Coronavirus Illness 2019 (COVID-19)

This steerage applies to all pharmacy workers to reduce their threat of publicity to SARS-CoV-2 and cut back the chance for sufferers throughout the COVID-19 pandemic. As a significant a part of the healthcare system, pharmacies play an essential function in offering medicines, therapeutics, vaccines, and important well being companies to the general public. Guaranteeing steady perform of pharmacies throughout the COVID-19 pandemic is essential. In the course of the pandemic, pharmacy workers can decrease their threat of publicity to the virus that causes COVID-19 and cut back the chance for sufferers through the use of the ideas of an infection prevention and management and social distancing.

Implement common use of face coverings

• People with out coronavirus signs (“asymptomatic”) and those that ultimately develop signs (“pre-symptomatic”) can transmit the virus to others earlier than exhibiting signs.  Which means the virus can unfold between folks interacting in shut proximity—for instance, talking, coughing, or sneezing—even when these individuals are not exhibiting signs.
• Everybody coming into the pharmacy ought to put on a face overlaying for supply management (i.e., to guard different folks in case the particular person is contaminated), no matter signs. CDC recommends individuals coming into public settings the place different social distancing measures are tough to take care of put on a fabric face overlaying, particularly in areas of considerable community-based transmission. Material face coverings shouldn’t be positioned on younger kids below age 2, anybody who has hassle respiratory, or is unconscious, incapacitated or in any other case unable to take away the masks with out help.
• Pharmacists and pharmacy technicians ought to at all times put on a facemask whereas they’re within the pharmacy for supply management.
• Medical or surgical facemasks are typically most well-liked over fabric face coverings for healthcare professionals (HCP) for supply management. If there are shortages of facemasks, facemasks must be prioritized for HCP who want them for PPE. Material face coverings ought to NOT be worn as an alternative of a respirator or facemask if greater than supply management is required.

Advise workers who’re sick to remain dwelling

Be sure that pharmacy workers who’ve fever or signs that could be because of COVID-19 keep dwelling and away from the office till they’ve recovered. Be certain that sick depart insurance policies are versatile, nonpunitive, and in step with public well being steerage and that staff are conscious of and perceive these insurance policies.

Filling prescriptions

Though the precise technique of getting ready medicines for dishing out shouldn’t be a direct affected person care exercise, the opposite parts of medicine dishing out similar to prescription consumption, affected person counseling, or affected person training must be carried out in ways in which keep social distancing and decrease the chance of publicity for pharmacy workers and sufferers. Along with following office steerage, pharmacy workers ought to:

• Present hand sanitizer containing no less than 60% alcohol on counters to be used by sufferers and have enough and quick access to cleaning soap and water or hand sanitizer for employees.
• Encourage all prescribers to submit prescription orders through phone or electronically. The pharmacy ought to develop procedures to keep away from dealing with paper prescriptions, in accordance with applicable state legal guidelines, laws, or government orders.
• After a prescription has been ready, the packaged medicine might be positioned on a counter for the affected person to retrieve, as an alternative of being immediately handed to the affected person. Different methods to restrict direct contact with sufferers embody:
  • Keep away from dealing with insurance coverage or profit playing cards. As a substitute, have the affected person take an image of the cardboard for processing or learn aloud the data that’s wanted (in a personal location so different sufferers can not hear).
  • Keep away from touching objects which have been dealt with by sufferers. If switch of things should happen, pharmacy workers ought to wash their fingers afterwards with cleaning soap and water for no less than 20 seconds or use an alcohol-based hand sanitizer containing no less than 60% alcohol. They need to at all times keep away from touching their eyes, nostril, or mouth with unwashed fingers.
• Encourage sufferers, particularly these at elevated threat of extreme sickness, to make use of alternate strategies to pick-up medicine. To lower threat of publicity, sufferers who’ve an elevated threat for extreme sickness because of COVID-19 could think about using:
  • Residence supply of medicines
  • Curbside pickup
  • Drive-through companies
  • Having another person who shouldn’t be at increased threat of extreme sickness choose up medicines for them

Use methods to reduce shut contact between pharmacy workers and sufferers and between sufferers:

• Use engineering controls the place the affected person and pharmacy workers work together, similar to on the pharmacy counter, to reduce shut contact:
  • Decrease bodily contact with sufferers and between sufferers. Keep social distancing (6 ft between people) for folks coming into the pharmacy as a lot as potential. Use signage/obstacles and flooring markers to instruct ready sufferers to stay 6 ft again from the counter, from different affected person interfaces, and from different sufferers and pharmacy workers.
  • To defend in opposition to droplets from coughs or sneezes, set up a piece of clear plastic on the affected person contact space to offer barrier safety (e.g., plexiglass kind materials or clear plastic sheet). Configure with a pass-through opening on the backside of the barrier for folks to talk by way of or to offer pharmacy gadgets.
  • For arduous non-porous surfaces, clear with detergent or cleaning soap and water if the surfaces are visibly soiled previous to disinfectant software. Continuously clear and disinfect all affected person service counters and affected person contact areas. Clear and disinfect often touched objects and surfaces similar to workstations, keyboards, telephones, and doorknobs.
  • Clear and disinfect self-serve blood stress items between prospects. These gadgets must be utilized in accordance with the producer’s directions.
    • Routine cleansing with cleaning soap and water will lower how a lot of the virus is on surfaces, which reduces the chance of publicity.
    • Disinfection utilizing EPA-approved disinfectants in opposition to COVID-19exterior icon also can assist cut back the chance when utilized in accordance with the producer’s directions.
    • Submit signage advising prospects to put on masks throughout use and to scrub their fingers or use a hand sanitizer that incorporates no less than 60% alcohol, each earlier than and after utilizing the blood stress unit.
  • Discontinue the usage of magazines and different shared gadgets in pharmacy ready areas. Be certain that the ready space is cleaned recurrently.
  • Promote the usage of self-serve checkout registers and clear and disinfect them often. Encourage the usage of and have hand sanitizer and disinfectant wipes out there at register places to be used by sufferers.
• Use administrative controls— similar to protocols or modifications to work practices, insurance policies, or procedures — to maintain workers and sufferers separated:
  • Promote social distancing by diverting as many sufferers as potential to drive-through home windows, curbside pick-up, or dwelling supply, the place possible.
    • Massive, outside signage asking pharmacy sufferers to make use of the drive-through window or name for curbside pick-up might be helpful.
    • Embody textual content or automated phone messages that particularly ask sick sufferers to remain dwelling and request dwelling supply or ship a nicely member of the family or pal to choose up their drugs.
  • Restrict the variety of sufferers within the pharmacy at any given time to stop crowding on the pharmacy counter or checkout areas past what might be managed by 6 ft distancing.
  • Pharmacists who’re offering sufferers with power illness administration companies, medicine administration companies, and different companies that don’t require face-to-face encounters ought to make each effort to make use of phone, telehealth, or tele-pharmacy methods.

Scale back threat throughout COVID-19 testing and different close-contact pharmacy care companies

Pharmacies which might be collaborating in public well being testing for COVID-19 ought to talk with native and state public well being workers to find out easy methods to operationalize and prioritize shopper testing. State and native well being departments will inform pharmacies about procedures to gather, retailer, and ship specimens appropriately, together with throughout afterhours or on weekends/holidays. Some pharmacies are together with self-collection choices.

Within the “CDC An infection Prevention and Management Suggestions for Sufferers with Suspected or Confirmed Coronavirus Illness 2019 (COVID-19) in Healthcare Settings,” there may be steerage for amassing respiratory specimens.

Pharmacy workers conducting COVID-19 testing and different close-contact affected person care procedures that can doubtless elicit coughs or sneezes (e.g., influenza and strep testing) must be supplied with applicable PPE. Employees who use respirators should be accustomed to correct use and observe an entire respiratory safety program that complies with OSHA Respiratory Safety commonplace (29 CFR 1910.134). Employees ought to obtain coaching on the applicable donning and doffing of PPE. Material face coverings ought to NOT be worn by workers as an alternative of a respirator or facemask if greater than supply management is required.

Present grownup vaccinations primarily based on native situations

Consider provision of routine scientific preventive companies, together with grownup vaccinations, that require face-to-face encounters. Based mostly on native situations, consider the chance of an in-person encounter versus the profit utilizing the Framework for Healthcare Techniques Offering Non-COVID-19 Scientific Care In the course of the COVID-19 Pandemic.

• Grownup vaccination must be thought of if the service might be delivered throughout a go to with no further threat to the affected person or the well being care supplier.
• Consideration must be given to prioritizing older adults or adults with underlying situations for vaccination because of their elevated threat of illness and problems if vaccination is deferred.
• Pharmacies ought to develop a technique for screening sufferers for fever and signs of COVID-19 previous to offering vaccinations.
• Well being care suppliers ought to observe commonplace precautions and cling to further PPE suggestions, together with use of a facemask always whereas within the facility. Use of eye safety is really useful in areas with reasonable to substantial neighborhood transmission. For areas with minimal to no neighborhood transmission, eye safety is taken into account elective, until in any other case indicated as a part of commonplace precautions.
• Hand hygiene must be carried out earlier than and after vaccine administration. If gloves are worn, they need to be modified and hand hygiene must be carried out between sufferers.