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Continuing Professional Development on Medication Safety

Frequently Asked Questions

  1. General Information
  2. Login
  3. Home
  4. Report an Incident
  5. Search
  6. Stats
  7. Your Account
  8. CE & Resources
  9. Quality Improvement
  10. Confidentiality/Privacy Policy

General Information

Who is ISMP Canada?

The Institute for Safe Medication Practices Canada (ISMP Canada) is an independent national not-for-profit agency committed to the advancement of medication safety in all healthcare settings. Our goal is the creation of safe and reliable systems for managing medications in all environments.

ISMP Canada works collaboratively with the healthcare community, regulatory agencies and policy makers, provincial, national and international patient safety organizations, the pharmaceutical industry and the public to promote safe medication practices.

ISMP Canada's mandate includes analyzing medication incidents, making recommendations for the prevention of harmful medication incidents, and facilitating quality improvement initiatives.

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Why should my pharmacy use CPhIR to report medication incidents?

The goal of ISMP Canada is to analyze medication incident reports and develop recommendations for enhancing patient safety in all healthcare settings. ISMP Canada created the CPhIR program with support from the Ontario Ministry of Health and Long-Term Care to specifically address incident reporting in community pharmacies. CPhIR contributes to the Canadian Medication Incident Reporting and Prevention System (CMIRPS).

Medication incidents are often under-reported. CPhIR will provide you with the ability to document and analyze contributing factors (e.g. miscommunication, staffing, and education) that can cause errors in the medication-use system. From the data reported and through understanding of the contributing factors, your pharmacy team can develop and implement system-based strategies for quality improvement and prevent potential errors from occurring again in the future.

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How long will it take to report a medication incident?

The amount of time depends on how much information is included in the report, but it probably will not take more than 10 minutes to complete a report.

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Is there a cost to using CPhIR?

There is an annual subscription rate to use CPhIR. Please refer to the ISMP Canada Product Price List.

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Login

I forgot my username and/or password - how do I get a new one?

ISMP Canada will provide a username and password to login for the first time. If the username and/or password is lost or forgotten, please contact ISMP Canada by clicking "Contact ISMP Canada" on the login page. This will launch an e-mail window. Please include your pharmacy name and the contact person in charge of CPhIR. You can expect a response within two business days.

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Is it possible to have more than one username per pharmacy?

No, each pharmacy location can only have access to one account. The key contact person will provide the username and password to pharmacy staff to report medication incidents. It is important to keep the password confidential.

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Home

What is an Open Incident?

An Open Incident is an incident that has been entered into the system and is available for editing within 90 days of the initial entry date.

All open incidents will automatically be closed after 90 days. Closed incidents can no longer be edited. Once an incident is closed, it is available for search and analysis.

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Can I access newsletters and publications about medication safety through CPhIR?

The following are provided by ISMP Canada complimentary to all CPhIR users and are accessible under the CPhIR home page:

  • ISMP Canada Safety Bulletins
  • SafeMedicationUse.ca Consumer Newsletters and Alerts
  • Medication Safety Alerts
  • TransPhIR from CPhIR Newsletter

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Report an Incident

Who can report a medication incident?

Any member of the pharmacy staff, including pharmacists, technicians, interns, and students, can use CPhIR to report medication incidents. All pharmacy staff members require the username and password to login to CPhIR.

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What information is required to report an incident?

The following information is mandatory:

  • Date Incident Occurred
  • Type of Incident
  • Incident Discovered By
  • Medication System Stages Involved in this Incident
  • Medication(s) Involved
  • Degree of Harm to Patient due to Incident
  • Incident Description/How the Incident was Discovered.

The following fields are optional: (i.e., not required to submit incident):

  • Time Incident Occurred
  • Patient's Gender
  • Patient's Age
  • Other Incident Information
  • Contributing Factors to this Incident
  • Actions at Store Level (Include action plan, person in charge, and target date for completion)
  • Shared Learning for ISMP Canada to Disseminate (What has been done to prevent a similar occurrence in the future)

When you are ready to click “Submit Report to ISMP Canada”, a reminder will pop up to make sure that you do not supply identifying information (e.g. patient name or date of birth, pharmacy name, or healthcare provider names). Once you hit submit, the incident information is then stored into the ISMP Canada secured CPhIR database.

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Do I enter the date the medication incident occurred or the date it was discovered?

Please enter the date the incident occurred. For example, if an incorrect medication was dispensed Tuesday evening and the patient returns Wednesday morning, the incident happened Tuesday evening and this is the date entered.

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If an incident or quality related event is identified and resolved prior to prescription order entry and dispensing, how can I capture this information in CPhIR?

In this case, if applicable, check the "Prescribing" option next to the "Medication System Stages Involved in this Incident" field. Alternatively, you can document this information in the "Incident Description" field.

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Can I enter more than two medications?

Yes, as you complete each medication field, a new medication field will appear.

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When a medication is entered, the black medication box disappears before I can choose a medication - can it stay open longer?

To view the options in the black auto-finish box, roll the cursor anywhere within the box and it will remain open until a selection is chosen.

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Can I enter the DIN instead of the medication name in the medication field?

Yes, the black auto-finish box will also appear if a partial DIN is entered. If the DIN is chosen from the list, the medication name will automatically be entered.

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If an incident occurs in which an incorrect medication has been dispensed, which medication should be identified in the Medication field?

The incorrectly dispensed medication should be specified in the "Medication" field, as this was the medication that was involved in the medication incident. Mention the intended medication that was to be dispensed in the "Incident Description" field.

For example, in the instance that Prevacid was inadvertently dispensed instead of Percocet, enter Prevacid in the "Medication" field and mention Percocet in the "Incident Description" field.

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The expiry date and lot number of the medication dispensed were not properly recorded. Where can I document this in CPhIR?

You can document this in the "Incident Description" field.

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Where can I document incidents that involve dispensing in blister packs?

Click on the "Expand All" button next to the "Other Incident Info" field. Under the "Rx Order Entry/Dispensing Label Generation" category, check the "Nursing Home/Blister Pack" option. Alternatively, you can document this information in the "Incident Description" field.

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With respect to drug shortages, often we have to dispense a generic brand or an alternative brand of a medication. If an incident involves the use of different brands of a medication, where can I document this in CPhIR?

Click on the "Expand All" button next to the "Other Incident Info" field. Under the "Rx Supply/Ordering" category, check the option(s) that apply to the incident. Alternatively, you can document this information in the "Incident Description" field.

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How about improper storage of medications? Where can I document this in CPhIR?

Click on the "Expand All" button next to the "Other Incident Info" field. Under the "Rx Preparation - Storage" category, check the option(s) that apply to the incident. Alternatively, you can document this information in the "Incident Description" field.

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If one of the contributing factors to the incident is due to an incorrect address being entered for the patient, where can I document this in CPhIR?

You can document this in the "Incident Description" field.

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How long do I have to edit an incident?

An incident can be edited within 90 days of the initial entry date.

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What will happen after the incident is open for 90 days?

All open incidents will automatically be closed after 90 days. Closed incidents can no longer be edited. Once an incident is closed, it is available for search and analysis.

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How do I edit or close an incident?

Only Open Incidents can be edited. Click on the "Home" tab, and under "Your Open Incidents", find the incident to be edited (listed numerically by incident number, or date incident was first entered) and click on the "incident number-Open" (in blue). The incident reporting form for the selected incident will appear. Edit information as needed. Once the report is complete, scroll to the bottom of the form and click the checkbox to "Close record from future edits". Then click "Submit Report to ISMP Canada" to close and submit the incident.

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When I submit an incident, an error window pops-up, what does this mean?

Upon submission, if one of the mandatory fields is not complete, a pop-up window will appear as a reminder to fill in all mandatory fields. Click OK to return to the form and fill in the missing information.

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It is taking quite a while to submit an incident after I press the "Submit Report to ISMP Canada" button. Why?

Depending on your Internet browser or connection, sometimes it may take longer to submit an incident. A pop-up message will alert you when submitting an incident takes longer than expected. This message will assure you that the incident is being submitted.

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I entered information into the form and it logged out, is the information saved?

No, after 24 minutes of inactivity, CPhIR will automatically time out for confidentiality reasons. All unsaved information will be lost. To prevent lost information, submit data as an open incident. Open incidents can be edited within 90 days.

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Search

How do I search for an open incident?

Open incidents cannot be searched. To find an open incident, click on the "Home" tab. All open incidents are sorted by incident number/date incident initially entered.

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When I search for an incident, it does not display in the results, how do I find it?

Only closed incidents can be searched. All open incidents are displayed on the home page.

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How do I export incident reports into PDF/Excel format?

Click the "Search" tab and enter the search criteria for the incidents exported. When the search results are displayed, scroll to the bottom of the page and click the "Export in PDF format" or "Export in Excel format". All search results will be exported in the new file, which will appear in a new window.

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Can I make customized graphs of my individual pharmacy data?

No, CPhIR does not graph individual pharmacy data. However, the "Search" function allows you to find the selected data you wish to graph and export the incidents into Excel. Using Excel, you can then create customized charts and tables.

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Stats

How do I view the graph with my pharmacy data and aggregate data?

Click the "Stats" tab. Select the "Type of Search Result" you would like to view and enter any of the specific search criteria. Scroll to the bottom of the form and click "Submit Search". The results will display as a graph and tables with your pharmacy data and aggregate data.

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I am using Internet Explorer and I can view my pharmacy data and aggregate data in tables but not in graphs. Why?

There is a security setting called "Binary and script behaviors" that has to be enabled for the graphs to render. To access the "Binary and script behaviors" setting, click on "Tools" and select "Internet Options". Under the "Security" tab, click on the "custom level ..." button. You will then see a "Settings" menu. Scroll down the menu and under "ActiveX controls and plug-ins", ensure that the "Binary and script behaviors" option is enabled.

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Your Account

How do I change my password?

Click on the "Your Account" tab. Enter the old password and type in the new password. Do not use the same password that you use for other online accounts. All passwords must be 8 characters in length with letters, numbers, and punctuation. Passwords are also case-sensitive. Remember to check your CAPS lock key. Re-enter the new password and click "Update Password".

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CE & Resources

If there are members of my pharmacy staff who are new or not yet familiar with the CPhIR program, what is the best way to become familiarized with this tool?

Under the "CE & Resources" tab, there are multiple CE modules that are very useful for learning about fostering a reporting culture, how to navigate through CPhIR as well as some general information about medication safety and analysis. For new users, Module 2: CPhIR Training Guide may be particularly useful. Each module is accompanied by a link to a set of presentation slides that the user can print or view in order to follow along during the module.

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Quality Improvement

What is Continuous Quality Improvement (CQI) and why is it important?

CQI is an online environment for community pharmacies to document staff meetings and discussion in response to medication incidents (and incident analysis); as well as action plans to improve medication safety in the practice setting. Continuous quality improvement helps make the environment safer for practitioners and patients.

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What is the difference between single and multi-incident analysis?

Single incident analysis allows you to analyze in detail of one reported incident (particularly those of high impact or resulting in severe patient harm) and identify potential contributing factors related to that incident.



Multi-incident analysis allows you to efficiently analyze a set of related incidents to identify potential system-based contributing factors. Either type of incident analysis will prompt you to develop system-based solutions to prevent similar incidents from recurring in your practice setting.

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Can I still edit my discussion after I finalize it?

Yes, you can click "edit" and revise or update any previous mediation incident discussion prior to finalizing it. Once you confirm that you would like to finalize the discussion, you will no longer be able to update the medication incident discussion.

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Why can't I search or add a new medication incident in my Medication Incident Discussion?

Open incidents cannot be searched or added into the "Medication Incident Discussion" section. To find an open incident, click on the "Home" tab, which shows a list of all your open incidents and you may check all the incidents that you wish to close. All open incidents are sorted by incident number/date incident initially entered. Only closed incidents can be searched and added into the "Medication Incident Discussion" section.

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How do I import more than one incident into my Medication Incident Discussion?

Once you open the "Medication Incident Discussion" window, there are two methods to import medication incidents for discussion at the staff meeting and they are listed as follows:

  • You may import each incident by clicking "Add CPhIR Incident" and inputting the CPhIR incident number.
  • You may import a set of related incidents by clicking "Import CPhIR Incidents" and search the set of related incidents by the criteria desired. Then you can select all the desired incidents by marking the checkboxes listed under the "Import" column. If you select the wrong incident, then you can simply unmark the checkbox or click the red-cross listed beside the CPhIR incident number. Once you complete your selection, click "Import Selected Incidents" to import all the desired incidents for your medication incident discussion with your staff members.

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Can I print CQI discussion for my records?

Yes. At the end of the documentation page, you can click "Save & Print" and a nicely laid out PDF of your staff meeting discussion will be available for you to save electronically or print as a hard copy.

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Will content from my CQI meeting discussion be reported to ISMP Canada?

The CQI module is intended for your pharmacy's own documentation purposes. When you are ready to click "save and close", a reminder will pop up to make sure that you do not supply identifying information (e.g. patient name or date of birth, pharmacy name, or healthcare provider names). Once you click "OK" (to submit), the meeting discussion is then stored into the ISMP Canada secured CPhIR database.

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I accidentally closed my webpage during the discussion, was my information saved?

No, unfortunately the information will not be saved. Therefore, it is recommended to periodically save your work to prevent any unnecessary loss.

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Confidentiality/Privacy Policy

How will data from CPhIR be used?

The goal of ISMP Canada is to analyze medication incident reports and develop recommendations for enhancing patient safety in all healthcare settings. Medication incidents submitted through CPhIR will be used only for the purposes of analysis, shared learning, and formulation of incident prevention strategies.

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Who has access to the data entered into CPhIR?

ISMP Canada has a privacy policy stating that data is used by ISMP Canada only for the purposes of analysis, shared learning, and incident prevention strategy formulation. Only selected employees at ISMP Canada have access to the data submitted through CPhIR.

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