Standards of Operation describe the minimum acceptable standards for operating a licensed pharmacy in the province. These standards are intended to promote safety and consistency in the provision of pharmacy services in the province.
The Standards of Operation for Community Pharmacy apply to all licensed community pharmacies as well as licensed hospital pharmacies when dispensing medications to out-patients. The Standards of Operation for Hospital Pharmacy apply to all licensed hospital pharmacies.
Standards of Pharmacy Operation – Community Pharmacy
Standards of Pharmacy Operation – Hospital Pharmacy
Standards of Pharmacy Operation – Hospital Pharmacy *for implementation by no later than January 1, 2027*
Standards of Pharmacy Operation – Hospital Pharmacy (previous version)
FAQ
Can I legally fill a prescription written by a prescriber who is not licensed in Newfoundland and Labrador (NL)?
In accordance with Section 64 of the Pharmacy Act, 2024, prescriptions written by prescribers who are not licensed and practicing in NL may be filled in this province if:
the prescriber is licensed and practises in Canada; and
the prescriber belongs to a class of persons who, if licensed in NL, would be entitled by law to prescribe in NL.
At this time, dentists, nurse practitioners, optometrists, pharmacists, physicians, registered nurses, and veterinarians all have varying authorities to prescribe in NL. An out-of-province prescriber would have to belong to one of these groups for their prescription to be valid in this province.
Pharmacy professionals are also reminded that the onus is on them to verify that prescriptions are current, authentic, complete, and appropriate before dispensing. This may include validating that the prescriber is appropriately registered and authorized to prescribe, or verifying that the prescription is written in accordance with any applicable legislation, both federal and provincial, including the Tamper Resistant Prescription Drug Pad Program, if applicable.
WHat methods of prescription transmission are acceptable?
As new technologies emerge and patient expectations change, there has been a shift in how prescriptions are transmitted from prescriber to pharmacy. Although there are many different methods in use, regardless of the method, pharmacy professionals are still expected to ensure that prescriptions are current, authentic, complete, and appropriate before dispensing. Additionally, pharmacy professionals have to meet expectations of the Personal Health Information Act and the CPNL Code of Ethics, with respect to patient privacy and security of personal health information. Acceptable methods could include:
Prescriptions that are handwritten and signed by the prescriber and then either given to the patient to bring to their pharmacy or faxed directly to a pharmacy from the prescriber in accordance with section 3.3 of the Standards of Pharmacy Operation – Community Pharmacy.
Prescriptions that are generated electronically, printed, and hand-signed by the prescriber and then either given to the patient to bring to their pharmacy or faxed directly to a pharmacy from the prescriber in accordance with the Standards of Pharmacy Operation.
Prescriptions that are generated electronically by a prescriber’s password-protected electronic medical record (EMR) and sent directly to a pharmacy from that system.
At this time, prescriptions for drugs referenced in section 4 of the Pharmaceutical Services Regulations – i.e. the “Drugs Required to be Written on Tamper Resistant Pads” – must still be written on the required pad before either being given to the patient to bring to their pharmacy or faxed directly to a pharmacy from the prescriber in accordance with the Standards of Pharmacy Operation.
What about apps or other technologies that allow a patient to send a picture of their prescription to the pharmacy?
If a patient uses an app, tect message, or email to provide the pharmacy with an image of a prescription, pharmacy team members may use the image to see if stock is available, offer an estimation on cost, or confirm third-party drug coverage. However, images of a prescription are not equivalent to an original prescription and should not be used to prepare prescriptions in advance of receiving the original copy. Doing so increases the risk of error as well as the possibility of creating inaccurate or duplicate records within the electronic health record (EHR). With more and more health professionals relying on the real-time information provided in the EHR, the integrity of the record is more important than ever, and pharmacy professionals have a responsibility to ensure the accuracy of the information they transmit to the EHR.
Pharmacy owners and pharmacists in charge are responsible for assessing whether new technologies comply with provincial legislation and standards of pharmacy practice before offering them to patients. This includes considering whether a Pricacy Impact Assessment may be necessary, in accordance with the guidance given by the Office of the Information and Privacy Commissioner (OIPC).
How should I handle new prescriptions or requests for refills when a prescriber passes away, retires, or otherwise ceases to practice?
As long as the prescriber was licensed at the time the prescription was written, it can be assumed that the prescription was written in good faith. As such, assuming the prescription is not more than a year old, it would still be considered a legal prescription. Another question to consider in these instances is whether filling or re-filling the prescription is appropriate – which needs to be assessed on a case-by-case basis. CPNL advises pharmacists who receive such requests that it is in their professional responsibility to evaluate the appropriateness of the prescription in each individual situation, considering questions related to patient assessment and the patient’s best interests. Questions to consider include, but are not limited to:
How long ago was the prescription written? Was it intended to be a short-term supply?
Is the medication for a condition that is considered to be chronic or long-term? If so, does the patient have an established stable, compliant history with the medication?
Is the patient unable to visit a new primary health care provider in a timely manner?
Is the patient at an increased risk of harm by filling or re-filling the medication? Or conversely, is the patient at an increased risk of harm if the medication is not provided in accordance with the original prescription?
Is the prescriber was still practicing, would I have consulted with the prescriber for any reason before filling or re-filling the medication?
Is there another option? Would providing an interim supply or prescription extension be appropriate, if indicated?
Regardless of the pharmacist’s decision, the patient should be advised to find a new or interim prescriber as soon as possible.
Standards of Practice
Standards of Practice are minimum standards that all registered pharmacy professionals are expected to meet. Regardless of position or practice environment, when a pharmacy professional performs a specific role, they must perform it to the level specified in the Standards of Practice for Pharmacists and Pharmacy Technicians as well as any additional standards of practice associated with that role.
Standards of Practice for Pharmacists and Pharmacy Technicians in Canada
Standards of Practice for the Administration of Drug Therapy by Inhalation or Injection
Standards of Practice for Continuous Quality Improvement and Medication Incident Reporting in Community Pharmacies
Standards of Practice for Medical Assistance in Dying
Standards of Practice for Pharmacist-Ordered Laboratory Tests
Standards of Practice for Pharmacy Compounding of Hazardous Sterile Preparations
Standards of Practice for Pharmacy Compounding of Non-Hazardous Sterile Preparations
Standards of Practice for Pharmacy Compounding of Non-Sterile Preparations
Standards of Practice for Prescribing by Pharmacists
Standards of Practice for the Provision of Compliance Packages
Standards of Practice for the Provision of Opioid Agonist Therapy Medications
Standards of Practice for the Provision of Pharmaceutical Care to Long-Term Care Facilities
Standards of Practice for the Provision of Pharmaceutical Care to Personal Care Homes
Standards of Practice for the Sale of Exempted Codeine Products in Community Pharmacies
