New Age Limit for Drug Administration by Injection Now in Effect

New Age Limit for Drug Administration by Injection Now in Effect 

As of Friday April 15, 2022, amendments to the Drug Administration by Injection and Intranasal Route Standards, Limits and Conditions to lower the age limit for drug administration by injection to patients 4 years of age are in effect. 

This means that pharmacists in British Columbia with valid injection certification may now administer immunizations by injection to children as young as 4 years old. 

These amendments were approved by the College Board at its February 2022 meeting. 

Pharmacists in BC have been involved in safely administering vaccines to patients 5 years of age and older for many years. With the onset of COVID-19, many public health resources have been re-deployed to address the pandemic, which has been reported to have impacted immunization services for children in some regions. The change to allow pharmacists to administer vaccines to patients as young as 4 years may have a beneficial impact for those seeking school-entry vaccines from pharmacies. 

The College expects registrants to practice within the scope of their education, training, and competence, and to seek out the knowledge and expertise they need to provide competent care, if necessary.

Additional Amendments to Drug Administration by Injection and Intranasal Route Standards, Limits and Conditions. 

The College also conducted an environmental scan of drug administration standards in other Canadian jurisdictions to determine if any areas of the Drug Administration Standards, Limits and Conditions would benefit from additional provisions or clarification . Many of these changes are housekeeping in nature.

The following amendments were also approved by the Board at its February 2022 meeting and are in effect as of April 15, 2022: 

Requirements to Act in the Patient’s Best Interest, and to administer a drug within the scope of their education, training, and competence

New standards were added to clarify that pharmacists must act in the best interest of the patient and to take all appropriate steps to ensure the drug is administered safely, and that they must only administer a drug within the scope of their education, training and competence. These are similar to provisions found in the Code of Ethics.

Requirements for Assessment of Appropriateness 

A new standard was added that requires a pharmacist to assess the appropriateness of the timing and frequency of drug administration. 

Requirements for Informed Consent 

Requirements for pharmacists to discuss the expected reaction with the patient or patient’s representative as part of the informed consent process were added to ensure patients have the information necessary to make an informed decision. 

Requirements for Drug Preparation 

New standards were added to clarify that pharmacists must ensure the drug to be administered is stable and has been stored and labelled appropriately prior to administration, and that they must take appropriate steps to ensure the right drug is administered to the right patient. 

Requirements Following Administration 

New standards clarify the requirement for a pharmacist to appropriately monitor a patient following drug administration, and to dispose of drugs, devices and supplies in a safe and appropriate manner. 

Requirements for “Notification and Providing Relevant Information”

A new standard was added outlining existing requirements to report adverse events and reactions to the applicable government agency. 

Requirements for Documentation 

New documentation standards were added, which require pharmacists to: 

• Document the identification of the pharmacist who administered the drug, as this is important for accountability and traceability. 
• Document the patient response to drug administration, and to document the management provided if an adverse event occurs. These are important for a complete record of the administration of the drug, as the absence of documentation may not be sufficient to demonstrate that the patient tolerated the drug administration well.
• Document the expiry date of the drug. Documenting the expiry date ensures that the pharmacist has checked it prior to administration. 

Requirements to Implement Emergency Measures 

To align with a principle-based format, the examples of specific emergency measures (e.g., basic first aid) were removed. In their place, a new standard was added requiring pharmacists to ensure access to the drugs, devices, and other necessary equipment and supplies used to treat reactions to administered drugs. 

Additionally, another new standard was added requiring pharmacists to respond appropriately to complications and emergencies if they arise.