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Interim guidance for community pharmacies on COVID-19, including prevention of infection. For further information on infection prevention and control, please refer to the NSW Health and Clinical Excellence Commission websites.

On this page

  1. Limits on dispensing and sales at pharmacies
  2. Advice for pharmacists for managing the supply of medicines in the pandemic and assisting patients in home isolation
  3. General precautions and hygiene
  4. Patients who present with symptoms of respiratory tract infection
  5. More information

Limits on dispensing and sales at pharmacies

On March 19 2020 the Commonwealth Government announced that community pharmacists will be required to enforce new limits on the dispensing and sale of selected prescription and over-the-counter medicines. This new measure was adopted to ensure equitable access to medicines for all Australians in light of the observed increases in demand for medicines due to the COVID-19 pandemic. The decision was developed in consultation with, and supported by the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia and received support from the National Pharmaceutical Services Association.


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Community pharmacists are now required to:

  • Limit dispensing of certain prescription products to 1 months' supply at the prescribed dose, and sales of certain over-the-counter medicines to a maximum of one unit per purchase. Limits have been applied to classes of medicines for which unavailability or an interruption to treatment could result in significant health impacts, or which are expected to be subject to increased consumer demand associated with the COVID-19 pandemic. The complete list of medicines is published on the TGA website and other medicines may be added overtime.
  • Confirm that the supply of salbutamol inhalers (provided on an over-the-counter basis) is appropriate by confirming the patient's diagnosis, as well as labelling the product indicating to whom it has been dispensed and recording the supply. Only one product should be supplied per customer.
  • Place paracetamol paediatric formulations behind the counter to assist in allocating supply equitably. Only one product should be supplied per customer.

In addition, pharmacists are strongly encouraged to limit dispensing and sales of all other medicines to one months’ supply or one unit. Dispensing of multiple repeats is permitted only for valid Regulation 49 prescriptions. PBS Regulation 49 must be used sparingly and only in exceptional circumstances in accordance with the legislated criteria. If pharmacists have doubts about the appropriateness of particular Regulation 49 prescriptions they should discuss this with the prescriber.

Limits on pharmacy sales will be accompanied by limits on orders from wholesalers, to ensure equitable distribution of stock, including to regional and rural pharmacies. Supply of quantities that are not clinically required for an individual may be illegal under the NSW Poisons and Therapeutic Goods Regulation (S 23, 34, 79) and contravene Pharmacy Board Professional Practice guidelines.

Advice for pharmacists for managing the supply of medicines in the pandemic and assisting patients in home isolation

For practical advice for pharmacists for managing the supply of medicines in the pandemic and assisting patients in home isolation and for social distancing, refer to Advice for pharmacists for managing the supply of medicines in the pandemic and assisting patients in home isolation. A one-page summary is also available.

General precautions and hygiene

When someone who has Coronavirus Disease 2019 (COVID-19) coughs or exhales, they release droplets of infected fluid. Most of these droplets fall on nearby surfaces and objects – such as benches or telephones. People could become infected with COVID-19 by touching contaminated surfaces or objects – and then touching their eyes, nose or mouth. If they are standing within 1.5m of a person diagnosed with COVID-19 they could become infected by breathing in droplets coughed out or exhaled by the infected person. In other words, COVID-19 spreads in a similar way to all respiratory viruses like the common cold and influenza.

Most persons infected with COVID-19 experience mild symptoms and recover without medical intervention. However, some go on to experience more serious illness and may require hospital care. Risk of serious illness rises with age: people over 40 seem to be more vulnerable than those under 40. People with weakened immune systems and people with chronic conditions such as diabetes, heart and lung disease are also more vulnerable to serious illness or complications.

Infection prevention and control precautions for COVID-19 will also help prevent the spread of other common infections which present to pharmacies and protect your patients and staff. Community pharmacies are recommended to implement these precautions and hygiene measures as soon as practicable.

Principles of infection prevention and control in the community pharmacy

  • Promote good cough etiquette and respiratory hygiene.
    Good respiratory hygiene prevents the spread of COVID-19. Keep distance where possible with people who have cold or flu-like symptoms, cover coughs and sneezes with disposable tissues or clothing (e.g. into elbow), dispose of used tissues, and clean your hands afterwards.
  • Promote regular and thorough hand-hygiene by staff and patients.
    Hand hygiene kills the virus on hands and prevents the spread of COVID-19. Hand Hygiene can be done using soap and water or a waterless alcohol hand rub/foam for at least 20 seconds.

    Wash your hands:
    • before entering an area used by other people
    • after using the bathroom
    • after coughing or sneezing
    • before preparing food or eating
    • regularly throughout the work day.
  • Keep the environment clean.
    Contamination on surfaces touched by staff and patients is one of the main ways that COVID-19 spreads.
  • Encourage sick staff members to remain at home

Hand hygiene, cough etiquette and respiratory hygiene in the pharmacy

For patients

  • Display signage/posters in the pharmacy to encourage patients to practice hand hygiene, cough etiquette and respiratory hygiene whilst in the pharmacy and generally in the community.
  • Put alcohol-based hand rub dispensers in prominent places around the pharmacy especially at counters where surfaces are touched. Inform patients of places where they can wash their hands with soap and water for the minimum of 20 seconds.
  • Use social distancing of 1.5m where possible. Speak to patients from a safe distance to avoid contact with respiratory droplets.

For pharmacy staff

  • Ensure staff have access to handwashing facilities and alcohol-based hand rub
  • Practice effective hand hygiene, wash hands thoroughly throughout the work day or use an alcohol-based hand rub.
  • Practice cough etiquette and respiratory hygiene.
    • If you have respiratory symptoms from any respiratory illness, stay at home.
    • Ensure that surgical masks and / or paper tissues are available for staff, for those who develop a runny nose or cough at work, along with closed bins for hygienically disposing of them.
  • Social distancing is an effective measure, and should be used where practicable.
    • Within a pharmacy environment this may mean attempting to keep a distance of 1.5 metres between staff and patients where possible. Speak to patients from the other side of a counter or desk where possible.
    • Pharmacists undertaking direct clinical services (e.g. vaccination) should do so following standard precautions – a mask would not be required as a routine for this procedure.
  • Brief your staff and patients that if COVID-19 starts spreading in your community, anyone with even a mild cough or fever (37.3oC measured or subjective fever) should stay at home and contact HealthDirect 1800 022 222 for advice.

Patients who present with symptoms of respiratory tract infection

On presentation to the pharmacy, the symptomatic patient should:

  • self-identify through use of signage in the pharmacy
  • be given a surgical/procedural mask (if available) to wear during the pharmacy presentation. Masks can be obtained from your local Primary Health Network (PHN)
  • be referred to HealthDirect on 1800 022 222 to discuss COVID-19 testing or consider ambulance if the patient has severe symptoms such as difficulty breathing.

Masks

Pharmacy staff are advised to not wear face masks (neither surgical masks or P2/N95 respirator masks) as a precautionary measure. P2/N95 respirator masks are not required to be worn by patients unless they are immunocompromised and have been directed to do so by their treating specialist. Unless masks are used correctly they are unlikely to protect against airborne pathogen spread.

Cleaning

Regular environmental cleaning in the pharmacy is important for reducing the risk of transmission of pathogenic organisms, it is particularly important in containing the risk of spread of COVID-19. Contamination on surfaces touched by staff and patients is one of the main ways that COVID-19 spreads.

Pharmacy staff can ensure that the pharmacy is clean and hygienic by cleaning surfaces using a detergent and disinfectant. This can be either by a 2-step cleaning/disinfecting process, or using a product that combines both steps.

  • Using a detergent
    • A detergent is a surfactant that facilitates the removal of dirt and organic matter.
    • Most hard surfaces including counters can be adequately cleaned with warm water and a neutral detergent as per the manufacturer’s instructions.
    • Allowing the cleaned surfaces to dry is an important aspect of cleaning.
    • Routine cleaning of floors with detergent and water is recommended.
  • Using a disinfectant
    • A disinfectant rapidly kills or inactivates most infectious agents.
    • Disinfectants are not to be used as general cleaning agents, unless combined with a detergent as a combination cleaning agent.
    • Disinfection should always be undertaken following, and in addition to, detergent cleaning.
    • To choose a disinfectant refer to national Infection Prevention and Control guidelines.

Waste management

There are no additional controls required for disposing of waste, follow routine processes for disposal. Ensure closed bins are provided for safe disposal of tissues by staff and patients.

More information

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Current as at: Monday 30 March 2020
Contact page owner: Health Protection NSW