirps@ismp-canada.org.

Building awareness for the

systems that can lead to

adverse events, changing

the culture to reporting and

learning from medication

incidents, are some of the

key factors in improving

patient safety.

f o c u s o n P a t i e n t s a f e t y

7CPhM Fall 2016 issue

The Manitoba Institute for Patient Safety (MIPS) is calling for applications for the Dr. John Wade Patient Safety Initiatives Grant. The grant recognizes and supports small Manitoba initiatives that advance the practice, awareness and knowledge of patient safety.

Dr. Wade was a pioneer in the establishment of MIPS and has dedicated his career to bettering the healthcare system and advocating for patient safety on both a local and national front.

Dr. Wade was appointed as a member and Chair of the Founding Board of the Canadian Patient Safety Institute and presently he is a Professor Emeritus of Community Medicine and Anesthesia at the University of Manitoba; Dean Emeritus of the University of Manitoba Faculty of Medicine; Past Chair of the Board of the Winnipeg Regional Health Authority; Assistant Executive Director of the Manitoba Medical Services Foundation and serves on several boards.

Patient safety is the responsibility of all healthcare professionals and as such the Dr. John Wade Patient Safety Initiatives Grant is open to MIPS’ member organizations, individuals, secondary schools, colleges, and post-secondary organizations, as well as community-based organizations. If you are involved in an initiative or program with the vision of improving patient safety and are interested in learning more about this opportunity, visit the MIPS website or complete an application soon. The deadline to submit applications to MIPS is Wednesday, November 2, 2016 at noon. Click here to view application.

Dr. John Wade Patient Safety Initiatives Grant

CancerCare Manitoba Checklist for Oral ChemotherapyCommunity pharmacies in Manitoba are dispensing an increasing number of oral chemotherapy agents. According to the Canadian Association of Provincial Cancer Agencies (CAPCA), up to 50% of new oncology drugs on the market are manufactured in oral form.

Many oral chemotherapy drugs possess the same adverse event and handling risks as intravenous and subcutaneous chemotherapy. Unlike chemotherapy administered intravenously or subcutaneously by trained healthcare professionals, patients or caregivers are responsible for the administration and storage of oral medications in their home. As such, community pharmacists play a key role in educating patients to ensure proper administration and storage of these drugs. Additionally, it is important for community pharmacists to ensure the prescription is correct and complete before dispensing the medication.

CancerCare Ontario (CCO), has developed an oral chemotherapy checklist. CancerCare Manitoba’s (CCMB) Quality, Patient Safety & Risk department in collaboration with CCO and CAPCA piloted this checklist at a pharmacy in Manitoba. This was done with support from the Manitoba Institute for Patient Safety (MIPS) Dr. John Wade Patient Safety Initiative. The success of this pilot is the impetus for the checklist to be implemented in community pharmacies in the province.

As a consequence of this pilot project, CancerCare Manitoba has made enhancements to its electronic prescriptions for oral chemotherapy. All prescriptions will now have the patients height, weight and body surface area, the phone number of the CCMB pharmacy as well as specific physician prescribing numbers.

The checklist will help guide community pharmacists through the clinical verification process. The checklist contains a number of key points that should be considered when verifying a prescription for cancer treatment. The checklist and accompanying feedback survey can be found on the CPhM website. Pharmacists are encouraged to complete the checklist when reviewing an oral chemotherapy order and file the completed checklist with the original prescription.

In addition to the checklist, pharmacists are also encouraged to complete the short survey that accompanies the checklist. Your feedback is important to further refine the checklist and oral chemotherapy prescriptions.

Pharmacists are also encouraged to review the professional development programs Oral Anti-Cancer Agents: Bridging the Gap and A Primer on Oral Anti-Cancer Therapy and Learn to be Safe - Medication Safety: A Guide for Pharmacists. These professional development programs are CPhM accredited learning activities and can be found on the College website.

P r a c t i c e a d v i s o r i e s f o r P a t i e n t s a f e t y

8 CPhM Fall 2016 issue

Part of the Council’s commitment to enhance

the quality of care and patient safety in Manitoba pharmacies was to instruct the Chair of the Complaints Committee to issue a report

following meetings of the Committee.

The intent of this report is to inform pharmacists of medication incidents,

thereby providing an opportunity to relate and

reflect upon their own practice with the goal of improving patient safety.

The College has recently fielded a number of questions related to “office use” prescriptions. In one instance, a written complaint was referred to the Complaints Committee involving an office use prescription.

Although office use prescriptions have been a part of the prescriber-pharmacist relationship for many years, pharmacists are reminded that, like any other prescription, a prescription for office use must be in compliance with all applicable legislation. Pharmacists must also use professional judgment in that they are responsible for the accurate, safe, and appropriate dispensing of the prescription, as per the following excerpt from the Pharmaceutical Regulations section 83:

Ensuring patient safety

83 Subject to any practice directions, a member must review each prescription and the patient's record and take appropriate action if necessary with respect to

• appropriateness of drug therapy;

• a drug prescribed by a practitioner outside his or her authorized scope of practice; or

• a drug that has not been prescribed consistent with standards of care and patient safety.

Some points to consider are:

• If there are questions regarding section 83(h) of the Pharmaceutical Regulations and the scope of practice of the prescriber, the pharmacist should contact the prescriber’s regulatory College for guidance.

• Pharmacies are not authorized to act as drug wholesalers as this would require an Establishment Licence from Health Canada. If the quantity of the drug ordered does not seem reasonable, the prescriber should be encouraged to open their own account with a drug wholesaler.

• All medications obtained through an “office use” prescription and subsequently given by the prescriber to the patient would not be entered into DPIN, which may represent an increased risk to the patient should there be an emergency and the need for a complete medication history.

• “Office use” prescriptions sold to prescribers may represent a risk to patient safety if they are administered to patients indiscriminately or not securely stored in the prescriber’s office. The Practice Direction on Patient Counselling still applies to "Office Use" prescriptions, including a discussion of storage requirements.

Office Use Only Rxs

P r a c t i c e a d v i s o r i e s f o r P a t i e n t s a f e t y

P r a c t i c e a d v i s o r i e s f o r P a t i e n t s a f e t y

9CPhM Fall 2016 issue

P r a c t i c e a d v i s o r i e s f o r P a t i e n t s a f e t y

PHIA and Confidentiality Personal Health Information is sensitive information and must be protected. The Personal Health Information Act of Manitoba (PHIA), provides patients with the right to access their personal health information, as well as the right to have their health information kept private.

Community pharmacists, hospitals and other facilities that keep personal health records are known as “trustees” and must protect the privacy of that information.

The Code of Ethics, Statement IV states “Pharmacists shall respect and protect the patient’s right of confidentiality”. The “Explanatory Document: Applying the Code of Ethics in Pharmacy Practice”, further expands on the obligations of the pharmacist under this statement:

Obligations:

• Provide care in a manner that protects each patient’s privacy.

• Seek only the information needed to make informed decisions about the patient’s health and treatment.

• Use information obtained in practice for the purposes for which it was obtained.

• Inform patients of the boundaries of professional confidentiality that may require the use and disclosure of their personal health information to other health care professionals.

In practice, pharmacists have many occasions when there is a need to protect personal health information and confidentiality of the patient.

In the dispensary or practice setting, pharmacists must be aware of their surroundings and adjust the volume of their voice when counselling or talking to patients. The pharmacist should also choose to talk to their patients in a confidential counselling area.

Privacy barriers should be installed around the patient prescription pick up area. These barriers can act as a sound dulling barrier and a visual barrier for privacy.

Within a pharmacy, it is not only the pharmacists who have a responsibility in protecting patient’s personal health information; all pharmacy staff must take part in this responsibility. Staff and suppliers who have access to personal health information must sign a pledge of confidentiality to be kept on site. This process should include anyone who accesses the dispensary or area where personal health information is available. Some examples of those who should sign a pledge of confidentiality are pharmacists, students, technical support staff, and delivery drivers who enter the dispensary.

Confidentiality of personal health information is a priority of all healthcare professionals. Pharmacy and hospital staff must abide by the requirements of PHIA in all activities within their practice. The College of Pharmacists of Manitoba form entitled Your Personal Health Information: Access and Privacy must be displayed in the pharmacy and acts as a visual reminder to patients and healthcare providers of the importance of protecting personal health information.

10 CPhM Fall 2016 issue

c o l l e g e u P d a t e s

The College of Pharmacists of Manitoba (College) would like to thank all of our hole sponsors and prize donors for their support of the College Golf Tournament which was held on Thursday, September 1, 2016, at the Selkirk Golf and Country Club. The net proceeds raised from the event, totalling over $1,500, were donated in support of the efforts of the Canadian Foundation for Pharmacy (CFP).

A sincere thank you is extended to all participants, staff, hole sponsors and prize donors who make this event a great success year after year. This year was no exception and it wouldn’t happen without their support.

As a philanthropic organization which prides itself on being a leader at the forefront of pharmacy evolution and innovation, CFP is committed to raising and allocating funds for the support of programs in pharmaceutical education, research and service. As an organization, they are committed to excellence and have played a critical role in providing research opportunities and supported a number of ground-breaking studies that demonstrate the value pharmacists can provide to their patients and the healthcare system. CFP has been a major force in advancing the profession of pharmacy and is supported by individual pharmacists, pharmaceutical manufacturers and pharmacy-related businesses.

Another Successful Day on the Course

Closest to the Hole #5 - Don Maksymyk Closest to the Hole #12 - Jim OlynykClosest to the Hole #16 - Michael ProutStraightest Drive Men - Gary Nazer Straightest Drive Women - Abby Lau

Low Net Male - Don MaksymykLow Net Female - Ronda ErosLow Gross Male - Gary NazerLow Gross Female - Norma PeckoverPutting Contest - Adam Heinrich

This year’s tournament winners are:

Apotex Inc.Caddy Shed Golf StoresCanadian Linen & Uniform ServiceThe Fairmont WinnipegGourmet Coffee SpecialistsNorwood HotelOffice ProRBC Convention Centre WinnipegHarry Shapiro Harry KaplanShoppers Drug Mart Store #2514

Abby LauShoppers Drug Mart Store #542

Arnold Chew

Apotex Inc.Campbell Marr LLPCollege of Pharmacy, University of ManitobaW.G. (Bill) EamerLifeScan Canada Ltd.McKesson CanadaOzturk Financial ServicesPharmacists ManitobaRBC Dominion SecuritiesSafeway - Sobey'sShoppers Drug Mart # 2414 - Petr ProchazkaSuper Thrifty Drugs Canada Ltd. The Blando Group - Scotia Wealth

Management - Scotia McCleodThompson Dorfman Sweatman LLP

2016 Hole Sponsors2016 Prize Sponsors

c o l l e g e u P d a t e s

11CPhM Fall 2016 issue

Pharmacy Compounding Standards As previously reported, the National Association of Pharmacy Regulatory Authorities (NAPRA) is developing a suite of model standards for pharmacy compounding documents. Current pharmacy practice for the compounding of sterile non-hazardous and hazardous preparations and non-sterile preparations in Canada includes many of the patient safety and quality assurance requirements of these new standards. However, additional requirements in the new standards include an onsite quality assurance program, increased oversight, recall procedures, enhanced equipment and facility requirements, among others.The Model Standards for Pharmacy Compounding of Non-hazardous Sterile Preparations were released in December of 2015 and the Model Standards for Pharmacy Compounding of Hazardous Sterile Preparations were released on September 21, 2016.

The Draft Model Standards for Pharmacy Compounding of Non-Sterile Preparations are now available for consultation. The College is encouraging pharmacists engaged in non-sterile compounding to review the document and provide feedback to CPhM by November 25, 2016.

Feedback will be collated and sent to NAPRA, which will be reviewed by NAPRA’s National Advisory Committee on Pharmacy Practice with support from a consultant and experts in the field. The final Model Standards for Pharmacy Compounding of Non-Sterile Preparations is expected to be finalized by the summer of 2017.

Implementation of the Model Standards in Canada will be under the authority of the respective provincial, territorial or Canadian Forces pharmacy regulatory bodies (“Colleges”). Each College will establish their respective process for the implementation of these standards in their jurisdiction. College staff are currently involved in preliminary discussions with stakeholders to gather information necessary for Council to plan a formal review and consultation process with members on the new compounding standards. Once the consultation process is completed, Council will then have the information and feedback from members necessary to determine a feasible implementation plan and timeline for when the new compounding standards will take effect. In the meantime, members are encouraged to visit the NAPRA website to review the new standards in preparation for the formal review and consultation process.

Feedback from pharmacists is vital to establishing relevant standards for Pharmacy Compounding of Non-Sterile Preparations in Manitoba. The College encourages pharmacists engaged in non-sterile compounding to send their feedback by email to feedback@cphm.ca by November 25, 2016. While general comments are welcome, it would be appreciated if submissions could specify the section and/or page number of the item being addressed, along with a rationale or reference supporting the comment, if any. Please indicate if your comments are on behalf of yourself or on behalf of an organization.

Closest to the Hole #5 - Don Maksymyk Closest to the Hole #12 - Jim OlynykClosest to the Hole #16 - Michael ProutStraightest Drive Men - Gary Nazer Straightest Drive Women - Abby Lau

Every summer, the College of Pharmacists of Manitoba recruits an under graduate student of pharmacy to work on various pharmacy practice projects as identified by the Registrar. This summer the College saw the return of Devyn Swark as a second year student. Devyn worked alongside of staff and contributed to the College in its day-to-day undertakings and its goals of promoting patient safety and patient-centred care. The College thanks Devyn for her work and wishes her another successful term.

The College would also like to announce the return of Ronda Eros as Practice Consultant, and Stacey Hjorleifson as Senior Administrative Assistant. Both Stacey and Ronda were previously members of College staff and they are welcomed back into the folds of College life once again.

Staff Updates

Orville Wagner, August 14, 2016

In Memoriam

d i s c i P l i n e d e c i s i o n

Pursuant to the Notice of Hearing dated the 9th day of October, 2013, it was alleged that Robert Becker, being a pharmacist under the provisions of The Pharmaceutical Act, C.C.S.M. c. P60 (“The Act”) and a registrant of the College of Pharmacists of Manitoba, was guilty of unskilled practice of pharmacy or professional misconduct, or both, as described in Section 35 of The Act, in that, in his role as pharmacist and / or pharmacy manager at the Paragon Nordic Pharmacy / Shoppers Drug Mart located at 328 Fischer Avenue, The Pas, Manitoba:

Mr. Becker entered a plea of guilty to the following:

1. on or about February 28, 2012, Mr. Becker dispensed a prescription for methyldopa instead of metronidazole for patient XX without confirming the accuracy of the prescription in accordance with sections 17(1)(g), 22.1(1) and 22.1(3) of the Pharmaceutical Regulation, Man Reg 56/92 (the “Regulation”) and sections 1.35(h), 7 and 9.1 of the MPhA Community Standards of Practice (the “Standards”) and sections 1, 6 and 8 of the MPhA Code of Ethics (the “Code”);

2. on or about May 7, 2013, Mr. Becker failed to confirm the accuracy of the drug to be dispensed, and dispensed a prescription for levetiracetam instead of levofloxacin for patient XX contrary to section C.01.041(1.1)(a) of the Food and Drug Regulations, C.R.C., c. 870, sections 17(1)(g) and 22.1(1) of the Regulation, sections 7 and 9.1 of the Standards, and sections 1 and 8 of the Code;

3. on or about May 10, 2013, upon being informed by patient XX that she had been prescribed and had ingested the wrong medication and upon dispensing the correct medication, Mr. Becker failed to advise the prescribing physician of the medication incident and change dispensing procedures to prevent the recurrence of the medication incident in accordance with section 14 of the Regulation, and sections 9.6 and 9.9 of the Standards.

In arriving at its decision, the Committee considered Mr. Becker’s complaints and discipline history with the College, and the previous restrictions imposed by the Complaints Committee. The Discipline Committee accepted a guilty plea to the three (3) counts, and pursuant to section 38 (c) The Act ordered that:

a. Mr. Becker pay a fine of $2,000.00 globally for these matters.

b. Mr. Becker pay costs in the amount of $8,000.00 as a contribution to the investigation and prosecution of these matters.

c. Payment of the fine and costs be paid no later than December 31, 2015.

d. Mr. Becker successfully complete the competency assessment initiated by the Complaints Committee;

e. Should Mr. Becker fail to successfully complete the assessment in (d), the matter is referred to Council for consideration of remediation to create and assess competency to practice.

f. Once the competency assessment is successfully completed, the following restrictions be placed on Mr. Becker’s pharmacist license:

i. Mr. Becker must complete six (6) months under the supervision of another pharmacist. For clarity, Mr. Becker may not practice as the sole pharmacist in the pharmacy for a period of six (6) months from the date of successful completion of the competency assessment; and

ii. Mr. Becker may not serve as a pharmacy manager for two (2) years from the date of successful completion of the competency assessment.

The decision was appealed to Council by Mr. Becker pursuant to section 42 of The Act. The Council’s decision was further appealed to the Courts pursuant to section 46 of The Act. The Discipline Panel’s original decision was upheld as outlined herein.

12 CPhM Fall 2016 issue

Robert Becker

Drug Schedules Notice Board

National Drug Scheduling Advisory Committee Meeting December 5, 2016

October 07, 2016

The next meeting of the National Drug Scheduling Advisory Committee (NDSAC) is scheduled for Monday, December 5, 2016. The primary purpose of the meeting is to consider the following matter:

Request for Schedule II status for naloxone hydrochloride nasal spray, when indicated for emergency use for opioid overdose outside hospital settings

Interested Party

Individuals, companies or organizations seeking Interested Party status for this agenda item are invited to contact NAPRA as soon as possible. All requests for Interested Party status must be submitted in writing to the NDSAC Secretariat via regular mail or E-mail no later than 4:00 p.m. (EST) on Friday, October 21, 2016.

Alternate Method of Participation

Individuals, companies or organizations who chose not to pursue Interested Party status or have been denied the status, can provide comments, in writing, related to the agenda item outlined above. The comments must be received by the NDSAC Secretariat via regular mail or E-mail no later than 4:00 p.m.

(EST) on Friday, November 25, 2016. Please note: only an acknowledgement of receipt for the comments received will be provided. All comments or information provided by this alternate method of participation shall be provided to NAPRA and any person, association or other entity that has realized Interested Party status.

Interim Recommendation Consultation Period

Once the interim recommendations of the NDSAC are posted, a consultation period occurs prior to the release of the final recommendations. Please note that, on an exceptional basis, the consultation period for this review has been shortened to 10 days, in response to federal/provincial/territorial government actions to increase access to naloxone for public health reasons. At the end of this period, the NAPRA Executive Committee will make its decision and publish the final recommendations.

Individuals, companies or organizations wishing to provide feedback on this review are therefore reminded of the opportunity to provide comments prior to the meeting via the alternate method of participation outlined above.

For more information, please contact Sarah Jennings, Acting Manager, Professional and Regulatory Affairs, NAPRA at 613-569-9658, ext. 230 or via email at sjennings@napra.ca.

For more updates from NAPRA’s Drug Schedules Notice Board, visit the links below:

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News & Announcements

Health Canada Advisory

October 03, 2016

Five unauthorized products seized from Keebo Sports Supplements in Winnipeg may pose serious health risks

Health Canada seized five unauthorized products promoted as workout or weight loss supplements from Keebo Sports Supplements at 1504 St. Mary’s Road, Winnipeg, Manitoba. The products are labelled to contain various prescription and other drug substances that may pose serious risks to the health of Canadians.

Health Canada Advisory

Health Product Infowatch

September 29, 2016

The September issue of the Health Product InfoWatch published by Health Canada is now available. This monthly publication provides clinically relevant safety information on pharmaceuticals, biologics, medical devices and natural health products. Please consult the index for a complete listing of previous issues.

http://www.hc-sc.gc.ca/dhp-mps/medeff/bulletin/index-eng.php

Health Canada Advisory

September 27, 2016

Expanded recall: All lots of "Rapidcuts Shredded" capsules recalled due to undeclared prescription drug

Further to a recent advisory, Health Canada is informing Canadians that Healthy Body Services Inc. is expanding its voluntary recall of Allmax-brand “Rapidcuts Shredded” capsules (NPN 80041658). All lots are now being recalled as a precaution after certain lots were found to contain an undeclared prescription drug (yohimbine hydrochloride).

Health Canada Advisory

Health Product Risk Communication

September 22, 2016

Zarontin (ethosuximide) - Defective Capsules Associated with Reduced Efficacy (Increased Frequency of

Seizures) - Erfa Canada 2012 Inc.

Erfa Canada 2012 Inc. and Health Canada have received reports of broken or leaking Zarontin soft gel capsules. Administration of defective Zarontin soft gel capsules can be associated with a lack of efficacy (increased frequency of seizures).

Health Canada Health Product Risk Communication

Advisory

September 20, 2016

Recall of Rapidcuts "Shredded" capsules due to undeclared prescription drug

Health Canada is advising Canadians that Healthy Body Services Inc. has initiated a voluntary recall of two lots (G4016A and G4016) of Allmax-brand “Rapidcuts Shredded” capsules (NPN 80041658) because the product contains a prescription drug (yohimbine hydrochloride) not listed on the label. Taking a prescription drug unknowingly and without the supervision of a healthcare professional can pose serious health risks. The

product is promoted as a work-out stimulant and fat-burner, and is sold at various retail outlets across Canada.

Health Canada Advisory

Information Update

September 15, 2016

Stronger, clearer labels for over-the-counter acetaminophen products to further address the risk of liver damage

Health Canada is releasing an updated Labelling Standard for over-the-counter acetaminophen products to help consumers use these products more safely. Product packages will include clearer instructions and stronger warnings to help reduce the potential for liver damage. This change is one of a number of steps Health Canada is taking in light of a safety review released in 2015.

Health Canada Information Update

Advisory

September 13, 2016

Unauthorized product “Black Orange” seized from Keebo Sports Supplements in Regina may pose

serious health risks

Health Canada seized an unauthorized product called “Black Orange” from Keebo Sports Supplements at 2101 Quance St., Regina, Saskatchewan. The product is sold as a pre-workout stimulant and is labelled to contain ingredients that can pose serious health risks (yohimbine HCl, a prescription drug, and the combination of ephedrine and caffeine).

Health Canada Advisory

Information Update

September 07, 2016

Health Canada reinforces the importance of preventing pregnancy while taking the acne drug isotretinoin to avoid birth defects

Health Canada is reminding Canadians of the serious risk of birth defects associated with taking the prescription acne drug isotretinoin while pregnant. Health professionals and women who are using, or considering using this drug are reminded of the importance of not getting pregnant while taking this treatment.

Health Canada Information Update

Health Product Risk Communication

September 07, 2016

PRIMAXIN 500 (imipenem and cilastatin sodium) for injection - Incorrect Labelling Information - Merck Canada Inc.

Imipenem and Cilastatin for Injection 500 mg/500 mg Single-Dose Vials - Incorrect Labelling Information -

Hospira Healthcare Corporation, a Pfizer Company

There is incorrect information regarding the final diluted concentration after reconstitution on the label of the outer package of PRIMAXIN 500 (imipenem and cilastatin sodium) and the multi-vial carton of Imipenem and Cilastatin for Injection, 500 mg/500 mg. It indicates the diluted concentration is 2.5 mg/mL instead of 5

mg/mL (when prepared as per the instructions in the package insert). Referencing this incorrect information could lead to a potential dosing error.

Information Update

September 01, 2016

Sage Products recalls topical skin protectant cloths (dimethicone 3%) and topical antiseptic cloths (chlorhexidine gluconate 2%) due to possible microbial contamination

Health Canada is advising Canadians of a voluntary recall of some lots of various Sage brand single-use, pre-moistened disposable cloths used for cleansing or protecting skin, due to possible contamination with the bacteriaBurkholderia cepacia (B.cepacia).

Health Canada Information Update

For more News & Announcements from NAPRA, visit the links below:

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