Saskatchewan Health

About: Saskatchewan Health is a government organization based out in Regina, Saskatchewan, Canada. It is known for research contribution in the topics: Population & Health care. The organization has 442 authors who have published 489 publications receiving 7728 citations.

AMS in the ICU: empiric therapy and adherence to guidelines for pneumonia.

Abstract: Antimicrobial stewardship (AMS) aims to preserve the efficacy of antimicrobials by selecting the right drug, dose and duration for the appropriate indication, resulting in maximum benefit and minimising adverse events and development of antimicrobial resistance.1 2 While AMS interventions may appear to be at odds with practice in the intensive care unit (ICU), they can improve quality of care without compromising patient outcomes.2 This study assessed if empiric antimicrobial therapy aligned with guideline recommendations for critically ill patients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP) or aspiration pneumonia. This retrospective chart review included patients discharged or expired from three mixed medical/surgical ICUs in Regina, Saskatchewan, Canada between October 2016 and March 2017. Patients were included if they were ≥18 years old and had ICD-10 codes corresponding to pneumonia and an indication for pneumonia recorded in their chart; they were excluded if they were not in the ICU while being treated for pneumonia or for any subsequent ICU re-admissions (ie, index admission only). Records were assessed for antimicrobial alignment with guideline recommendations for each type of pneumonia.3–5 If the regimen was not guideline concordant, further assessment by two clinical experts was conducted to determine if it was still clinically appropriate by taking into consideration local antibiogram patterns and other available patient-specific factors, such as allergies, recent antimicrobial exposure, suspected co-infections and concomitant disease states. This study …

Prevalence of Cigarette Smoking Among Adult Emergency Department Patients in Canada.

Abstract: Author(s): Tolmie, Andrew D.; Erker, Rebecca; Sullivan, Emily; Graham, Thomas; Oyedokun, Taofiq; Stempien, James | Abstract: Introduction: Tobacco smoking is a priority public health concern, and a leading cause of deathand disability globally. While the daily smoking prevalence in Canada is approximately 9.7%,the proportion of smokers amongst emergency department (ED) patients has been found to besignificantly higher. The purpose of this survey study was to determine the smoking prevalence ofadult ED patients presenting to three urban Canadian hospitals, and to determine whether there wasan increased prevalence compared to the general public.Methods: A verbal questionnaire was administered to adult patients aged 18 years and olderpresenting to Royal University Hospital, St. Paul’s Hospital, and Saskatoon City Hospital inSaskatoon, Saskatchewan. We compared patients’ smoking habits to Fagerstrom tobaccodependence scores, readiness to quit smoking, chief complaints, Canadian Triage Acuity Scalescores, and willingness to partake in ED-specific cessation interventions.Results: A total of 1190 eligible patients were approached, and 1078 completed the questionnaire.Adult Saskatoon ED patients demonstrated a cigarette smoking prevalence of 19.6%, which issignificantly higher than the adult Saskatchewan public at 14.65% (Pl0.0001). Out of the smokingcohort, 51.4% indicated they wanted to quit smoking and would partake in ED-specific cessationcounselling, if available. Of the proposed interventions, ED cessation counselling was most popularamongst patients (62.4%), followed by receiving a pamphlet (56.2%), and referral to a smokers’ quitline (49.5%).Conclusion: The higher smoking prevalence demonstrated amongst ED patients highlights theneed for a targeted intervention program that is feasible for the fast-paced ED environment. TrainingED staff to conduct brief cessation counselling and referral to community supports for follow-up couldprovide an initial point of contact for smokers not otherwise receiving cessation assistance.

Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging

Abstract: Background: despite the efforts of multiple stakeholders to promote appropriate care throughout the healthcare system, studies show that two out of three lower back pain (LBP) patients expect to receive imaging. We used the Choosing Wisely Canada patient-oriented framework, prioritizing patient engagement, to develop an intervention that addresses lower back pain imaging overuse. Methods: to develop this intervention, we collaborated with a multidisciplinary advisory team, including two patient partners with lower back pain, researchers, clinicians, healthcare administrators, and the Choosing Wisely Canada lead for Saskatchewan. For this qualitative study, data were collected through two advisory team meetings, two individual interviews with lower back pain patient partners, and three focus groups with lower back pain patient participants. A lower back pain prescription pad was developed as an outcome of these consultations. Results: participants reported a lack of interactive and informative communication was a significant barrier to receiving appropriate care. The most cited content information for inclusion in this intervention was treatments known to work, including physical activity, useful equipment, and reliable sources of educational material. Participants also suggested it was important that benefits and risks of imaging were explained on the pad. Three key themes derived from the data were also used to guide development of the intervention: (a) the role of imaging in LBP diagnosis; (b) the impact of the patient-physician relationship on LBP diagnosis and treatment; and (c) the lack of patient awareness of Choosing Wisely Canada and their recommendations. Conclusions: the lower back pain patient-developed prescription pad may help patients and clinicians engage in informed conversations and shared decision making that could support reduce unnecessary lower back pain imaging.

Departmental Initiative to Improve Documentation in the Medical Record by Acute Care Pharmacists

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T Scores, FRAX, Frailty Phenotype, Falls, and Its Relationship to Fractures in Patients on Maintenance Hemodialysis.

Abstract: Background:Despite the magnitude of fracture and the consequences in patients receiving hemodialysis, optimal risk assessment tools in this population are not well explored. Frailty and falls—known...