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Bylaws

BYLAWS OF THE COUNCIL OF THE COLLEGE OF PHARMACISTS OF BRITISH COLUMBIA

1. Definitions

BYLAW 1 - REGISTRATION AND LICENSURE

2. Definitions
3. Renewal of registration of pharmacists continuing in practice
4. Registration of students
5. Registration of qualifying candidates
6. Initial registration of pharmacists
7. Non-practising Register
8. Practical training and preceptorship
9. Assessments for registration
10. Document replacement

BYLAW 2 - BOARD OF EXAMINERS

11. Structure
12. Assessments
13. Records
14. Reporting

BYLAW 3 - INQUIRY COMMITTEE

15. Structure
16. Records and referral
17. Reporting

BYLAW 4 - DISCIPLINE COMMITTEE

18. Structure
19. Citation
20. Hearing procedure
21. Penalty
22. Records
23. Reporting
24. Notice of disciplinary action

BYLAW 5 - COMMUNITY PHARMACY

25. Definitions
26. Responsibilities of the community pharmacy manager
27. Quality management
28. Community pharmacy premises
29. Operation without a pharmacist
30. Equipment and references
31. Sale and disposal of drugs and devices
32. Drug procurement/inventory management
33. Returned drugs
34. Advertising of prescription and other professional services
35. Records
36. Pharmacist/practitioner relationship
37. Community pharmacy support persons
38. Prescription
39. Prescription copy and transfer
40. Prescription label
41. Dispensing
42. Collection of patient information
43. Patient record
44. Pharmacist/patient dialogue
45. Schedule II and III drugs

BYLAW 6 - PHARMANET

46. Definitions
47. Responsibilities of the pharmacy manager and pharmacy owner
48. Collection of information for the PharmaNet database
49. Confidentiality
50. Applications for disclosure of information from PharmaNet
51. PharmaNet Committee

BYLAW 7 - RESIDENTIAL CARE FACILITIES AND HOMES

52. Definitions
53. Supervision of pharmacy services
54. Quality management
55. Prescription authorizations
56. Dispensing
57. Contingency medications
58. Standing orders
59. Returned medications
60. Medication containers and prescription labels
61. Patient record
62. Resident medication administration records
63. Medication safety and advisory committee
64. Resident medication review
65. Resident-oriented pharmacy services
66. Respite care pharmacy services
67. Leave-of-absence medications

BYLAW 8 - HOSPITAL PHARMACY

68. Definitions
69. Responsibilities of the hospital pharmacy manager
70. Hospital pharmacy licence
71. Quality management
72. Hospital pharmacy premises
73. Equipment and references
74. Medication distribution
75. After hours service
76. Prescription label
77. Returned medications
78. Medication procurement/inventory management
79. Inpatient pass medications
80. Emergency department medications
81. Investigational/emergency release medications
82. Medication repackaging and compounding
83. Function of hospital pharmacy support persons
84. Patient record and medication order review
85. Medication administration
86. Patient-oriented pharmacy services
87. Residential care
88. Documentation

BYLAW 9 - GENERAL

89. Appointment of an auditor
90. Conduct
91. Disclosure

Appendix 1: Discipline hearing subpoena form
Appendix 2: Fee schedule

Notes: In these bylaws, unless the context otherwise requires expressions defined in "The Pharmacists, Pharmacy Operations and Drug Scheduling Act" hereinafter called "the Act" and any amendment or amendments thereto must have the meaning so defined, and words importing persons shall include bodies corporate.

Every bylaw must come into force on the day on which it is approved by the Lieutenant Governor in Council.

Definitions [Top of Page]

In these bylaws:
"child-resistant package" means a package that complies with the requirements of the Canadian Standards Association Standard CAN/CSA-Z76.1-M90, entitled Reclosable Child-resistant Packages, published January 1990, as amended from time to time;

"drug administration" means the act of giving a drug to an ambulatory patient in a facility, either orally or by any other route;

"electronic transmission" means transmission of information via facsimile or electronic mail;

"health record" means a patient's medical chart or medical record;

"leave-of-absence or pass drugs" means drugs supplied to a patient for a specified time period during which he or she is away from the hospital or residential care facility or home;

"medication administration record" means a record on which is recorded the administration of all doses of drugs to a patient in a residence licensed under The Community Care Facility Act or in a hospital;

"monitored dosage system" means a system of drug distribution in which prescriptions are dispensed for an individual patient and blister-packaged in accordance with scheduled administration times;

"patient health information" means information:

(a) about the health of the individual, including a medical history,

(b) about any disability that individual has or has had,

(c) about any health services or disability services that are being provided or have been provided to that individual, or

(d) collected before or in the course of, and incidental to, the provision of any pharmacy services to that individual, and includes prescriptions and pharmacy patient records;

"patient record" means a record of all drugs dispensed to a designated patient, as well as information pertaining to that patient;

"triplicate/duplicate prescription program" means a program designed to monitor Schedule IA drugs, which may be sold by a pharmacist to a practitioner or on the prescription of a practitioner in accordance with section 31 (6);

"verbal transmission" means the oral transmission of information in person, via telephone or via recorded voice message.

BYLAW 1 - REGISTRATION AND LICENSURE [Top of Page]

Definitions

In bylaw 1:
"English language proficiency requirements" means demonstration of English language proficiency by achieving a satisfactory rating in an English language proficiency assessment approved by the College or on the Test of Spoken English⁸;

"forensic assessment" means an assessment of the knowledge of federal and provincial legislation and Council policies governing the practice of pharmacy in British Columbia;

"framework of professional practice" means a description of the roles, functions and activities performed and the underlying knowledge, skills, abilities, and attitudes that a registrant needs in order to achieve safe and effective pharmacy practice outcomes for the people of British Columbia;

"patient care setting" means a pharmacy practice setting in which pharmacy services are provided directly to patients;

"practical assessment" means an assessment of the knowledge, skills and abilities required to solve practical problems in actual or simulated pharmacy practice situations;

"preceptor" means a pharmacist supervising practical training who meets the criteria approved by Council, is not under investigation by the Inquiry Committee or Discipline Committee, and has not been found guilty in a disciplinary action in the three-year period preceding the date of application for preceptorship;

"quality assurance program" means a program approved by Council to assess, maintain and enhance the quality of the practice of the profession and the continuing competency of pharmacists;

"related practical experience" means experience gained in providing pharmacy services which is similar or equivalent to pharmacy services provided by a pharmacist.

Renewal of registration of pharmacists continuing in practice

(1) To be eligible for annual renewal of registration, a pharmacist on the Register of Pharmacists must

(a) comply with the requirements of section 16 (1) of the Act,

(b) complete and submit the application form provided by the Registrar,

(d) meet the deadline for registration, which will be the last day of the month preceding the anniversary date of initial registration or re-registration.

(2) Where a pharmacist's registration is suspended under section 16 (2) of the Act for ninety or fewer days, reinstatement to the Register of Pharmacists shall be made following;

(a) compliance with the requirements of section 16 (1) of the Act and section 3 (1) of these bylaws, and

(b) payment of the late payment fee specified in the Fee Schedule attached to these bylaws. A reinstated pharmacist's registration will be for a one-year period from the last day of the month preceding the date of reinstatement.

(3) Where a pharmacist's registration is suspended under section 16 (2) of the Act for greater than ninety days, reinstatement to the Non-practising Register shall be made following payment of the late payment fee specified in the Fee Schedule attached to these bylaws.

(4) To be eligible for transfer from the Non-practising Register to the Register of Pharmacists, the former registrant must comply with the requirements of section 7 of these bylaws.

(5) Following the registration of a pharmacist on the Register of Pharmacists, the Registrar must issue to the registrant a receipt stating that the registrant is entitled to practise as a pharmacist for the year ending the last day of the month preceding the date of re-registration.

Registration of students

(1) To be eligible for registration on the Register of Students, an applicant must

(a) comply with the requirements of section 13 of the Act,

(b) complete and submit the application form provided by the Registrar,

(i) evidence of enrollment in the Faculty of Pharmaceutical Sciences at the University of British Columbia,

(ii) legal identification by means of a copy of birth certificate or Canadian citizenship certificate or similar document approved by the Registrar,

(iii) a copy of marriage or other legal certification if the applicant's legal name is different from that in subsection 4 (1) (c) (ii), and

(iv) a statement of disclosure regarding any previous criminal, civil or disciplinary convictions taken or pending against the applicant, and;

(d) pay the student registration fee specified in the Fee Schedule attached to these bylaws.

Registration of qualifying candidates

(1) To be eligible for registration on the Register of Qualifying Candidates, an applicant must

(a) comply with the requirements of section 14 of the Act,

(b) complete and submit the application form provided by the Registrar,

(c) provide evidence of successful completion of the Pharmacy Examining Board of Canada Evaluating Examination or registration with the Pharmacy Examining Board of Canada by examination, subject to subsections (i) and (ii)

(i) if not registered with the Pharmacy Examining Board of Canada, the applicant must do so either before or during the period of registration as a Qualifying Candidate, or

(ii) if registered with the Pharmacy Examining Board of Canada under section 15 of The Pharmacy Examining Board of Canada Act or section 17.1(c) of the Bylaws to The Pharmacy Examining Board of Canada Act, evidence of at least ten years' practice as a pharmacist in a Canadian jurisdiction, of which at least 1000 hours must have been within the three years immediately preceding application.

(d) provide;

(i) a copy of birth certificate or Canadian citizenship certificate, or similar document approved by the Registrar,

(ii) a copy of marriage or other legal certification if the applicant's legal name is different from that in subsection 5 (1) (d) (i),

(iii) a letter from the Registrar of any other pharmacy jurisdiction in which the applicant is licensed or has held a licence to practise which must include the dates of licensure and confirmation of the applicant's eligibility for continuing licensure or relicensure in that jurisdiction, and

(iv) a statement of disclosure regarding any previous criminal, civil or disciplinary convictions taken or pending against the applicant, and

(e) pay the qualifying candidate registration fee specified in the Fee Schedule attached to these bylaws.

(2) The Council may authorize the Registrar to approve the registration of an applicant who is unable to comply with subsection 5 (1) (d) (iii) because he or she is not registered as a pharmacist in another jurisdiction.

(3) A student may be transferred to the Register of Qualifying Candidates six months after graduation from the Faculty of Pharmaceutical Sciences at the University of British Columbia.

Initial registration of pharmacists

(1) To be eligible for registration on the Register of Pharmacists, a student or a qualifying candidate must

(a) comply with the requirements of section 15 (1) of the Act,

(b) complete and submit the application form provided by the Registrar,

(c) if a student, provide evidence of graduation from the Faculty of Pharmaceutical Sciences at the University of British Columbia,

(d) if a student, provide evidence of completion of the appropriate practical training requirements in accordance with section 8 of these bylaws, and as follows

(i) 160 hours of practical training under a preceptor approved by the Registrar, or

(ii) practical pharmacy experience in a patient care setting in another jurisdiction in Canada or the United States of at least 1000 hours within the three years immediately preceding application,

(e) if a qualifying candidate, provide evidence of completion of pharmacy practice or related practical experience in a patient care setting in another jurisdiction in Canada or the United States of at least 1000 hours within the three years immediately preceding application,

(f) if a qualifying candidate who is unable to provide evidence of compliance with subsection 6 (1) (e), provide evidence of completion of the appropriate practical training requirements in accordance with section 8 of these bylaws, and as follows

(i) 160 hours (if evidence of at least 1000 hours within 3 to 7 years immediately preceding the application), or

(ii) 500 hours (if evidence of less than 1000 hours within 7 years immediately preceding the application),

(g) successfully complete the

(i) Pharmacy Examining Board of Canada qualifying assessment,

(ii) English language proficiency assessment,

(iii) forensic assessment, and

(iv) practical assessment,

(h) pay the pharmacist registration fee specified in the Fee Schedule attached to these bylaws, and

(i) meet the deadline for registration, which will be

(i) prior to expiration of registration on the Register of Students, or

(ii) three years from the date of registration on the Register of Qualifying Candidates.

(2) The Council may authorize the Registrar to waive all or part of the practical training requirements in subsections 6 (1) (f) (i) and (ii) for a qualifying candidate who provides evidence of pharmacy practice in a patient care setting in a jurisdiction outside Canada or the United States or of employment in an occupation related to the practice of pharmacy in another jurisdiction within the last three years.

Non-practising Register

(1) The Registrar must keep a Non-practising Register.
(2) A pharmacist who ceases to practise may transfer to the Non-practising Register by submitting to the Registrar a written request, which includes a statutory declaration that he or she will not provide the services of a pharmacist while registered under this section.

(3) While on the Non-practising Register, a former registrant will not be responsible for payment of any fees.

(4) Where a former registrant has been on the Non-practising Register for a period less than six years, he or she may transfer to the Register of Pharmacists by

(a) completing and submitting the application form provided by the Registrar,

(b) if applicable, submitting evidence of practice as a pharmacist in a patient care setting or in an occupation related to the practice of pharmacy in another jurisdiction during any part of the time the former registrant has been on the Non-practising Register,

(c) if applicable, submitting a letter from the Registrar of any other pharmacy jurisdiction in which the former registrant has held a licence to practise during any part of the time the former registrant has been on the Non-practising Register which must include the dates of licensure and confirmation of eligibility for continuing licensure or relicensure in that jurisdiction,

(d) providing a statement of disclosure regarding any criminal, civil or disciplinary actions taken or pending against the former registrant while on the Non-practising Register,

(e) complying with continuing registration requirements, and

(f) paying the transfer fee and current pharmacist registration fee specified in the Fee Schedule attached to these bylaws.

(5) Where a former registrant has been on the Non-practising Register for a period of six years or more, he or she may be reinstated to the Register of Pharmacists by

(a) complying with subsections 7 (4) (a) through (e),

(b) paying the fee to transfer from the Non-practising Register to the Register of Qualifying Candidates specified in the Fee Schedule attached to these bylaws,

(d) comply with continuing registration requirements,

(e) pay the pharmacist registration fee specified in the Fee Schedule attached to these bylaws, and

(f) meet the deadline for registration, which will be three years from the date of registration on the Register of Qualifying Candidates. If the deadline for registration is not met, the applicant's name will be transferred to the Non-practising Register.

(6) The Council may authorize the Registrar to waive all or part of the practical training requirements in subsection 7 (5) (c) for a former registrant who provides evidence of pharmacy practice in a patient care setting in a jurisdiction outside Canada or the United States or of employment in an occupation related to the practice of pharmacy in another jurisdiction within the last three years.

Practical training and preceptorship

(1) Practical training requirements based on the framework of professional practice must be determined by the Board and approved by Council.

(2) Practical training can only be commenced after successful completion of English language proficiency requirements, payment of the practical training fee specified in the Fee Schedule attached to these bylaws, and approval of the application for preceptor's certificate.

(3) Practical training must be supervised by a pharmacist preceptor.

(4) A preceptor must apply in writing to the Registrar for a preceptor's certificate prior to supervising practical training. The preceptor's certificate must include the

(a) name of the preceptor who is supervising the practical training,

(b) name of the registrant who is completing the practical training,

(d) site of the practical training.

(5) The preceptor's certificate must be conspicuously displayed in the pharmacy.

(6) A registrant completing practical training must record his or her hours on the provided time record and upon completion of the required training must submit to the Registrar the completed time record and certification of completion, which must be signed by both the registrant and the preceptor.

(7) A registrant may apply to extend a period of practical training by submitting a written request to the Registrar.

(8) Where a period of practical training for a registrant has been extended, the preceptor must apply to the Registrar for a new preceptor's certificate.

Assessments for registration

(1) Subject to the approval of the Council, the Board must establish policies for assessment and provide them in writing to a candidate upon his or her application to register with the College.

(2) The forensic assessment may be taken by

(a) a student after entering his or her fourth year in the Faculty of Pharmaceutical Sciences at the University of British Columbia, or

(b) a qualifying candidate upon his or her registration as such.

(3) The practical assessment may only be taken by a registrant after he or she has completed all requirements for student or qualifying candidate registration, the English language proficiency requirements, and any required practical training.

(4) Practical assessments will be conducted at such times and sites as are determined by the Board. Written notification of times and sites must be provided to all students and qualifying candidates who are or who may become eligible to take the assessments.

(5) Subject to the approval of the Council, the Board must set a procedure for determining a minimum standard for successful completion of each assessment.

(6) A student or qualifying candidate that has not met the minimum standard set by the Board may be required to complete

(a) practical training,

(b) remedial education, and/or

(7) Each successful assessment result will be valid for a period of three years from the date of the assessment.

(8) A registrant who has not met the required standard on a College assessment may apply in writing to the Board for a review of the conditions of the assessment administration. A request for review must comply with policy and procedure approved by the Council, a copy of which must be provided to the candidate prior to the assessment.

(9) (a) The quality assurance program is the Program approved by the

Document replacement

(1) A pharmacist requiring replacement of his or her diploma for loss or destruction of original, legal change of name, or change of name to married name may, on request accompanied by the current diploma if in existence or an affidavit or statutory declaration, if not in existence, attesting to the reason the replacement diploma is required, obtain a replacement copy from the Registrar upon payment of the required fee specified in the Fee Schedule attached to these bylaws.

(2) A pharmacy requiring replacement of its licence for any of the following reasons

(a) change of manager,

(b) change of director,

(d) change of corporate name, or

(e) change of location may, on request accompanied by a letter from the pharmacy manager attesting to the reason the replacement licence is required, obtain a replacement copy from the Registrar upon payment of the required fee specified in the Fee Schedule attached to these bylaws.

BYLAW 2 - BOARD OF EXAMINERS [Top of Page]

Structure

(1) In accordance with the Act, Council must appoint one Board member as chair for a term of three years, and the chair may be eligible for reappointment. Council may revoke an appointment at any time, for cause.

(2) Where a vacancy occurs on the Board, the President of the College may appoint a replacement to act until the next meeting of Council, when Council must appoint a replacement for the remainder of the term.

(3) If the chair resigns or is unable to continue in that capacity, the Board must elect one of its members to act as chair until the next meeting of Council, when Council must appoint a replacement for the remainder of the term.

(4) The chair may appoint for a term of two years, from within the Board, directors of assessments, who are eligible for reappointment.

(5) The Board must annually review the appointment of assessors for all assessments and preceptors for practical training. A pharmacist eligible for appointment as an assessor or preceptor must satisfy the criteria determined by the Board and approved by Council.

Assessments

(1) A registrant who fails an initial assessment may repeat the assessment in accordance with the Board policies approved by the Council.

(2) Where the invigilator has reason to believe that a registrant has engaged in improper conduct during the course of an assessment, the invigilator must make a report to the Board and may recommend that the Board take one or more of the following courses of action

(a) fail the registrant,

(b) pass the registrant,

(d) disqualify the registrant from participating in any assessment for a period of time.

(3) After considering a report made under subsection 12 (2), the Board may take one or more of the courses of action specified in subsection 12 (2).

(4) A registrant disqualified under subsection 12 (2) (d), must be provided with written reasons for the disqualification.

Records

(1) The chair of the Board must ensure that a record is maintained of

(a) results of all assessments,

(b) progress of registration of all students and qualifying candidates,

(d) disposition of reviews referred to in section 9 (8).

Reporting

(1) The chair of the Board must submit to the Council annually a summary of all matters dealt with by the Board.

BYLAW 3 - INQUIRY COMMITTEE [Top of Page]

Structure

(1) Where a vacancy occurs on the Inquiry Committee, the President of the College may appoint a replacement to act until the next meeting of Council, when Council must appoint a replacement for the remainder of the term.

(2) If the chair resigns or is unable to continue in that capacity, the committee must elect one of its members to act as chair until the next meeting of Council, when Council must appoint a replacement for the remainder of the term.

(3) The Registrar may appoint a panel of three or more members of the committee to conduct an investigation. The Registrar must designate a member of the panel to act as chair of an investigation.

(4) A committee member may not serve on both the Inquiry Committee and the Discipline Committee during the same term of appointment.

(5) No member of the Inquiry Committee may sit on the panel hearing a matter in which he or she has had any prior involvement.

Records and referral

(1) A formal record must be kept of any findings and action that is taken by the Inquiry Committee under section 48 of the Act.

(2) Where the Inquiry Committee takes action under section 48 (4) of the Act, written reasons why the case was dismissed must be kept.

(3) Records of the Inquiry Committee must be retained for not less than six years following the conclusion of an investigation.

Reporting

(1) The chair must submit to the Council annually a summary of the matters dealt with by the Inquiry Committee, including a report on the resolution of those matters.

BYLAW 4 - DISCIPLINE COMMITTEE [Top of Page]

Structure

(1) Where a vacancy occurs on the Discipline Committee, the President of the College may appoint a replacement to act until the next meeting of Council, when Council must appoint a replacement for the remainder of the term.

(3) The Registrar may appoint a member of the Law Society of British Columbia to act as counsel to the Discipline Committee.

(4) The Registrar may appoint a panel of three or more members of the committee to conduct a discipline hearing. The Registrar must designate a member of the panel to act as chair at a hearing.

(5) A committee member may not serve on both the Discipline Committee and the Inquiry Committee during the same term of appointment.

(6) No member of the Discipline Committee may sit on the panel hearing a matter in which he or she has had any prior involvement.

Citation

(1) A citation may include one or more respondents.

(2) The Registrar may join one or more complaints or other matters which are to be the subject of a discipline hearing in one citation as appropriate in the circumstances.

(3) The Registrar may sever one or more complaints or other matters which are to be the subject of a discipline hearing as appropriate in the circumstances.

(4) The Registrar may amend a citation before a hearing, and the panel may amend a citation during a hearing. The respondent must be notified of any amendment to a citation.

(5) Where a citation is amended under subsection 19 (4) prior to a discipline hearing, and the amended citation changes the date, time or place of the hearing, the Registrar must notify any complainant of the amendment not fewer than fourteen days before the date of the hearing.

Hearing procedure

(1) The chair of the Discipline Committee, the chair of the panel, or the Registrar may adjourn a hearing.

(2) The chair of the Discipline Committee or the chair of the panel may cause a subpoena in the form appended to these bylaws to be served upon a witness to a discipline hearing.

(3) All proceedings at a hearing must be transcribed by a court reporter. At the commencement of the hearing, the chair must administer an oath or affirmation to the court reporter as follows

(a) oath: "Do you solemnly swear that you will truly and faithfully record the evidence given on this hearing to the best of your ability, so help you God?" or

(b) affirmation: "Do you solemnly promise, affirm and declare that you will truly and faithfully record the evidence given on this hearing to the best of your ability?"

(4) The Discipline Committee may admit evidence in any manner it considers appropriate.

(5) Before a witness testifies, the chair of the panel must administer an oath or affirmation to the witness as follows

(a) oath: "Do you solemnly swear that the evidence you are about to give on this hearing will be the truth, the whole truth and nothing but the truth, so help you God?" or

(b) affirmation: "Do you solemnly promise, affirm and declare that the evidence you are about to give on this hearing shall be the truth, the whole truth and nothing but the truth?"

(6) All determinations and orders of the Discipline Committee or panel under sections 54 (1) and 54 (2) of the Act must be agreed upon by the majority of its members. The panel must prepare and keep written reasons for its determinations and orders.

(7) In determining the penalty to be imposed on a respondent under section 54 (2) of the Act, the Discipline Committee must, after making a determination on the facts, consider a previous relevant disciplinary decision regarding the respondent or an undertaking or consent to a reprimand given by the respondent under section 48 (6) of the Act.

(8) All discipline hearings shall be recorded, and any person may obtain, at his or her expense, a transcript of any part of the hearing which he or she was entitled to attend.

Penalty

(1) In accordance with the Act, the Discipline Committee or the panel may impose a fine of up to $25,000 on a respondent.

(2) In accordance with the Act, costs may include part or all of one or more of the following

(a) the cost of investigation,

(b) transportation, accommodation or other reasonable expenses incurred by a witness to attend a hearing,

(d) the cost of a transcript of a hearing if applicable,

(e) the cost of publishing a public notice,

(f) a fee of $750 for each part or full day of hearing,

(g) reasonable fees and disbursements of the College counsel and if applicable, the committee counsel, and

(h) any other amount, arising out of the hearing, for which the College would otherwise be liable.

Records

(1) Records of the Discipline Committee must be retained for not less than six years following the date a decision is rendered.

Reporting

(1) The chair must submit to the Council annually a summary of the matters dealt with by the Discipline Committee, including a report on the resolution of those matters.

Notice of disciplinary action

(1) When action is taken against a respondent under section 54 of the Act, a summary of the circumstances and of any decision must be published in a form approved by the Registrar, and may include the name of the respondent(s), the facts of the case, the reasons for the decision(s), and the disposition of the case, including the nature of any limitation or suspension, and the date it is in effect.

(2) Where disciplinary proceedings result in the limitation, suspension or cancellation of a registrant's licence to practise, the Registrar must notify regulatory authorities for the profession of pharmacy in other jurisdictions.

BYLAW 5 - COMMUNITY PHARMACY [Top of Page]

Definitions

In bylaw 5:
"community pharmacy" means a pharmacy which sells drugs to the public either directly or via delivery or mail order;

"dispensary" means the area of a community pharmacy that contains Schedule I drugs;

"prescription copy" means a copy of a prescription that may be given to a patient by a registrant for information purposes only and may not be used to dispense a prescription;

"prescription transfer" means the consignment via direct pharmacist-to-pharmacist communication, of all remaining refill authorization(s) for a particular prescription to a requesting community pharmacy;

"professional products area" means the area of a community pharmacy that contains Schedule III drugs;

"professional service area" means the area of the community pharmacy that contains Schedule II drugs;

Responsibilities of the community pharmacy manager

(1) A pharmacist may not serve as manager of more than one pharmacy at any one time.

(2) The community pharmacy manager must

(a) actively participate in the day-to-day management of the community pharmacy,

(b) as part of a quality management program under section 27, develop, maintain and enforce policies and procedures to comply with the standards of practice as stated within current community pharmacy legislation,

(c) confirm that the staff members who present themselves as pharmacists and who are employed to practise as pharmacists hold valid licences to practise,

(d) notify the Registrar in writing of the appointments and resignations of registrants to the community pharmacy staff as they occur,

(e) respond in writing to the Registrar's queries regarding community pharmacy practice and, where applicable, identify the registrant(s) involved in any matter under review,

(f) advise the Registrar in writing of the termination of a registrant's employment for cause including professional practice problems, theft, or drug or alcohol abuse,

(g) ensure that registrant and community pharmacy support person staffing levels are commensurate with the workload volume and patient care requirements at all times,

(h) ensure that new information directed to the community pharmacy pertaining to drugs, devices and drug diversion tactics is immediately accessible to registrants,

(i) establish policies and procedures to specify the duties to be performed by students, qualifying candidates, and support persons,

(j) be responsible for inventory management and procedures for proper destruction of unusable drugs and devices,

(k) ensure that purchase records for narcotic and controlled drugs are signed by a pharmacist,

(l) assume responsibility for the appropriate security and storage of all Schedule I, II, and III drugs,

(m) ensure that each individual working in the community pharmacy wears a badge that clearly identifies him or her as a registrant or community pharmacy support person,

(n) ensure that confidentiality is maintained with respect to all community pharmacy and patient records in accordance with section 35,

(o) in the event that he or she will be absent for more than eight weeks, notify the Registrar,

(p) notify the Registrar in writing at least thirty days before relinquishing an appointment as pharmacy manager,

(q) ensure the correct and consistent use of the community pharmacy operating name as it appears on the community pharmacy licence for all pharmacy identification on or in labels, directory listings, signage, packaging, advertising or stationery,

(r) submit to the Registrar a diagram of the community pharmacy and the premises in which it is located, and apprise the Registrar in writing of proposed pharmacy design changes or structural renovations and submit a new community pharmacy diagram for approval before the commencement of construction or other related activities, and

(s) in the event of a community pharmacy closure or relocation

(i) unless there are extenuating circumstances, notify the Registrar in writing at least thirty days before the effective date of a proposed closure or relocation,

(ii) provide for the safe transfer and appropriate storage of all Schedule I, II, and III drugs,

(iii) advise the Registrar in writing of the disposition of all drugs and prescription records at the time of a closure, and provide a copy of the closing inventory of all narcotic and controlled drugs, as defined in the Regulations to the Food and Drugs Act (Canada) and the Regulations to the Controlled Drugs and Substances Act (Canada), as provided to federal authorities,

(iv) arrange for the safe transfer of a closed community pharmacy's prescription records and for their continuing availability in another community pharmacy, and

(v) remove all signs and advertisements from the closed community pharmacy premises.

Quality management

(1) The community pharmacy manager must implement a documented, ongoing quality management program that monitors staff performance, equipment, facilities, and adherence to standards of practice.
(2) The program must include a process for the reporting and documentation of known, alleged and suspected prescription errors and discrepancies and their follow-up.

Community pharmacy premises

(1) A diagram of the community pharmacy must be approved by the Registrar before the issuance of the community pharmacy licence. A copy of the diagram must be returned to the community pharmacy manager who is responsible for reporting any changes to the Registrar.

(2) The diagram must be drawn to scale and must include the location of

(a) all entrances, stairs, or escalators,

(b) washroom(s),

(d) appliances and fixtures,

(e) dispensary,

(f) narcotic and controlled drug storage equipment,

(g) professional service area,

(h) professional products area, and

(i) patient consultation area.

(3) The diagram must be accompanied with a description of the type of security alarm system and the method by which the dispensary is made inaccessible to the public.

(4) The community pharmacy manager must ensure that establishments in which the community pharmacy does not comprise 100 per cent of the total area of the premises must meet the following requirements

(a) the professional products area may extend no more than 7.6 meters from the perimeter of the dispensary and must be made visually distinctive from the remaining areas of the premises by means of unique decor, design components and signage, and

(b) a sign reading "Medication Information" must be clearly displayed to identify a counselling area or counter at which a member of the public can obtain a registrant's advice on Schedule I, II and III drugs.

(5) The dispensary area must

(a) be a minimum of 15 square meters,

(b) be made inaccessible to the public by means of gates or doors across all entrances,

(d) contain a dispensing counter with a minimum of 3 square meters of clear working space(s), aside from service counters,

(e) have adequate shelf and storage space,

(f) have a double stainless steel sink with hot and cold running water, and

(g) be designated as a nonsmoking area.

(6) In all new and renovated pharmacies, an appropriate area must be provided for patient consultation. The location of this area must ensure privacy and be conducive to confidential communication. This area must include one of the following, but may not be limited to

(a) a private consulting room, or

(b) a semiprivate area with suitable barriers.

(7) All new and renovated pharmacies must have a separate and distinct area with a minimum size of 4 square meters reserved as storeroom space.

Operation without a pharmacist

(1) Except as described in this bylaw, a community pharmacy must not be open for business unless a pharmacist is in the community pharmacy. The operation of a premises without the presence of a pharmacist may occur if the dispensary, the professional service area, and the professional products area are not accessible to or available for use by any person and the following requirements have been met

(a) the Registrar must be notified of the hours during which the pharmacist is not present,

(b) a physical barrier must surround the dispensary, the professional service area, and the professional products area, and must be of a type that will preclude all access to this area by the public and anyone who is not a pharmacist,

(d) hours when a pharmacist is on duty must be posted.

(2) When the requirements of subsection 29 (1) have been met, the following activities may be performed by anyone who is not a pharmacist

(a) requests for prescriptions, orders for Schedule II and III drugs and telephone requests from patients to order a certain prescription may be placed in the dispensary area by dropping them through a slot in the barrier,

(b) dispensed prescriptions (if outside barrier) may be given to a patient when the pharmacist is not present provided the requirements in section 44 have been met. These drugs must not be directly accessible or visible to the public, and

(c) orders from drug wholesalers, containing Schedule I, II, and III drugs, may be received but must be kept secure and remain unopened.

(3) After community pharmacy hours, the premises must be secured with suitable locks and alarms to detect unauthorized entry.

Equipment and references

(1) No community pharmacy may operate without maintaining the equipment set out in subsection 30 (2) and the references set out in subsection 30 (3).

(2) The dispensary area must be equipped with the following items

(a) telephone,

(b) refrigerator,

(d) computer system connected to PharmaNet,

(e) balance having a sensitivity rating of 0.01,

(f) metric weights (10 mg to 50 g) for balances requiring weights, or instruments with equivalent capability,

(g) metric scale graduates (a selection, including 10 ml size),

(h) mortar and pestle,

(i) spatulas (metal and nonmetal),

(j) funnels (glass or plastic),

(k) stirring rods (glass or plastic),

(l) ointment slab or parchment paper,

(m) counting tray,

(n) disposable drinking cups,

(o) soap dispenser and paper towel dispenser, and

(p) plastic or metal garbage containers to be used with plastic liners.

(3) The community pharmacy must contain the reference material approved by Council.

Sale and disposal of drugs and devices

(1) Schedule I, II, and III drugs must only be sold from a pharmacy.

(2) A registrant must not sell or dispense a drug after the date on which the drug is labelled to expire.

(3) A registrant must not sell a Schedule I, II, or III drug for the purpose of resale by an unauthorized person.

(4) Every registrant in a community pharmacy is responsible for the protection from loss, theft or unlawful sale of all Schedule I, II, and III drugs in the community pharmacy.

(5) A pharmacist must not sell or dispose of a drug specified or referred to by category in Schedule I except

(a) on the prescription or order of a practitioner,

(b) for an inventory transfer to a pharmacy by order of a pharmacist,

(d) by destruction, in accordance with Council policy.

(6) Triplicate/duplicate prescription program drugs must not be sold or dispensed unless

(a) the pharmacist has received one part of the triplicate/duplicate prescription form approved by the Council of the College of Pharmacists of BC and the Council of the College of Physicians and Surgeons of BC,; (b) the prescription is dispensed before midnight of the fifth day following the date of issuance by the practitioner,; (c) only one drug is presented on each prescription form, except for exemptions stipulated by the Registrars of the College of Pharmacists of British Columbia and the College of Physicians and Surgeons of British Columbia,; (d) the prescription form is signed by the patient or the patient's representative upon receipt of the dispensed drug, and; (e) requirements of section 38 (1) have been satisfied.
A pharmacist must obtain a new triplicate/duplicate prescription on each occasion the drug is dispensed, with the exception of part-fill situations.

Drug procurement/inventory management

(1) A pharmacist must purchase Schedule I, II, or III drugs from

(a) a wholesaler or manufacturer licensed to operate in Canada, or

(b) another pharmacy.

(2) A pharmacist who supplies a Schedule I drug to another pharmacist or practitioner must retain documentation of the transaction.

(3) A registrant must retain invoices recording the purchase and receipt of Schedule I drugs and drugs regulated by the Controlled Drugs and Substances Act, and any records documenting the transfer of such drugs for any reason other than as authorized by a practitioner's prescription must be retained for not less than three years.

(4) All drug shipments must be delivered unopened to the community pharmacy or a designated secure storage area.

(5) The community pharmacy manager must ensure there is a drug recall procedure for community pharmacy inventory, the results of any recall must be documented.

(6) Nonusable and expired drugs must be stored in a separate area of the community pharmacy or a secure area of the storeroom until final disposal.

Returned drugs

(1) No registrant may accept for return to stock or reuse any drug previously dispensed.

Advertising of prescription and other professional services

(1) A community pharmacy manager must not advertise or permit any person to advertise professional services or drugs or any aspect thereof on behalf of the pharmacy which he or she operates, other than in compliance with the requirements of this bylaw.

(2) When advertising pharmacy services that are required by legislation, the statement, "Required in all British Columbia pharmacies," must accompany the advertising and must be of the same size and prominence as all other print in the advertising.

(3) Any advertising undertaken by a community pharmacy manager, or any person acting on behalf of the manager or the pharmacy he or she operates, must not include

(a) false information,

(b) inaccurate statements,

(d) statements that are deceptive or misleading, or

(e) testimonials or comparative statements or endorsements relating to the quality of pharmacy services.

(4) A pharmacist or community pharmacy must not use the title "specialist" or any similar designation suggesting a recognized special status or accreditation as a pharmacist or a pharmacy on any letterhead or business card or in any other marketing activity.

(5) A pharmacist may state in any advertising a special practice area, provided that the pharmacist

(a) has been engaged in the practice of pharmacy for at least three years, and

(b) has, during the most recent three-year period that the pharmacist has practised, devoted at least 20 per cent of his or her time to practising in each special practice area in respect of which the pharmacist wishes to refer.

(6) Prescription drug price advertising must include the following information

(a) drug product's proprietary (brand) name, if any,

(b) drug product's generic name and the manufacturer's name,

(d) total price charged for a specific number of dosage units or quantity of the drug product, and

(e) the phrase "only available by prescription."

(7) Where prescription drug price advertising includes any inferred or direct reference to a fee charged for professional services, the total prescription price must also be incorporated into the advertisement, and both figures must be featured equally.

(8) Prescription drug price advertising must not include any reference to the safety, effectiveness or indications for use of the advertised prescription drug products.

(9) A registrant or community pharmacy manager, when called upon by the Registrar to do so, must verify the statements made in the registrant's or pharmacy's advertising.

Records

(1) All patient records must be stored on the premises in a secure manner to protect patient confidentiality.

(2) All information contained on prescriptions shall be considered privileged and confidential and shall not be released to any person without the express consent of the practitioner or patient, and prescriptions shall not be subject to perusal by any person other than those exempted in section 39 (6).

(3) Without restricting the generality of subsection 35 (2), no registrant may, for commercial purposes, release or permit the release of information or an abstract of information obtained from a prescription, which would permit the identity of the practitioner or the patient to be determined.

(4) Subsection 35 (3) does not apply to the release of information when it is done for noncommercial purposes in accordance

(a) with the requirements of the Act and these bylaws, or

(b) with the express written consent of the practitioner, the patient and the pharmacy manager.

(5) All prescriptions and patient records must be retained for a period of not less than three years.

(6) Notwithstanding subsection 35 (5), a registrant must not destroy prescription or patient records until any audit or investigation is completed.

(7) A registrant must dispose of community pharmacy records in a manner that preserves patient confidentiality

(a) paper records must be shredded or incinerated, and

(b) computerized records must be rendered unreadable through the use of an appropriate mechanical, physical or electronic process and converted into such a form that they can not be reconstructed in whole or in part.

(8) A registrant must ensure that individual records are not lost or removed during the destruction process and that the resulting waste does not include fragments of readable personal information.

Pharmacist/practitioner relationship

(1) A registrant must not divide, split or otherwise share charges for professional services rendered or enter into any arrangement or agreement to do so.

Community pharmacy support persons

(1) No pharmacist may permit support persons or a person who is not a registrant to direct, influence, control or participate in the management of the professional function of the community pharmacy. The pharmacist is solely responsible for the provision of community pharmacy services.

(2) Functions involving patient-specific monitoring and evaluation of drug therapy must be performed by a pharmacist or by a student or qualifying candidate under the direct supervision of a pharmacist, and include but are not limited to

(a) receipt of a verbal prescription from a practitioner,

(b) determination of the authenticity of a prescription,

(c) review of a prescription for completeness and appropriateness with respect to the drug, dosage, route, and frequency,

(d) review of the patient record for potential drug interactions, allergies, therapeutic duplications, and/or other potential problems,

(e) verification of the accuracy of a dispensed prescription,

(f) verification of the accurate entry of drug and patient information into the PharmaNet patient record,

(g) dialogue with a patient concerning the patient's drug history and/or patient record,

(h) consultation with a practitioner with respect to a patient's drug therapy,

(i) follow-up on a suspected adverse drug reaction,

(j) dialogue with a patient regarding Schedule II and III drugs, and

(k) provision of drug and poison information.

(3) A pharmacist may delegate technical functions relating to the operation of the community pharmacy to support person(s) provided that the pharmacist exercises appropriate supervision of the support person(s) by implementing procedures, checks and controls to ensure the accurate and safe delivery of community pharmacy services.

Prescription

(1) The pharmacist is responsible for ensuring that the prescription is authentic and contains the following information

(a) date,

(b) name and address of the patient,

(d) quantity of the drug which may be dispensed,

(e) dosage instructions for use by the patient which shall include a specific frequency or interval or maximum daily dose,

(f) refill authorization where applicable, which shall include the number of refills and interval between refills,

(g) name and identification number of the practitioner, and in the case of a written prescription, the signature of the practitioner,

(h) date on which the drug is dispensed, and

(i) the pharmacist must sign, initial or otherwise identify him- or herself each verbal prescription received from a practitioner.

(2) Prescription authorizations may be electronically transmitted by facsimile by a prescriber to a pharmacy, provided that the following requirements are met

(a) the prescription must be sent only to a pharmacy of the patient's choice with no intervening person having access to the prescription authorization,

(b) the prescription must be sent directly from the prescriber's office, directly from a health institution for a patient of that institution, or from another location, provided that the pharmacist is confident of the prescription's legitimacy,

(c) the equipment for the receipt of the facsimile prescription must be located within a secure area to protect the confidentiality of the prescription information,

(d) in addition to the requirements of subsections 38 (1)(a) through (h), the prescription must include the

(i) prescriber's telephone number for verbal verification, facsimile number, and approved unique identifier if applicable,

(ii) time and date of transmission,

(iii) name and fax number of the pharmacy intended to receive the transmission.

(e) the pharmacist is responsible for verifying the origin of the transmission and the authenticity of the prescription, and

(f) the prescription drug order must be maintained on permanent quality paper by the pharmacy.

(g) facsimile transmissions can be accepted from a prescriber registered to practice in any Canadian province.

(h) pharmacist-to-pharmacist communication of prescription transfers (for other than narcotics and controlled drugs) may be completed by facsimile transmission. The transferring pharmacist must include his or her name and the address of the pharmacy with the other required documentation. The name of the pharmacist requesting the transfer must also be known and recorded on the document to be faxed. The receiving pharmacist must ensure the authenticity of the transmission.

(3) A pharmacist must ensure that prescription authorizations for all triplicate/duplicate prescription drugs are not transmitted electronically.

(4) A pharmacist may receive verbal prescription authorizations either directly from a practitioner or from a practitioner's recorded voice message.

(5) A pharmacist may accept refill authorization for Schedule I drugs, relayed by a practitioner's agent, only if the pharmacist is confident the agent has consulted with the practitioner and has accurately conveyed the practitioner's instructions.

(6) Each pharmacist involved in dispensing a drug must sign, initial or otherwise identify him- or herself on the prescription.

(7) If a patient presents a new prescription for a previously prescribed drug, the pharmacist must cancel any unused refill authorizations remaining on any previous prescription for that drug.

(8) A pharmacist must not dispense a prescription that is issued for more than one patient.

Prescription copy and transfer

(1) A pharmacist must file the authorization to dispense a prescription and, if requested to do so, must provide a copy of the prescription to the person who presented it or to another pharmacist, unless the practitioner has indicated to the contrary.

(2) A prescription copy may be provided for information purposes only and must contain

(a) name and address of the patient and of the practitioner,

(b) name, strength, quantity and directions for use of the drug,

(d) the number of authorized refills remaining,

(e) name and address of the community pharmacy,

(f) signature of the pharmacist supplying it, and

(g) an indication that it is a copy.

(3) Upon request, a pharmacist must transfer to another pharmacy licensed in Canada a prescription for a drug provided that the drug or drug product does not contain a narcotic or controlled drug and the transfer occurs between two pharmacists.

(4) The pharmacist who transfers the prescription to another pharmacist must

(a) enter on the patient record the following

(i) date of the transfer,

(ii) identification of the pharmacist from whom the prescription was transferred, and

(iii) identification of the community pharmacy to which the prescription was transferred,

(iv) identification of the pharmacist to whom the prescription was transferred, and

(b) transfer all remaining refill authorization(s).

(5) This bylaw shall not preclude a pharmacist from

(a) supplying prescription copies to a corporation providing pharmaceutical benefits to a patron of a pharmacy under or pursuant to a drug insurance plan for the purpose of adjudication for payment, and

(b) making available for audit purposes to an authorized representative of the provincial government prescriptions for which the government has been invoiced.

(6) A pharmacist must make prescriptions accessible to authorized inspectors of the Health Protection Branch of the Department of National Health and Welfare and the College of Pharmacists of British Columbia.

Prescription label

(1) All drugs dispensed under a prescription of a practitioner must be labelled with a typed or machine printed label that must contain the following

(a) name, address and phone number of the community pharmacy,

(b) prescription number and current dispensing date,

(d) name of the practitioner,

(e) unless the practitioner otherwise instructs,

(i) for single-entity products, the generic name of drug followed by the brand name or the manufacturer name or the Drug Identification Number,

(ii) for multiple-entity products, the brand name or all ingredients listed followed by the manufacturer name or the Drug Identification Number,

(iii) for compounded preparations, all ingredients,

(iv) quantity and strength of the drug,

(f) practitioner's directions for use, and

(g) any other information required by good community pharmacy practice.

(2) Where a drug container size is too small to accommodate a full label according to subsection 40 (1), the registrant must affix a trimmed prescription label to the small container. This label must include, at a minimum, the

(a) prescription number,

(b) current dispensing date,

(d) name of the drug.

The complete prescription label must be affixed to a larger container and the patient counselled to keep the small container inside the large container.

(3) The prescription label may contain directions for use in the language of the patient. All other label information must be in English.

Dispensing

(1) Unless the practitioner has indicated, in accordance with sections 30 (1) and (3) of the Act, that a particular brand of a drug is to be dispensed, the pharmacist may exercise product selection and dispense an interchangeable drug as defined in the Act. Drugs listed as noninterchangeable will be a matter of Council policy.

(2) A pharmacist may adjust the quantity of drug dispensed from the originally prescribed quantity in the following situations

(a) patient requests to purchase a smaller amount,

(b) manufacturer unit-of-use standard of package size does not exactly match the prescribed quantity,

(d) drug misuse is suspected,

(e) quantity prescribed exceeds amount covered by the patient's drug plan,

(f) a trial prescription quantity is authorized by the patient,

(g) the safety of patient might be in question due to possible overdose, and

(h) an intervention is required.

(3) Where the authenticity of the prescription is suspect, the pharmacist may refuse to dispense the drug.

(4) All drugs must be dispensed in a container that is certified as a child-resistant package except where

(a) the practitioner or the person who presents the prescription to be dispensed directs otherwise,

(b) in the professional judgment of the pharmacist in the particular circumstances or the particular situation, it is advisable not to use a child-resistant package,

(c) a child-resistant package is not suitable because of the physical form of the drug or the manufacturer's packaging is designed to improve patient compliance, or

(d) the person who dispenses the drug is unable to obtain a child-resistant package because supplies of such packages are unavailable on the market.

(5) The pharmacist shall restrict the time span for ongoing prescription authorization to a maximum of one year from the prescribing date, except for prescriptions for oral contraceptives, for which pharmacists shall restrict the time span for ongoing prescription authorization to a maximum of two years from the prescribing date.

Collection of patient information

(1) No registrant may collect personal information regarding a patient unless

(a) the information relates directly to and is necessary for providing health care services to the patient or for related administrative purposes, or

(b) the collection of that information is expressly authorized by or under an enactment.

Patient record

(1) A patient record must be prepared and maintained for each patient for whom a Schedule I drug is dispensed.

(2) The patient record must include the following information

(a) patient surname, given name and where applicable, another given name or initial,

(b) personal health number as assigned by the British Columbia Ministry of Health,

(d) when available, patient telephone number,

(e) patient date of birth,

(f) patient gender,

(g) when available, allergies and idiosyncratic responses,

(h) the source of the information referred to in subsection 43 (2) (g),

(i) date the information referred to in subsection 43 (2) (g) is collected,

(j) date drug is dispensed,

(k) prescription number,

(l) generic name, strength and dosage form of drug

(m) Drug Identification Number,

(n) quantity of drug dispensed,

(o) intended duration of therapy, specified in days,

(p) date and reason for early discontinuation of therapy,

(q) directions to patient,

(r) identification of prescribing or authorizing practitioner, and

(s) special instructions from the practitioner to the pharmacist.

(3) When a registrant obtains a drug history from a patient, he or she must request the following information

(a) medical conditions and physical limitations,

(b) adverse drug reactions, including allergies,

(c) past and present prescribed drug therapy including the drug name, strength, dosage, frequency, duration and effectiveness of therapy,

(d) compliance with prescribed drug regimen, and

(e) Schedule II and III drug use.

(4) A pharmacist must review the patient record before the release of a drug in order to identify and take appropriate action, where applicable, for

(a) appropriateness of therapy,

(b) drug interactions,

(d) therapeutic duplication,

(e) contraindicated drugs,

(f) degree of compliance,

(g) correct dosage, route, frequency and duration of administration and dosage form, and

(h) any other deviation from contemporary pharmaceutical care which may adversely affect the patient.

Pharmacist/patient dialogue

(1) Pharmacist/patient dialogue must be in person wherever practicable, or by telephone and must respect the patient's right to confidentiality.

(2) Subject to subsection 44 (6), a pharmacist, or a student or qualifying candidate under the direct supervision of a pharmacist, must enter into direct dialogue with the patient regarding a Schedule I drug. Such dialogue must include

(a) confirmation of the identity of the patient,

(b) identification and purpose of the drug being dispensed,

(d) common adverse effects or interactions and therapeutic contraindications that may be encountered, including their avoidance, and the actions required if they occur,

(e) storage requirements,

(f) prescription refill information,

(g) response to questions and expressed needs, and may include

(i) how to monitor the response to therapy and expected outcomes within defined time periods,

(ii) action to be taken in the event of a missed dose,

(iii) when to seek medical attention, and

(iv) complementary measures.

(3) Where, during pharmacist/patient dialogue, a drug-related problem is identified, the pharmacist must take appropriate action to resolve the problem.

(4) Where an adverse drug reaction as defined by the Health Protection Branch, Health Canada, Guidelines for Reporting Adverse Drug Reactions is identified, the pharmacist must notify the patient's practitioner, make an appropriate entry on the patient record and report the reaction to the BC Regional Adverse Drug Reaction (ADR) Reporting Centre.

(5) Alternative forms of patient information, including written information leaflets, pictogram labels, video programs, etc., may be used to supplement person-to-person pharmacist/patient dialogue.

(6) The pharmacist must use any reasonable means to comply with subsections 44 (1) and (2) for patients or their representatives who have language or communication difficulties.

(7) The pharmacist must respect the patient's right to confidentiality by endeavoring to ensure that pharmacist/patient dialogue with respect to Schedule I, II and III drugs takes place in an area where that discussion cannot be overheard by others.

Schedule II and III drugs

(1) Schedule II and III drugs that are originally prescribed by a practitioner and dispensed by prescription must have authorization by the practitioner if the patient wishes to continue receiving the drug by prescription.

(2) Schedule II drugs must be displayed in and distributed from the dispensary or an immediately adjacent professional services area from which there is no opportunity for patient self-selection. Intervention by a pharmacist, or by a student or qualifying candidate under the direct supervision of a pharmacist, at the time of sale is required in order to ensure provision of cautions and advice for proper use.

(3) Schedule III drugs must be located in and distributed from the professional products area and be under direct visual and audible supervision from the dispensary in order to provide the opportunity for pharmacist/patient dialogue.

(4) Only a pharmacist, or a student or qualifying candidate under the direct supervision of a pharmacist, may consult with a patient regarding the selection and use of a Schedule II or III drug.

(5) The pharmacist must be accessible and approachable to consult with the patient who is seeking to self-medicate with a Schedule II or III drug.

BYLAW 6 - PHARMANET [Top of Page]

Definitions

In bylaw 6:

"database" means those portions of the provincial computerized pharmacy network and database referred to in section 37 of the Act, containing patient records and general drug information;

"HealthNet/BC Professional and Software Compliance Standards" means the document, jointly approved by the College and the Pharmacare division of the provincial Ministry of Health, which specifies the requirements to be met by an in-pharmacy computer system in order to connect to PharmaNet;

"in-pharmacy computer system" means the computer hardware and software utilized to support pharmacy services in a pharmacy;

"patient keyword" means an optional confidential pass code selected by the patient which limits access to the patient's PharmaNet record until the pass code is provided to the pharmacist;

"PharmaNet patient record" means the patient record referred to in section 43 and is the record of information referred to in the HealthNet/BC Professional and Software Compliance Standards as the "patient profile;"

"terminal" means any electronic device connected to a computer system, which allows input or display of information contained within that computer system.

Responsibilities of the pharmacy manager and pharmacy owner

(1) At such time as PharmaNet connection is available to a pharmacy, the pharmacy manager and the pharmacy owner must (a) equip the pharmacy with an in-pharmacy computer system which meets the requirements set out in the current HealthNet/BC Professional and Software Compliance Standards,

(b) install any terminal capable of accessing and displaying patient records, in an area of the pharmacy which

(i) is only accessible to registrants and support persons, and

(ii) is under the direct supervision of a pharmacist,

(d) upgrade computer software as needed to comply with changes to the HealthNet/BC Professional and Software Compliance Standards,

(e) require all registrants, nonpharmacist owner managers/directors, pharmacy support persons and computer software programmers or technicians who will access the in-pharmacy computer system, to sign an undertaking, in a form approved by the Council, to maintain the confidentiality of patient record information, and

(f) maintain in the pharmacy for a period of two years after employment has ended, the undertakings referred to in subsection 47 (1) (e).

(2) A pharmacy manager or the pharmacy owner must display and make available to the public, information endorsed from time to time by the College, pertaining to the collection, retention, maintenance, use and confidentiality of patient record information.

Collection of information for the PharmaNet database

(1) A pharmacist must keep the PharmaNet patient record current.

(2) A pharmacist must reverse information in the PharmaNet database, pertaining to drugs not released to the patient or the patient's representative and record the reason for the reversal within thirty days of the original entry of the information on PharmaNet.

(3) A pharmacist must revise information in the PharmaNet database pertaining to corrected billings for prescriptions billed to a payment agency other than Pharmacare or the patient and record the reason for the revision within 90 days of the original entry on PharmaNet.

(4) At the request of the patient, a pharmacist must establish, delete or change the patient keyword.

(5) Where a patient or patient's representative requests an alteration to be made to the PharmaNet information, the pharmacist may

(a) correct the information on record, or

(b) if the pharmacist refuses to alter the PharmaNet information, he or she must inform the person requesting the change of his or her right to request correction under section 29 of The Freedom of Information and Protection of Privacy Act (1996).

Confidentiality

(1) Except as otherwise required by law, only the following persons may access a patient's PharmaNet record

(a) the patient,

(b) the patient's representative,

(d) support person(s) on the pharmacy staff, and

(e) computer software vendors and computer technicians during the installation and maintenance of the in-pharmacy system.

(2) A pharmacist must take all reasonable steps to positively identify a patient, patient's representative(s), pharmacist and practitioner in compliance with College guidelines, before complying with a request to

(a) establish a patient record,

(b) update a patient's clinical information,

(d) establish, delete, or change a keyword,

(e) view a patient record,

(f) answer questions regarding the existence and content of a patient record,

(g) correct information,

(h) disclose relevant patient record information to another pharmacist for the purpose of dispensing a drug or device, and/or

(i) disclose relevant patient record information to another pharmacist or practitioner for the purpose of monitoring drug use.

(3) A registrant must report any violation of confidentiality to the College immediately.

Applications for disclosure of information

(1) A request for the disclosure of patient information from a federal or provincial government payment agency or an insurer that reimburses the cost of prescribed drugs must be submitted in writing to the pharmacy manager.

(2) On being satisfied that the patient has consented to the disclosure in subsection 50 (1), the pharmacist may release the information.

(3) Requests for patient information from PharmaNet submitted to the PharmaNet Committee by the Minister of Health or designate, regulatory bodies for practitioners, or researchers must be submitted in writing on the form approved by Council and must be accompanied by an application fee in the amount specified in the Fee Schedule attached to these bylaws.

(4) Before releasing patient information from PharmaNet, where the PharmaNet Committee has approved the request, the applicant must pay a processing fee specified in the Fee Schedule attached to these bylaws.

PharmaNet Committee

(1) In accordance with the Act, Council appoints members of the PharmaNet Committee for terms of up to three years, and the members may be eligible for reappointment. Council may revoke an appointment at any time, for cause.

(2) The committee members must elect a chair from amongst themselves. The chair may serve a two-year term, and be eligible for a maximum of six years' continuous service.

(3) If the chair resigns or is unable to continue in that capacity, the committee may elect one of its members to act as chair.

(4) Where a vacancy occurs on the PharmaNet Committee, the President of the College may appoint a replacement to act until the next meeting of Council, when Council must appoint a replacement for the remainder of the term.

(5) The chair of the PharmaNet Committee may appoint a panel of three or more members of the committee in compliance with section 38 (4) of the Act to conduct committee business. The chair of the PharmaNet Committee must designate a member of the panel to act as chair.

(6) If panels of the PharmaNet Committee are used, at least one member of any panel must not be a registrant, a former registrant, an owner of a pharmacy or a director of a corporation that owns a pharmacy.

(7) The chair of the PharmaNet Committee may terminate an appointment to the panel for cause and may fill a vacancy on a panel.

(8) The PharmaNet Committee chair must keep a record of

(a) all matters coming before the committee,

(b) referrals made to other College committees, agencies or persons, and

(9) The chair must submit to the Council annually a summary of the matters dealt with by the PharmaNet Committee.

BYLAW 7 - RESIDENTIAL CARE FACILITIES AND HOMES [Top of Page]

Definitions

In bylaw 7:
"medication" in bylaw 7 has the same meaning as drug;

"medication safety and advisory committee" means a committee consisting of, but not limited to, the manager of the residential care facility, the pharmacist appointed by the licensee and the manager of care or the health care professional responsible for immediate supervision of all health care services in the facility and mandated according to The Community Care Facility Act, Adult Care Regulations or Child Care Regulations to make policy recommendations for all matters relating to the use of medications in the facility;

"resident" means a person who lives in and receives care in a residential care facility or home or an extended-care or long-term care unit;

"residential care facility" means a residence licensed under The Community Care Facility Act to provide care to seven or more persons;

"residential care home" means a residence licensed under The Community Care Facility Act to provide care to three to six persons.

Supervision of pharmacy services

(1) No pharmacist may provide pharmacy services to a residential care facility or home or to a resident thereof unless the pharmacist has been appointed by the licensee of that facility or home.

(2) A pharmacist must not allow any person to interfere with his or her professional duties, as specified in the Act and these bylaws.

(3) The pharmacist must facilitate the implementation of this bylaw and must confirm ongoing compliance with the bylaw by visiting and auditing a residential care facility at least every three months and a residential care home at least once every year. A record of these audits must be maintained in the pharmacy for a period of three years.

(4) The pharmacist must advise in the development of policies and procedures for

(a) safe and effective distribution, administration and control of medications within the residential care facility or home,

(b) reporting medication incidents, and

(c) monitoring therapeutic outcomes and reporting adverse drug reactions. These policies and procedures must be available in a policy and procedure manual in the residential care facility or home.

(5) The pharmacist must ensure that all medications are stored in a separate and locked area within the residential care facility or home. This medication storage area must not be used for any other purpose and must be inspected by the pharmacist during onsite audits.

(6) The pharmacist must ensure that a copy of this bylaw is available in the residential care facility or home.

Quality management

(1) A pharmacy providing services to a residential care facility or home must have a documented ongoing quality management program that monitors the pharmacy services provided. The program must include a process for the reporting and documentation of medication incidents and discrepancies and their follow-up.

Prescription authorizations

(1) A pharmacist must only dispense a medication to a resident upon the receipt of an authorization from a practitioner.

(2) When the resident is readmitted to a facility or home following a period of hospitalization, new prescription authorizations must be received from a practitioner before the resumption of medication administration.

(3) A prescription authorization may be transmitted from the practitioner to the pharmacy servicing the residential care facility or home verbally, electronically or in written form.

(4) If a prescription authorization is transmitted verbally, the pharmacist must immediately reduce the authorization to written form and keep it as a hard copy.

(5) If a prescription authorization is transmitted electronically, the pharmacist may use the facsimile hard copy as the permanent written record for dispensing, numbering, initialing and filing.

(6) A prescription authorization, written and signed by a practitioner on a resident's health record at a residential care facility or home, may be electronically transmitted to the pharmacy and the pharmacist may dispense the medication.

Dispensing

(1) A blister-packaged, monitored dosage system must be used except where the form of the medication does not permit such packaging. Each package must contain no less than a one-day and no more than a 35-day supply of medication.

(2) Where directions for the use of a medication are changed by the practitioner, the pharmacist must, following receipt of the required confirmation, initiate and dispense a new prescription.

Contingency medications

(1) The pharmacist may establish a supply of contingency medications at a residential care facility or home to permit the commencement of therapy upon receipt of a prescription authorization and to continue the regimen until the medication supply arrives from the pharmacy.

(2) Contingency medications must be prepared by the pharmacy and dispensed in a blister-packaged monitored dosage system, where applicable.

(3) A list of the contingency medications stocked must be available in the residential care facility or home and in the pharmacy.

(4) Records of use of contingency medications must be kept in the residential care facility or home and must include

(a) date(s) and time(s) the medication was used,

(b) name, strength and quantity of the medication used,

(d) name or initials of the person who administered the medication, and

(e) name of the practitioner.

Standing orders

(1) Standing orders for Schedule II and III medications and for unscheduled drugs that are administered for common, self-limiting conditions may be established by the medication safety and advisory committee for a residential care facility or home.

(2) Standing order medications for a resident must be authorized by a practitioner. Reorders must be authorized and signed by a practitioner on an annual basis. Signed standing orders must be available at the residential care facility or home, both for staff to consult and for inspection.

(3) Records of use of standing order medications are not required; however, medication administration must be recorded on the resident's medication administration record.

Returned medications

(1) The pharmacist must provide for the return of all discontinued medications to the pharmacy at the time of the next scheduled medication delivery.

(2) All previously dispensed medications must not be redispensed unless returned to the pharmacy in a sealed dosage unit or container as originally dispensed and where the labelling is intact and the labelling includes the medication lot number and expiry date.

(3) If the pharmacist cannot confirm the integrity of the medication that has been returned, the medication must not be redispensed.

(4) Policies and procedures must be in place to ensure that following the hospitalization of a resident, the resident's medications are returned to the pharmacy.

Medication containers and prescription labels

(1) The pharmacist must be responsible for the labelling of all medications. Where a resident has obtained a supply of a Schedule II or III medications from an external source, the medications must be sent to the pharmacy for

(a) identification,

(b) repackaging in a blister-package if applicable,

(d) inclusion on the patient record and subsequent medication administration record.

(2) All prescribed medications must be labelled with a typed or machine printed label that contains the following

(a) name, address and phone number of the pharmacy,

(b) prescription number and current dispensing date,

(d) name of the practitioner,

(e) for single-entity products, the generic name of drug followed by the brand name or the manufacturer name or the Drug Identification Number,

(f) for multiple-entity products, the brand name or all ingredients listed followed by the manufacturer name or the Drug Identification Number,

(g) for compounded preparations, all ingredients where possible,

(h) strength of the medication,

(i) practitioner's directions for use which must include specific dosing frequency or interval,

(j) route of administration,

(k) medical indication for use for all "as required" prescription authorizations, and

(l) accessory or cautionary statements as indicated.

(3) If labels are produced for intended application to a resident's medication administration record, the label must indicate "for MAR."

(4) Blister-packages and all other repackaged medications must be labelled with the medication expiry date and manufacturer lot number.

(5) A pharmacist may not delegate the labelling of medication containers or blister-packages to an employee of a residential care facility or home.

Patient record

(1) The pharmacist must maintain a patient record for each resident.

(2) The patient record must include

(a) resident's full name, personal health number as assigned by the British Columbia Ministry of Health, birth date, gender, practitioner name, the name of the facility and where possible, the resident's location within the facility,

(b) diagnoses,

(d) prescription number, names and Drug Identification Numbers of all medications dispensed, directions for use, dosage form, strength, quantity, route of administration, dosage times, dates dispensed and dates and reasons for early discontinuation of therapy.

(3) Where a medication is to be administered on a "when necessary" basis, the patient record and prescription label must clearly indicate the following

(a) specific indication for which the medication is to be given, and

(b) minimum interval of time to be observed between doses, or

(4) Before dispensing a medication, the pharmacist must review the patient record to identify any

(a) drug interactions,

(b) allergies,

(d) contraindicated medications,

(e) unintended dosage changes,

(f) inappropriate drug therapy,

(g) unusual dosages, or

(h) any other potential drug-related problems which may adversely affect the resident.

Resident medication administration records

(1) The pharmacist must provide a medication administration record for each resident in a residential care facility or home.

(2) The medication administration record must be current for each resident based on the information on the patient record and must be sent to the residential care facility or home for each month.

(3) The resident's medication administration record must include

(a) resident's full name,

(b) resident's location within the facility or home, where possible,

(d) allergies,

(e) diagnoses,

(f) month for which the record is to be used,

(g) name and strength of all medications currently being administered, including those to be administered on a "when necessary" basis,

(h) full directions for use.

Medication safety and advisory committee

(1) A pharmacist who provides pharmacy services to a residential care facility must be a member of that facility's medication safety and advisory committee.

(2) The pharmacist must ensure that the medication safety and advisory committee meets at least every six months to perform its duties and that each committee member receives a copy of the proceedings.

(3) The pharmacist must ensure that a record is kept of the proceedings of the medication safety and advisory committee meetings. This record must be available to the Inspector for a period of three years.

Resident medication review

(1) At residential care facilities, each resident's medication regimen must be reviewed on site, at least every six months, by the pharmacist, with a practitioner when available and a registered nurse where one is employed. Any other appropriate residential care facility staff member approved by the medication