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Legislation and Supporting Documents Practice Resources Pharmacy Technicians Expanded Scope of Practice Forms & Pharmacy Signs Implementation of the December 2006 Pharmaceutical Act

Expanded Scope of Practice

  

Administering Drugs and Vaccinations

College resources for administration of drugs and vaccinations

Practice Direction - Standard # 5: Administration of Drugs including Vaccines 

Administration of Drugs Including Vaccines Policy and Procedure Manual Content Template

The purpose of this document is to describe the minimum content of the manual, for the administration of drugs and vaccines, and to provide a tool that a  pharmacy may use in the development of the manual specific to that  pharmacy.


Manitoba Immunization Program eligibility criteria and off-site immunization clinics

For the most up-to-date information on the processes and procedures for requesting client immunization history and for reporting immunizations for input into the Manitoba Immunization Monitoring System, please see the Manitoba Health Immunization Program Manual for Immunization Providers in Manitoba .

Manitoba Health advises that, as a result of the regulations, pharmacies should not be ordering any of the vaccines listed under Schedule 2 through private wholesalers if the patients being immunized meet the publicly-funded program criteria. Patients do not require a prescription for these vaccines and the pharmacies should order the vaccines through the Provincial Vaccine Warehouse.

Please note, publically funded vaccines are provided free-of-charge to individuals who are registered with Manitoba Health, Healthy Living and Seniors and for those who are part way through an immunization series started in another province or territory as part of a publicly-funded program (pending product vailability). Uninsured visitors will be provided vaccines free-of-charge if there is an immediate public health need, as determined in consultation with a health care provider.  

Off-site immunization clinics

Manitoba Health, Healthy Living and Seniors ( MHHLS) has instructed that pharmacies planning to hold off-site immunization clinics lead by a pharmacy team need to provide advance notice of the date and location of the clinic to the local Regional Health Authority (RHA) Public Health office.  By contacting the RHA office in advance, the pharmacy can ensure that immunization efforts are not duplicated and if necessary, an alternate day or location can be arranged in order to maximize immunization efforts.  A list of the RHA Public Health Offices and contact information can be found here: https://www.gov.mb.ca/health/publichealth/offices.html . The pharmacy holding an offsite immunization clinic must also be registered with Manitoba Health as an immunization provider, the pharmacists providing the injections must be certified by the College to provide injections, and the offsite immunization clinic must meet the requirements of proper procedures and patient care as outlined in the legislation and applicable Practice Directions.  

Needle Stick Injury Information:

Integrated Post-exposure Protocol for HIV, HBV and HCV: Guidelines for Managing Exposures to Blood and Body Fluids (Assessment of need for post-exposure prophylaxis (PEP) by healthcare facility)

Need Stick Injury Guidelines

The Workplace Safety and Health Act (section 45.1 - Needles in Medical Workplaces)

SAFE Work Manitoba – Needle Stick injury (video)

Upcoming Workshops

Pharmacists seeking authority to administer drugs and vaccinations must have completed an Administration of Injections Practical Skills Workshop (offered through the College or otherwise). The College also advertises all upcoming Administration of Injections Practical Skills Workshops on the PD Programs webpage and through the bi-weekly e-newsletter, the Friday Five .

Injection authority certification requirements:

Those who successfully complete an injections workshop and possess current certification in CPR Level C (or HCP) and Emergency or Standard First Aid from an in-person training program that is recognized as an approved first aid training agency/program/provider by the Workplace Safety and Health (WSH) Branch of the Manitoba government; (which must be kept current for the duration of the certification of authorization to administer drugs by injection) are eligible to apply for authorization to administer drugs and vaccinations by injection. A list of all approved programs can be found here by selecting the “First Aid” tab on the list.

Members who are applying for certification of injection authority must submit a copy of:

Item 1 – Option 1 - the Certificate of Successful Completion of a CCCEP Stage 2 continuing education course on the
administration of drugs by injection (view a sample College-Issued Certificate of Successful Completion for those who completed the CPhM Administration of Injections Certificate Program )

OR

Item 1 – Option 2 - Documentation or a letter of standing from the regulatory authority where injection authorization is currently held stating that the applicant successfully completed training in a CCCEP Stage 2 course and/or has been taught to the 15 competencies, 

AND 

Item 2 – Statement of Successful Completion/Participation of the Manitoba Module: Administration of Injections .

All pharmacists must submit two Items 1 and 2 above with their application, regardless of the location of the workshop.

Download the Application:

Application for Authorization to Administer Drugs and Vaccinations by Injection

Completed applications and supporting documents can be forwarded to the College of Pharmacists of Manitoba by email: applications@cphm.ca (preferred method) Fax: 204.237.3468, or mailed to the College office: 200 Taché Avenue, Winnipeg, MB R2H 1A7.

Injection Authority Recertification and Retraining:

At the April 25, 2014, Council meeting, Council approved a motion accepting the following recommendations regarding injection recertification:

    • A self-declaration of proficiency of knowledge and skills as part of annual renewal
    • Retraining in a full CCCEP Stage II injection course if an injection has not been given in the preceding three years
    • As of January 1, 2015, retraining in a full CCCEP Stage II injection course if an injection has not been given within one year after completion of the initial training course; and
    • As of January 1, 2015, a pharmacist must apply and receive certification of injection authorization from the College of Pharmacists of Manitoba within one year of completing the required training or within one year of graduating from a Faculty of Pharmacy in Canada


Injection Authority from another Canadian Province: 

On April 25, 2014, Council approved a motion to recognize a pharmacist’s authorization to administer injections from another Canadian jurisdiction if that province has the same CCCEP Stage II injection training accreditation requirement and that pharmacist’s authorization is current/active at the time of application. These pharmacists must still complete the Manitoba Module: Administration of Injections, meet the CPR/First Aid requirements, and submit an Application for Authorization to Administer Drugs and Vaccinations by Injection to the College of Pharmacists of Manitoba.


Prescribe a Drug for Self-Limiting Conditions (not including smoking cessation)

DPIN Pharmacist Prescriber Number  

Manitoba Health has informed the College of Pharmacists of Manitoba that effective January 1, 2014, all licensed pharmacists have been entered into DPIN as prescribers. The individual pharmacist prescriber number has the prefix of “X” followed by your five digit pharmacist licence number (e.g. X12345). A pharmacist will need to use this prescriber number when entering a prescription into DPIN that he or she has prescribed, when authorizing a continued care prescription, or when adapting a prescription.

Drugs Available for Prescribing under Schedule 3 to the Manitoba Pharmaceutical Regulation

Available Drugs for Prescribing under Schedule 3 to the Manitoba Pharmaceutical Regulation

Practice Direction:

Prescribing Practice Direction

Prescribing and Dispensing Practice Direction

Requirements:

The Application for Authorization to Prescribe a Drug Included in Schedule 3 to the Pharmaceutical Regulation for Self-limiting Conditions (not including smoking cessation) is now available.  All Manitoba pharmacists endeavoring to prescribe the drugs for self-limiting conditions with the exception of smoking cessation, as permitted in Schedule 3 (Subsection 118(2)) to the Manitoba Pharmaceutical Regulations, must successfully complete the online Self-Limiting Conditions Independent Study Program , as well as apply to the College of Pharmacists of Manitoba and be granted a certificate of authorization.

Download the application:

Application for Authorization to Prescribe a Drug Included in Schedule 3 to the Pharmaceutical Regulation for Self-limiting Conditions

Completed applications and supporting documents can be forwarded to the College of Pharmacists of Manitoba by email: applications@cphm.ca (preferred method) Fax: 204.237.3468, or mailed to the College office: 200 Tache Avenue, Winnipeg, MB R2H 1A7.


Prescribe a Drug for Smoking Cessation

DPIN Pharmacist Prescriber Number

Manitoba Health has informed the College of Pharmacists of Manitoba that effective January 1, 2014, all licensed pharmacists have been entered into DPIN as prescribers. The individual pharmacist prescriber number has the prefix of “X” followed by your five digit pharmacist licence number (e.g. X12345). A pharmacist will need to use this prescriber number when entering a prescription into DPIN that he or she has prescribed, when authorizing a continued care prescription, or when adapting a prescription.

 

Drugs Available for Prescribing under Schedule 3 to the Manitoba Pharmaceutical Regulation

Available Drugs for Prescribing under Schedule 3 to the Manitoba Pharmaceutical Regulation

Requirements:

All Manitoba pharmacists who would like to only apply for certification of authorization to prescribe a drug included in the smoking cessation category of Schedule 3 to the Pharmaceutical Regulation must:

AND

  • Have successfully completed one of the following programs in person or online*:

    • CATALYST (all 5 modules), or
    • PACT (Level 1 and 2, and PACT Pharmacist Specialty Module), or
    • QUIT, or
    • TEACH (Core Course) or
    • Canadian Network for Respiratory Care (CNRC) Tobacco Educator Course
    • Smoking Cessation: Counsel to Quit (if completed prior to accreditation expiration); and
  • Have read the product monographs of the drugs that the pharmacist is prescribing, and reviewed other resources when necessary or appropriate.

* Along with the Application for Authorization to Prescribe a Drug Included in Schedule 3 to the Pharmaceutical Regulation for Smoking Cessation , pharmacists must submit the statement(s) of completion of one of the above smoking cessation programs. Please note that pharmacists who complete PACT must submit two separate statements of successful completion: a statement of successful completion of Level 1 AND a statement of successful completion of the PACT Pharmacy Specialty Module (which is available upon completion of a questionnaire).

(Please note that pharmacists wanting to obtain CEU credit for completing any of the PACT modules must fill in an  Independent Study Accreditation Request Form , and submit it to the College).

Download the application:

Application for Authorization to Prescribe a Drug Included in Schedule 3 to the Pharmaceutical Regulation for Smoking Cessation

Completed applications, and supporting documents can be forwarded to the College of Pharmacists of Manitoba by email: applications@cphm.ca (preferred method) Fax: 204.237.3468, or mailed to the College office: 200 Tache Avenue, Winnipeg, MB R2H 1A7.

Additional Resources

Additional recommended resource on smoking cessation: Prescribing for Smoking Cessation Resource Document


Lab Test Ordering

The Pharmaceutical Regulation in Manitoba provides pharmacists with the authority to order and receive the results of laboratory tests following the guidelines and restrictions set out in the Regulation and the appropriate practice directions. However, pharmacists in Manitoba are currently not allowed to order lab tests for patients who are not inpatients of a hospital ("outpatients") until Manitoba Health has decided whether the pharmacist-ordered test is an insured benefit and laboratory service providers establish the necessary infrastructure to enable such test ordering.

Manitoba Module: Ordering Laboratory Tests *NEW!*

Once lab test ordering for outpatients is permitted by Manitoba Health, all pharmacists wanting to include test ordering for outpatients as part of their practice must complete the Manitoba Module: Ordering Laboratory Tests . Successful completion of the Manitoba Module does not automatically grant pharmacists the authority to order lab tests for outpatients in Manitoba.

This program is accredited for 1.5 CEU by the College of Pharmacists of Manitoba.

Ordering Lab Tests for Manitoba Pharmacists

Once lab test ordering for outpatients is permitted by Manitoba Health, pharmacists wanting to order lab tests for outpatients must complete the " Manitoba Module: Ordering Lab Tests ."  The Manitoba Module will be hosted independently on the Advancing Practice website at a cost of $50 + GST.  As well, it will be hosted along with the new, optional, 7 module course, "Ordering Lab Tests for Manitoba Pharmacists" at a cost of $300 + GST. The online " Ordering Lab Tests for Manitoba Pharmacists " program was developed by the University of Manitoba, College of Pharmacy in partnership with the College of Pharmacists of Manitoba to help meet the learning needs of Manitoba pharmacists who plan on incorporating the ordering of lab tests into their pharmacy practice. This program can be accessed by visiting www.advancingpractice.com

Pharmacists, who want to order lab tests, must be knowledgeable in all pertinent aspects of lab test ordering.  Section 18 of the Pharmaceutical Regulation states that a member may only engage in the aspects of pharmacy practice that he or she has the requisite knowledge, skill and judgment to provide or perform and that are appropriate to his or her area of practice.

Aside from the required Manitoba Module, pharmacists who want to order lab tests for outpatients can choose to complete additional training that best meets their learning needs.


Extended Practice Pharmacist

Initial Qualification and Registration as an Extended Practice Pharmacist

Extended Practice Pharmacists in Manitoba have received additional training to prescribe and manage patient medication therapy within the scope of their specialty practice.  Extended Practice Pharmacists must be authorized by the College and work in a collaborative practice with other health-care professionals.

A collaborative practice setting is defined as a practice setting in which a pharmacist works closely and cooperatively with other health-care professionals (physicians and/or nurse practitioners) to provide care to a common patient or group of patients. The Extended Practice Pharmacist, along with the other health-care professionals within the practice, have access to the same diagnostic and health information to aide in providing enhanced care to the patient.

The Pharmacist Directory, on the College website, indicates if a pharmacist is registered as an Extended Practice Pharmacist.

The professional designation for Extended Practice Pharmacists is EPPh. The designation will be noted all  prescriptions and orders issued by an Extended Practice Pharmacist and include treatment goal, diagnosis or clinical indication.

Extended Practice Pharmacists must prescribe within their specialty area of practice and cannot prescribe Canadian Drugs and Substances Act (CDSA) products.

Extended Practice Pharmacists will improve patient access to pharmaceutical experts, increase patient safety by providing enhanced drug therapy management and collaborative care, and contribute to better health outcomes for Manitobans.

The following is an excerpt of the Pharmaceutical Regulation related to the specialty qualifications for registration as an Extended Practice Pharmacist. A pharmacist may apply for registration as an extended practice pharmacist if he or she meets the qualifications as described in the pharmaceutical regulation and practises in a collaborative practice with a physician or a registered nurse (extended practice). Please review the application for further details

Included within the excerpt under section C and G are the programs that Council of the College has approved for qualification as an Extended Practice Pharmacist.

Section 96 of the Manitoba Pharmaceutical Regulations

Specialty qualifications

96 A member is qualified as a specialist in an area upon providing evidence satisfactory to the registrar that he or she has one or more of the following qualifications:

(a) board certification from the American Board of Pharmacy Specialties in one of the following specialties, is currently practising, and has practised for at least 1000 hours in the two years before applying for registration, in a healthcare setting in one of the following specialty areas:

(i) ambulatory care pharmacy,
(ii) nuclear pharmacy,
(iii) nutrition support pharmacy,
(iv) oncology pharmacy,
(v) pharmacotherapy,
(vi) psychiatric pharmacy;

(b) board certification in geriatric medicine from The Commission for Certification in Geriatric Pharmacy, is currently practising, and has practised for at least 1,000 hours in the two years before applying for registration, in a geriatric healthcare setting;

(c) a postgraduate clinical degree of Pharmacy (Pharm D, M.Sc. or Ph.D.) from a program approved by the council, is currently practising, and has practised for at least 1,000 hours in the two years before applying for registration, in a healthcare setting and in the specialty area;

The following programs qualify for Extended Practice Pharmacist status under Pharmaceutical Regulation 97(c):

Program

Program Provider

Date Approved by Council

Doctor of Philosophy (Ph.D.)

University of Manitoba

June 23, 2014

Doctor of Pharmacy (Pharm. D.)

University of British Columbia

June 23, 2014

Doctor of Pharmacy (Pharm. D.)

University of Toronto

June 23, 2014

Doctor of Pharmacy (Pharm. D.)

University of Colorado

June 23, 2014

Doctor of Pharmacy

University of Minnesota

October 4, 2014

Doctor of Pharmacy

Purdue University

April 8, 2016

(d) successful completion of the Canadian Diabetes Educator Certification Board examination, is currently practising, and has practised for at least 5,000 hours in the five years before applying for registration, in a diabetes healthcare setting;

(e) successful completion of the Certified Respiratory Educator examination administered by the Canadian Network for Respiratory Care, is currently practising, and has practised for at least 5,000 hours in the five years before applying for registration, in a respiratory healthcare setting;

(f) certification by the National Certification Board for Anticoagulation Providers, is currently practising, and has practised for at least 5,000 hours in the five years before applying for registration, in a related healthcare setting;

(g) certification from any other program approved by the council as equivalent to a program described in this section, coupled with a similar practising requirement.

  The following programs qualify for Extended Practice Pharmacist status under Pharmaceutical Regulation 97(g):

Program

Program Provider

Date Approved by Council

Accredited Canadian Hospital Residency Program (ACPR)

Canadian Hospital Pharmacy Residency Board

October 5, 2015



Once registered with the College as an extended practice pharmacist, a member will have additional prescribing authorization for Schedule I drugs of the Manual but only within the scope of their specialty.

DPIN Pharmacist Prescriber Number  

Manitoba Health has informed the College of Pharmacists of Manitoba that effective January 1, 2014, all licensed pharmacists have been entered into DPIN as prescribers. The individual pharmacist prescriber number has the prefix of “X” followed by your five digit pharmacist licence number (e.g. X12345). A pharmacist will need to use this prescriber number when entering a prescription into DPIN that he or she has prescribed, when authorizing a continued care prescription, or when adapting a prescription.

       Ongoing Registration Requirements  

A pharmacist may renew their registration as an extended practice pharmacist if she or he provides evidence to the registrar that:

(a) confirms the continued certification under clause 96(a), (b), (d), (e), (f) or (g) of the Pharmaceutical Regulation, if the member's certification is based on qualification under one of those clauses;

(b) in the three-year period before the member applies for renewal, the member has engaged in the practice of pharmacy in their area of specialty for at least 600 hours;

(c) confirms participation in the college's continuing professional development program under section 17, of which at least 15 hours relate to the member's specialty; and

(d) the member meets any additional requirements established by the council. 
 

Download the application:

2017 Application for Registration as an Extended Practice Pharmacist
Completed applications can be forwarded to the College of Pharmacists of Manitoba by email: applications@cphm.ca (preferred method) Fax: 204.237.3468, or mailed to the College office: 200 Tache Avenue, Winnipeg, MB R2H 1A7.