1. Centralization of Services
When do you Refer?
Centralization of Services
Chains may need to close some locations
and set up hub stores
Computer software
Access patient profiles from remote location or
DPIN remote profile
Central fill
Public has to be notified of any changes
If staff are constantly sick it may be necessary to close some of the pharmacies and relocate staff to a restricted number of open locations. Which pharmacies are going to stay open, and which pharmacies will close?
It is important that your computer software sets up your system so that you can access patient profiles from the computers at closed locations
Notify the public should this occur how?

2. How has the Pandemic Affected my Practice?
When do you Refer?

3. How is the Pandemic Currently Affecting my Practice?
When do you Refer?
How is the Pandemic Currently Affecting my Practice?
It already has!
Increased public awareness
More people asking about how to manage cold and flu symptoms
Absenteeism
Colleagues more aware of the need to stay home if sick
No increase in antiviral medications
Not prescribed unless high risk
Testing for H1N1 not done routinely
So far in my own practice, with H1N1 I have noticed an increase lately in cold and flu management, including which medications patients can purchase over the counter.
People seem to be more aware of their environment, and it is safe to say that almost everyone has heard some sort of information about H1N1.
Recently I have placed hand sanitizer at the drop off counter, pick up counter, and counselling area, and have noticed that people are using it quite frequently.
Staff are also taking more sick days, which indicates they are aware of the situation and the appropriate protocols to stay home if you are sick.
There hasn’t been an increase in the prescribing of antiviral medications thus far in the pharmacy I work in, but this can be attributed to the fact that antivirals are not routinely prescribed unless you are a patient who is at high risk of developing complications from the flu
Testing for the H1N1 virus is not routinely done unless you are a patient at high risk.

4. Resources for Pandemic Planning
When do you Refer?
Resources for Pandemic Planning
Review Emergency Preparedness Plans
CPhA
_resources/pandemic2.cfm
Manitoba Pharmaceutical Association
Resource Kit
Health Canada
Preparedness Kit Handout: alerte/h1n1/guide/pdf/h1n1_preparedness_kit-eng.pdf
Flu Prevention Checklist: alerte/h1n1/guide/pdf/h1n1_prevention_list-eng.pdf
H1N1 Preparedness Guide: Order copies at O-Canada ( ) alerte/h1n1/guide/pdf/h1n1_guide-eng.pdf
‘Pharmacists are strongly encouraged to review their emergency preparedness plans. CPhA has developed an extensive pandemic guide for pharmacists that includes information on the role of the pharmacist, infection control, developing your plan, supply chain issues, business continuity, etc.’ 3CPHA has posted documents on their website which can assist you with infection control and personal measures that you can adopt as best practices that will increase the odds that you will stay healthy during this flu season.
The Manitoba Pharmaceutical Association will be developing a Resource package for pharmacists in Manitoba which includes a useful Manager’s Checklist. This resource package will be mailed out to pharmacists, and is also accessible at their website,
Health Canada: The following can be used as handouts for your patients
Preparedness Kit: Highlights a home preparedeness kit for you to follow BEFORE you get sick.
Flu Prevention Checklist: Highlights what you should do to prevent getting sick
H1N1 Preparedness Guide: Useful information for everyone about H1N1

8. Resources for Pandemic Planning
When do you Refer?
Resources for Pandemic Planning
Pharmacists should regularly visit the MHHL H1N1 Flu Information Site at
Information changes all of the time so regularly update yourself
Patient handouts/posters:
Could it be the Flu? Handout/Poster for Patients
Handwashing/Coughing Etiquette posters
Video for kids about handwashing and coughing:

15. Resources for Updated H1N1 Information
Manitoba Health
INFECTION PREVENTION AND CONTROL GUIDELINES: s/ipcili.pdf
Public Health Division: x.html#guidelines

16. More Resources for Updated H1N1 Information
When do you Refer?
More Resources for Updated H1N1 Information
Public Health Contact Information:
Manitoba:
H1N1 Flu Hotline:
The Canadian Flu Guide: (FREE CEUs)
Health Canada website: alerte/h1n1/faq_rg_h1n1-eng.php
Centers for Disease Control and Prevention:
Public Health Agency of Canada: aspc.gc.ca/alert-alerte/h1n1/surveillance-eng.php
MPhA H1N1 Flu Information site:
Manitoba Health H1N1 Flu Information site:
How to Prepare a Tamiflu Suspension:

17. In Summary Understand your role as a pharmacist
When do you Refer?
In Summary
Understand your role as a pharmacist
Triage and patient referral, communication, planning
Have a pandemic plan in place
Consider prevention, public education, labour, communication, security, hours of operation, critical activities, inventory, vendors, centralization of services
Resources for pandemic planning
Patient handouts
Many resources available for updated information – Use them!
(Read slide)

18. References When do you Refer?
1. Key Facts on H1N1 Flu Virus – Public Health Canada. alerte/h1n1/fs-fr_h1n1—eng.php?option=print. Accessed 16/09/09
2. Public Health Agency of Canada: Frequently Asked Questions – H1N1 Virus. aspc.gc.ca/alert-alerte/h1n1/faq_rg_h1n1-eng.php. Accessed 16/09/09
3. World Health Organization: Global Alert and Response: Pandemic (H1N1) 2009 Update 69: Accessed October 16, 2009
4. CHE Learning Module: swf
5. Guidance on H1N1 influenza vaccine sequencing, Public Health Agency of Canada H1N1 update, European Centre for Disease Control and Prevention (in .pdf format): Accessed October 2, 2009.
6. The Canadian Pandemic (H1N1) 2009 Flu Guide. Educational Program. swf
7. The Canadian Press: Lots of rest, fluids, chicken soup a recipe for toughing out Swine flu: doctors. Written by: Sheryl Ubelacker, Health Reporter Oct. 12, 2009: =0&channel_id=0
8. Swine Flu FAQ: Msn source: documentid= Accessed September 29, 2009.
9. The Benefit of Hand Washing – Health Canada. maladies/hands-mains-eng.php#how. Accessed September 29,2009
10. Health Canada. Symptoms of the Flu Virus (H1N1 and Seasonal) and Severity Indicators. Accessed October 20, 2009
Health Canada Website: Tools and Resources: alerte/h1n1/tools_outils-eng.php . Accessed October 20, 2009
Manitoba Health H1N1 Flu Information site: Accessed October 20, 2009

19. When do you Refer?
Questions?