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Health Care

Updates:

Information on the 2018/2019 Influenza vaccine is available on the Ministry of Health and Long Term-Care website.

http://health.gov.on.ca/en/pro/programs/publichealth/flu/uiip/ 

Public Health Ontario has released a document on Influenza Vaccines for Children and Older Adults for the 2018/2019 Influenza season.

https://www.publichealthontario.ca/en/eRepository/influenza-vaccines-2018-19-season.pdf

The Outbreak Status Report is updated weekly on Thursday, providing health care providers and our community with a snapshot of possible viruses or other pathogens circulating in our communities.

Weekly Outbreak Status Report

 

Advisories:

An infection prevention and control lapse investigation by Ottawa Public Health (OPH) has identified that patients who had some minor surgical procedures at the Main Street Family Medical Centre, located at 1251 Stittsville Main Street, may have been exposed to improperly cleaned medical equipment. For more information regarding the extent of the laspe please visit OPH

Vaccine Recall in China: Two batches of DTaP vaccine were recalled by China Food and Drug Administration (CFDA) on October 29, 2017 after failing potency testing. For more information on management of children who may have been vaccinated in China.

Public Health Notes are published monthly with each issue highlighting a current area of public health concern. Public Health Notes will keep accessible for six months online. Anyone requesting previous issues which have been removed can contact 613-732-3629 x555.

Alcohol & Other Drugs

The Canadian Centre on Substance Abuse changes lives by bringing people and knowledge together to reduce the harm of alcohol and other drugs on society.

Guidelines for Healthcare Providers to Promote Low-Risk Drinking Among Patients

Communicating Alcohol-Related Health Risks

Canada Low-Risk Alcohol Drinking Guidelines-FAQ

Chronic Illness and Alcohol-Infographic

Alcohol Screening, Brief Intervention & Referral

Quitting Smoking

Supports for your patients to quit smoking are available through a variety of programs and services in Renfrew County and District.

Resources

The following resources are can assist health care providers to support patients with cutting back or quitting tobacco.

You Can Make It Happen – A resource for health care providers to assist their patients and clients to quit smoking.

TEACH – Training Enhancement in Applied Cessation Counselling and Health – A training program to ensure that practitioners who provide services to people who use tobacco have the knowledge and skills to deliver effective, evidence-based cessation interventions.

Tobacco Free RNAO – A resource for Registered Nurses in Ontario to integrate smoking cessation into daily nursing practice.

Ottawa Model for Smoking Cessation – A program that systematically identifies, provides treatment, and offers follow-up to all smokers seen in clinical practice. The inpatient part of this program is implemented by hospitals in Renfrew County.

Fall Prevention

Fall prevention online learning is a one-hour course for personal support workers, volunteers and informal caregivers of older adults

Falls are a serious health issue for older adults, their families and the health care system. The course is based on current research, the Canadian Fall Prevention Curriculum, and what has been shown in practice to prevent falls.

By the end of the modules, participant will be able to:

  • Identify risk factors for falls
  • Reinforce fall prevention messages with clients and families
  • Incorporate fall prevention strategies at every client interaction
  • Communicate with clients and the circle of care to reduce/minimize the risk of falls
  • Be aware of local fall prevention services and resources.

To take the course:

  • Set up an account to access online courses at Ottawa Public Health.
  • See Steps to Accessing External eLearning (ulearn) for further instructions.
  • Please complete the fluid survey at the end of the module to help us improve our service.
  • For technical difficulties, contact HRServiceCentre@ottawa.ca
  • For in-person group sessions please contact Renfrew County and District Health Unit (613-735-8651 ext. 666 or 1-800-267-1097.)

The Personal Support Worker Fall Prevention Training module was developed collaboratively by Renfrew County and District Health Unit and the three other public health units in the Champlain LHIN region. Ottawa Public Health has adapted this as an online module.

Baby-Friendly Initiative

Renfrew County and District Health Unit is designated as a Baby Friendly Community Health Service under the Baby Friendly Initiative (BFI).

BFI is a global campaign to promote, protect, and support breastfeeding. Based on guidance from BFI, the Health Unit is committed to:

  • helping parents make informed decisions about feeding their baby;
  • supporting all families with feeding their children in a safe and nurturing way;
  • recommending breastmilk as the only food for babies until they are six months old;
  • recommending that breastmilk be included in a child’s diet up to two years and beyond;
  • protecting women’s rights to breastfeed anytime, anywhere;
  • and working with community organizations to protect, promote and support breastfeeding.

For a centralized source of quality, evidence-informed resources that support the Baby-Friendly Initiative see Breastfeeding Resources Ontario.

Client-Friendly Breastfeeding Policy

Renfrew County and District Health Unit’s Client Friendly Breastfeeding Policy in English or French.

The Health Unit’s full Breastfeeding Policy is available upon request. Email familyhealth@rcdhu.com.

Infant Feeding Surveillance

BFI requires the Health Unit to monitor breastfeeding rates and trends in the community. See Infant Feeding in Renfrew County and District (PDF 30 pages) or the Executive Summary (PDF 4 pages) for the findings from our first two years of infant feeding surveillance.

 

Breastfeeding

Family Physicians can provide direct counselling in a professional, supportive atmosphere and this has a major impact on the infant feeding decisions of families. Because family physicians have an extended relationship with their patients before pregnancy, during pregnancy and in the postpartum, they have many opportunities to support, educate and encourage breastfeeding.

Physicians Breastfeeding Toolkit – Quick Reference Guide

 

Healthy Babies, Healthy Children Program

Healthy Babies Healthy Children is a voluntary, free home visiting program for women and their families in the prenatal period, and women with children from birth until their transition to school.

Healthy Babies Healthy Children program offers support in the home for every child and parent identified with challenges. This includes assessment, teaching, referral and service coordination.

Renfrew County and District Health Unit’s home visiting team consists of Registered Nurses and Home Visitors. Staff members work with clients on:

  • achieving healthy pregnancy;
  • good nutrition and feeding (including breastfeeding);
  • healthy child development;
  • safety;
  • adjusting to parenthood;
  • accessing community resources and more.

Referral

To refer to the Healthy Babies Healthy Children Program:

 

 

Renfrew County and District Health Unit offers immunization services to people of all ages living in Renfrew County and District.

Immunization Clinic Schedule

Please see the new RCDHU Immunization Clinic Schedule.

Routine Vaccinations

Routine vaccines are publicly funded.

Ontario Ministry of Health and Long-Term Care – Ontario’s publicly funded immunization schedules

Ontario Ministry of Health and Long-Term Care – Immunization requirements for school attendance: information for health care providers

Vaccine Orders

Routine publicly funded vaccine will now be available the 1st and 3rd weeks of each month.

Publicly funded vaccine orders should be faxed at 613-735-3067 Attn: Vaccine Orders or emailed to Renfrew County and District Health Unit at vaccineorders@www.rcdhu.com.

All orders must be placed by 4:00 pm on the Thursday prior to the 1st and 3rd week of each month to allow for processing and availability. The vaccines will be available to Health Care Providers beginning on Wednesday at your nearest RCDHU office location.

This does not include Influenza vaccine (schedule available in the Fall) or high risk vaccines. The High Risk Vaccine order form is a specific form which can be received by contacting 613-735-8653 ext: 582. These vaccines will be processed in a timely fashion based on availability.

Please ensure that you order adequate vaccine supply for your needs based upon the vaccine ordering schedule.

Vaccine Ordering and Delivery Schedule 2018-2019

Vaccine Return Form

Vaccine Order Form – General

High Risk Vaccine Order Form

Shingles Vaccine Order Form

Menactra School Based Immunization Program Vaccine Order Form/Release Record

HPV School Based Immunization Program Vaccine Order Form/Release Record

Hepatitis B School Based Immunization Program Vaccine Order Form/Release Record

 

Transporting Vaccines

Vaccines are highly temperature and light sensitive. They must be maintained and stored between +2°C to +8°C, and protected from sunlight and florescent light at all times in order to be potent on administration. Do not transport vaccines in the trunk of a car.

An insulated vaccine cooler with ice packs and thermometer, as demonstrated below, are required to pick up the vaccines from RCDHU for transportation. For further detailed information see link below.

Transporting Vaccines

Reporting Cold Chain Incidents

Vaccines must be kept between 2°C to 8°C to ensure the vaccines stay potent and effective. When the vaccine storage refrigerator varies above or below these temperatures, this is known as a cold chain incident and must be immediately reported to the Renfrew County and District Health Unit by calling 613-735-8653. A Public Health Nurse will provide instructions and investigate the cold chain break to determine the best follow up actions.

Please complete the form below for all of the expired and/or exposed vaccines. All vaccines must be accompanied with the form when submitting to the Health Unit.

Vaccine Return Form

Vaccine Cold Chain Incident Report

Vaccine Exemption Forms

To be exempted from immunization requirements for attending school, either a statement of conscience or religious belief affidavit must be completed, or have a statement of medical exemption completed by a doctor or nurse practitioner. As of September 1, 2017 parents who are choosing to complete a statement of conscious or religious belief affidavit must complete a mandatory education session provided by Renfrew County and District Health Unit. For more information please call 613-735-8653 ext 513.

If your child will be attending school and is medically unable to be vaccinated, a statement of medical exemption must be completed by a medical doctor or nurse practitioner:

To be exempt from immunization requirements for children attending licensed child care, either a statement of conscience or religious belief affidavit must me completed by a parent or guardian, or a statement of medical exemption must be completed by a medical doctor or nurse practitioner:

NOTE: If providing a statement of conscience or religious belief affidavit, it must be signed by a qualified commissioner. 

Adverse Event Following Immunization

To report an adverse event following immunization, please complete the Report of an Adverse Event Following Immunization, and fax to 613-735-3067.

Resources

Immunize Canada

National Advisory Committee on Immunization

Vaccine Storage and Handling Guidelines

Zika virus fact sheet for HCP

Outbreaks

Under the Ontario Health Protection and Promotion Act, outbreaks of respiratory and enteric infections in institutions are reportable to the local Medical Officer of Health on the same day as the outbreak is suspected or confirmed.

When an outbreak is reported to the Health Unit, a Public Health Nurse (for respiratory outbreaks) or a Public Health Inspector (for enteric outbreaks) offers to assist staff at the facility in their efforts to prevent the spread of the illness.

*NEW* Outbreak Management Guide

The Outbreak Management Guide contains all relevant information to assist facilities in fulfilling their duties to report and in managing an enteric or respiratory outbreak, as per ministry standards and guidelines.

Resources for Enteric Outbreaks in Long-Term Care Homes

Control of Gastroenteritis Outbreaks in Long-Term Care Homes: A Guide for Long-Term Care Homes and Public Health Unit Staff (PDF, 95 pages, 2.5 MB)

Annex C: Testing, Surveillance and Management of Clostridium difficile in All Health Care Settings (PDF, 42 pages, 1.3 MB)

Enteric Supporting Documents

Enteric Outbreak Line Listing Form (PDF, 1 page, 57 KB)

Enteric Diseases Surveillance Protocol for Ontario Hospitals (PDF, 11 pages, 46 KB)

Enteric Outbreak Notification Form

Resources for Respiratory Outbreaks in Hospitals, Long-Term Care Homes and Retirement Residences

A Guide to the Control of Respiratory Infection Outbreaks in Long-Term Care Homes

AMMI Canada Guideline: Guidance on the use of antiviral drugs for influenza in acute care facilities in Canada, 2014-2015

AMMI Canada Guidelines: Guidance for practitioners on the use of antiviral drugs to control influenza outbreaks in long-term care facilities in Canada, 2014-2015 season

Respiratory Supporting Documents

Influenza Surveillance Protocol for Ontario Hospitals

Initial Respiratory Outbreak Notification form

Respiratory Outbreak Line Listing for Institutions RESIDENT and STAFF form

Respiratory Outbreak Management Team Meeting Checklist form

Hospitalizations, Complications and Deaths of Line Listed Cases form

Outbreak Transfer Notification form

Ontario Final Report of an Institutional Respiratory Infection Outbreak form

We are experiencing a respiratory outbreak poster

Controlling respiratory outbreaks: What visitors need to know fact sheet

Additional Precautions Signage and Lanyard Cards

Recommended steps for putting on and taking off personal protective equipment (PPE)

Virus Respiratory Kit Instructions

Public Health Laboratories General Test Requisition

General Resources

Ontario Respiratory Pathogen Bulletin is posted every Friday during influenza season (November to April).

Provincial Infectious Diseases Advisory Committee (PIDAC)

Routine Practices and Additional Precautions in All Health Care Settings (PDF, 113 pages, 3 MB)

Web Sites

Infection Prevention and Control Canada

Influenza

Flu shots are available free for all Ontario residents over six months of age. They are available through local drug stores, health care providers, and Renfrew County and District Health Unit.

Local Influenza Activity

Many people with influenza-like illness do not seek medical care or have lab testing done. Therefore reporting of laboratory confirmed influenza cases to public health units significantly underestimates the burden of influenza in Ontario.

For information on the number of lab confirmed influenza cases in Renfrew County and District, see the Local Influenza Activity section of our Weekly Outbreak Status Reports.

Web Sites

Ontario Ministry of Health and Long-Term Care – Universal Influenza Immunization Program

Government of Canada – For health professionals: Flu (influenza).

An influenza pandemic is declared when a new strain of flu virus emerges that has never been seen before and begins to spread quickly around the world.  For example, in Spring 2009, a new strain of the influenza virus, the H1N1 virus, caused a pandemic.  As it was a new strain and because humans had little to no natural immunity to this virus, it caused serious and widespread illness.

The frequency of pandemics is unpredictable, but experts agree that we need to be prepared for the next one. Renfrew County and District Health Unit’s Pandemic Influenza Plan provides direction on responding to an influenza pandemic in coordination with federal, provincial and local pandemic influenza plans

Infection Control

Renfrew County and District Health Unit works with hospitals, long-term care homes, day nurseries and other community settings to ensure infection control programs are in place where required and that infection prevention practices are followed. Health Unit staff participate in the infection control committees of hospitals and long-term care homes in Renfrew County and District.

Resources
Provincial Infectious Diseases Advisory Committee (PIDAC)

Best Practice Documents:

  • Best Practices for Prevention, Surveillance and Infection Control Management of Novel Respiratory Infections
  • Infection Prevention and Control in Perinatology
  • Cleaning, Disinfection and Sterilization of Medical Equipment/Devices
  • Environmental Cleaning for Prevention and Control of Infections
  • Infection Prevention and Control Programs in Ontario
  • Best Practices for Hand Hygiene
  • Infection Prevention and Control for Clinical Office Practice
  • Routine Practices and Additional Precautions Annexes A, B and C
  • Surveillance of Health Care Associated Infections

Hand Hygiene Fact Sheet for Health Care Settings (PDF 1 page, 470 KB)

Web Sites

Regional Infection Control Networks (Ontario)

Infection Prevention and Control Canada

 

Reportable Diseases

The Ontario Health Protection and Promotion Act lists over 68 communicable diseases that must be reported to local health units. Physicians and other practitioners, administrators of hospitals, superintendents of institutions, and school principals are responsible for reporting to the local Health Unit. All reports are followed up by a Public Health Nurse or Public Health Inspector.

How to report communicable diseases:

PLEASE NOTE: Respiratory and gastroenteritis outbreaks in institutions should be reported immediately by telephone when an outbreak is suspected or confirmed. See Outbreak Management for forms and resources to use during an outbreak.

Resources

Renfrew County and District Health Unit

Recommendations for Tuberculosis (TB) Screening in Long-Term Care and Retirement Homes (PDF, 2 pages, 300 KB)

Public Health Ontario

Public Health Ontario Laboratory Test Directory

Sexually Transmitted Infections Case Management and Contact Tracing Best Practice Recommendations (PDF)

Guidelines for Testing and Treatment of Gonorrhea

Public Health Agency of Canada

Canadian Guidelines on Sexually Transmitted Infections

Canadian Tuberculosis Standards, 7th Edition, 2014

Lung Association

Tuberculosis Information for Health Care Providers, 5th edition (PDF, 34 pages, 1,240 KB)

 

Rabies Prevention and Control

The Health Unit works to prevent human cases of rabies through the following activities:

  • monitoring the type, number and location of animals that have tested positive for rabies in Renfrew County and District and surrounding areas
  • having a Rabies Contingency Plan and keeping it up to date
  • investigating when people are exposed to animals suspected of having rabies
  • having a supply of anti-rabies vaccine
  • consulting with doctors in deciding when there is a need to give the vaccine to a person who has been exposed to an animal suspected of having rabies
  • Public Health Inspectors investigate animal bites and scratches that are reported to the Health Unit. The owner has to put the suspect animal into quarantine. This is necessary to ensure that the rabies virus was not present in the saliva of the animal when the person was bitten or scratched. The animal is checked at the end of the quarantine period to make sure it is free of rabies symptoms.

All animal bites and scratches involving humans must be reported to the Health Unit immediately using the Contact with Suspected Rabid Animal Report Form. If a person exposed requires rabies post-exposure prophylaxis, fill in the Request for Rabies Post Exposure Vaccine Form and report it to the Health Unit immediately.

Resources

Guidance Document for the Management of Suspected Rabies Exposures (PDF, 18 pages, 180 KB)

Web Sites

Ontario Ministry of Natural Resources – Rabies in Humans

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Pembroke Office

TEL: 613-732-3629 or 1-800-267-1097

Renfrew Office

TEL: 613-432-5853 or 1-800-465-5000