Jacob Saling, PharmD

Pharmacies have to act fast during public health emergencies such as the coronavirus disease 2019 (COVID-19) pandemic. As an essential business, it is of the highest importance to put policies into place to protect pharmacy staff so that the business can continue to function and serve the needs of its patients during this public health crisis.

Frontline health-care workers have higher rates for seropositivity than non-clinical staff during a pandemic.

 Using guidance from governmental and professional organizations can aid in the rapid development of safety protocols for pharmacy personnel.

Resources from institutions such as the Centers for Disease Control and Prevention (CDC), pharmacy consultant organizations, wholesaler and buying groups, and state and national pharmacy associations are the first step to developing and implementing new emergency policies.

Using such guidance, some key best practices for protecting pharmacy personnel during the COVID-19 pandemic include:

Closing the pharmacy retail front-end and diverting patients to drive-through and/or curbside service.

Enrolling patients in appointment-based medication synchronization to reduce patient trips to pharmacy.

Using shift teams to prevent crossover infection.

Increasing hand washing and pharmacy cleaning.

Including pharmacy personnel in decision-making whenever possible and ensuring explicit and constant communication on policies, procedures, and best practices for implementation into busy pharmacy workflow

In an effort to keep pharmacy staff healthy, Gault Family Pharmacy closed the front-end of all retail locations and are operating via the drive-through, curbside pickup, and delivery services.  Their delivery services have been greatly expanded and pharmacy staff are making increased efforts to enroll all patients in appointment-based medication synchronization to decrease the number of trips that patients are making to the pharmacy.

A shift team-based approach has been implemented to increase the degree of separation inside the pharmacies. This team-based approach divides pharmacy staff into different shifts and does not allow for any crossover of staff members.

Implementing this approach also prepares the pharmacy for a scenario where if any of the team members becomes infected, the whole team of the individual infected would quarantine and the pharmacy would still be able to operate with the opposite team. With the implementation of this policy, increased hand washing has been integrated into pharmacy workflow. It is also mandatory that staff thoroughly clean the pharmacy at the open and close of business.

Determining policies and procedures to select for the pharmacy also followed a team-based approach to ensure buy-in and to ensure that each team member was on the same page.

Once the decisions were made, explicit direction was given to personnel on how to best implement hand washing into workflow and 2 different cleaning solutions (with different contact times) have been provided to pharmacies with instructions on how to use each and when. It is also important to make address the individual staff member’s desire for additional precautions, such as permission to wear masks.

In some cases, a pharmacy may not be able to close their front end. In these cases, additional precautions such as the installation of plexiglass partitions at checkout lanes as well as providing signage and marking on floors indicating where to line up to maintain 6 feet of distance from other patients to promote social distancing.

As essential businesses in a public health crisis, such as the COVID-19 pandemic, pharmacies have an obligation to ensure access to patient care and medication access. However, in doing so, pharmacists and support personnel who on the frontlines are potentially at risk of infection.

To protect pharmacy staff, it is critical to stay up-to-date on the latest guidance from governmental and professional organizations, adapt guidance to the unique characteristics of the pharmacy, and ensure consistent communication with explicit instructions for pharmacy personnel.

Marshall C, Kelso A, McBryde E, Barr IG, Eisen DP, Sasadeusz J, Buising K, Cheng AC, Johnson P, Richards M. Pandemic (H1N1) 2009 risk for frontline health care workers. Emerging infectious diseases. 2011 Jun;17(6):1000.

Centers for Disease Control and Prevention. 2020. 

https://www.pharmacist.com/coronavirus?is_sso_called=1

COVID-19: Information From The States - NASPA

https://naspa.us/resource/covid-19-information-from-the-states

Pharmacist.com. 2020. [online] Available at: 

https://www.pharmacist.com/sites/default/files/files/APHA%20Meeting%20Update/PHARMACISTS_COVID19-Final-3-20-20.pdf

Articles

Key best practices for protecting pharmacy personnel during the COVID-19 pandemic.