Medical Program: CDC Guidance for Pharmacy Staff on Minimizing Exposure to COVID-19

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You're listening to The Drug Report on ReachMD, hosted by Linda Bernstein, Pharm.D., Clinical Professor on the Volunteer Faculty of the School of Pharmacy, University of California, San Francisco.

Dr. Bernstein:
Welcome to The Drug Report with a special focus on the COVID-19 pandemic.

Pharmacies play a vital role in the healthcare system by providing medicines, therapeutics, vaccines, and critical health services to the public. The Centers for Disease Control has provided a guidance for pharmacy staff to minimize their risk of exposure to the COVID-19 virus and reduce customer risk during the pandemic.  Here are some highlights: 

• Staff should be advised to stay home if they are sick until they have recovered, particularly if they have a fever or respiratory symptoms. Make sure sick leave policies are flexible and nonpunitive and that they are understood by employees.   

Direct patient contact that occurs when medication dispensing, such as for prescription intake, patient counseling, or patient education, may expose pharmacy staff to individuals who may have respiratory illness. Follow the CDC workplace guidance, previously published, and also:   

• Provide hand sanitizer on counters for use by customers and have sufficient and easy access to soap and water or hand sanitizer for staff.
• Encourage all prescribers to submit prescription orders via telephone or electronically. Develop procedures to avoid handling paper prescriptions, as appropriate.
• Filling and dispensing prescriptions does not require use of PPE. After a prescription has been prepared, the packaged medication can be placed on the counter for the customer to retrieve, instead of being directly handed to the customer. Also…
  • Avoid handling insurance or benefit cards
  • Avoid touching objects that have been handled by customers. If transfer of items must occur, pharmacy staff should wash their hands afterwards with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer containing at least 60% alcohol. Avoid touching eyes, nose, or mouth with unwashed hands.
•  Use engineering controls where the customer and pharmacy staff interact, such as the pharmacy counter, to minimize close contact:
  • Minimize physical contact with customers and between customers. Maintain social distancing of 6 feet between individuals. Use signage/barriers and floor markers as required.
  • To shield against droplets from coughs or sneezes, install a section of clear plastic shield at the customer contact area to provide barrier protection
  • Frequently clean and disinfect all customer service surfaces. To disinfect, use products that meet EPA’s criteria for use against SARS-CoV-2.
  • Discontinue the use of magazines and other shared items in pharmacy waiting areas.
  • For pharmacies with a co-located retail clinic, use signs to ask customers who have respiratory symptoms to wait for their appointment in a separate part of the store.
  • Promote the use of self-serve checkout registers and clean them frequently.
  • Use administrative controls — such as protocols or changes to work practices, policies, or procedures — to keep staff and customers separated:
    • Promote social distancing by diverting as many customers as possible to drive-through windows, curbside pick-up, or home delivery, where feasible.
      • Request sick customers stay home and ask for home delivery or send a well family member or friend to pick up their medicine.
  • Limit the number of customers in the pharmacy
  • Use every effort to use telephone, telehealth, or tele-pharmacy strategies.
  • Close self-serve blood pressure units.

If your pharmacy is involved in public health testing, consult with state and local health departments about procedures to collect, store, and ship specimens appropriately. Pharmacy staff conducting COVID-19 testing and other close-contact patient care procedures that will likely elicit coughs or sneezes (e.g., influenza and strep testing) should be provided with appropriate PPE.

For The Drug Report, I’m pharmacist Dr. Linda Bernstein.

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