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Pharmacist Extended Practice Regulations
made under Section 83 of the
S.N.S. 2011, c. 11
O.I.C. 2013-173 (May 28, 2013), N.S. Reg. 214/2013
1 These regulations may be cited as the Pharmacist Extended Practice Regulations.
2 In these regulations,
“Act” means the Pharmacy Act;
“extended practice” means any of the following practices:
(i) directly administering drug therapy to a patient, including drug therapy by injection,
“permit” means a permit that authorizes a pharmacist to directly administer drug therapy to patients by injection;
“standards of practice” means the standards of practice adopted and amended by the College;
“testing” means ordering, receiving, conducting or interpreting a test or service needed to properly manage drug therapy for a patient;
“valid permit” means a permit that has been obtained or renewed as required by these regulations and has not expired or been suspended or revoked by the College.
Pharmacist may carry out extended practice
3 A pharmacist may carry out an extended practice in compliance with these regulations.
Pharmacist’s responsibilities in carrying out extended practice
4 (1) A pharmacist may carry out an extended practice only within the practice of pharmacy, including a practice of pharmacy within a collaborative practice with other health professionals.
(2) A pharmacist must not carry out an extended practice if the pharmacist lacks the knowledge, skills and competencies to practise it safely and in the context of the needs of the patient who is being served.
(3) A pharmacist must not carry out an extended practice unless it is in the best interests of the patient.
(4) A pharmacist who carries out an extended practice must do so in accordance with the standards of practice.
(5) A pharmacist must not carry out an extended practice in a pharmacy without first confirming that the pharmacy conforms with the regulations made under the Act and with the standards of practice.
(6) A pharmacist who carries out an extended practice is professionally responsible and accountable for the extended practice.
Administering drug therapy
5 (1) A pharmacist may directly administer drug therapy to a patient only if the drug therapy is
(a) prescribed by a person authorized to prescribe it, including the pharmacist; or
(b) a drug therapy that does not require a prescription.
(2) A pharmacist who directly administers drug therapy to a patient must meet all of the following requirements:
(a) the pharmacist must administer the drug therapy safely and appropriately;
(b) the pharmacist must confirm that there are policies and procedures in place for administering drug therapy and dealing with emergencies, and must adhere to those policies and procedures.
Administering drug therapy by injection
6 (1) In addition to the requirements of Section 5, a pharmacist who directly administers drug therapy to a patient by injection must meet all of the following requirements:
(a) the pharmacist must have a valid permit and must display the permit conspicuously in their pharmacy;
(b) the route that the pharmacist uses to administer the injection must be provided for in the standards of practice;
(c) before administering the injection, the pharmacist must
(i) provide the patient or the patient’s agent with enough information for the patient or the patient’s agent to make an informed and voluntary decision regarding the injection, and
(ii) obtain the informed consent of the patient;
(d) the pharmacist must monitor the post-administration response to the injection in accordance with the standards of practice;
(e) the pharmacist must communicate the record of the injection to the patient’s primary health care provider as soon as possible.
(2) No person may represent that a pharmacist is authorized to administer drug therapy by injection unless that pharmacist holds a valid permit.
Permit issuance and renewal
7 (1) The Registrar may issue a permit to a pharmacist.
(2) To be eligible for a permit, a pharmacist must successfully complete either of the following:
(a) an education and training program for administering drug therapy by injection as required by the standards of practice;
(b) an education and training program for administering drug therapy by injection that is provided in another province and is determined by the Registrar to be the equivalent of the education and training referred to in clause (a).
(3) To obtain a permit, a pharmacist must provide all of the following to the Registrar:
(a) evidence satisfactory to the Registrar that the pharmacist has met the education and training requirements of subsection (2);
(b) evidence the pharmacist is currently certified in cardiopulmonary resuscitation and first aid as required by the standards of practice;
(c) a signed application for the permit in the form provided by the Registrar;
(d) the fee specified by the Council.
(4) On issuing a permit to a pharmacist, the Registrar must enter a notation of the permit in the register maintained under subsection
12(2)[14(1)] of the Act with respect to the pharmacist.
(5) A permit expires 1 year from the date it is issued or renewed.
(6) To renew a permit, a pharmacist must provide the Registrar with all of the following:
(a) evidence that the pharmacist is currently certified in cardiopulmonary resuscitation and first aid, as required by the standards of practice;
(b) confirmation that the pharmacist has complied with the renewal requirements set out in the standards of practice;
(c) a signed application for the renewal in the form provided by the Registrar;
(d) the fee specified by the Council.
Information and consent respecting testing
8 Before testing, a pharmacist must
(a) provide the patient or the patient’s agent with enough information for the patient or the patient’s agent to make an informed and voluntary decision regarding the test; and
(b) obtain the informed consent of the patient.
Procedures and requirements for test results
9 (1) A pharmacist who provides testing must interpret and advise the patient of the results of the testing in accordance with the standards of practice.
(2) A pharmacist must advise the patient’s primary health care provider as soon as reasonably possible of any changes in the patient’s drug therapy initiated by the pharmacist as the result of a test.
(3) A pharmacist who provides testing must promptly forward the results to the patient’s primary health care provider in either of the following circumstances:
(a) the test results reveal an issue that is outside the pharmacist’s knowledge, skills and competencies;
(b) the pharmacist considers it to be in the best interests of the patient to involve another health care provider.
(4) A pharmacist must keep a patient’s primary health care provider informed of the general state of the patient’s health as revealed by the pharmacist’s testing.
(5) If a patient does not have a primary health care provider, the pharmacist must do the following, as appropriate in the circumstances:
(a) counsel the patient to obtain emergency or other medical care;
(b) advise the patient about available health care resources.