PIPD Update May 30, 2025

 New and updated Infection Prevention and Control documents

Infection Prevention and Control (IPAC) has made some changes to the Transmission Based Precautions Table:

• Clarified in point two of general principles that contact plus precautions should be used for undiagnosed gastrointestinal illness if C. difficile is clinically suspected.
• Candida auris - added a note to use droplet/contact precautions if C. auris is found in the sputum or tracheal aspirate.
• Measles:
• Case - added information on family presence for cases in SHA facilities.
• Susceptible contact - added a note to increase the duration of precautions to 28 days if measles immunoglobulin is given.
• Updated the entry for "infectious mononucleosis" to "mononucleosis."
• Mycobacterium tuberculosis - Added direction to refer to Roy Romanow Provincial Laboratory (RRPL) compendium for special instructions when sending specimens for testing.
• Pertussis - clarified the "period of communicability."
• Added an entry for Shiga-toxin E. coli (STEC).

Additionally, new measles outbreak management guidelines for acute care facilities were created and have been posted in the IPAC measles toolkit.

CNE Update 

Rx Crush - this replaced the Dissolve-a-dose. The RX Crush is not a perfect system. We know and SHA is working on a replacement. In the meantime, to keep yourself safe if using hazardous meds:
1. Put on all your PPE and an N95. Place a blue pad for your work station. 
2. Place pill/tablet into ziploc end of pouch. Zip firmly closed.

3. Attach ENFit syringe with desired amount of diluent.

4. Crush (gently) to desired consistency.

5. Using the attached syringe, push the fluid into the bag and create solution.

6. Draw out medication.

7. Discard RX Crush pouch in hazardous waste bin.

8. Call a 1600 if you have any spillage, pouch break, powder aerosolized, etc.

Potassium Phosphate - a memo from pharmacy:
Starting the May 30 evening, all peripherally administered potassium phosphate will be prepared by pharmacy. 

This is to ensure the potassium component of the potassium-phosphate will be at the correct, safe peripheral concentration.

Since the monograph and pump concentrations will not be updated, the nurse will have to run via ‘no drug selected’ at this time since the concentration does not match the standard in the monograph or drug lines. 

Central Line administration - Pharmacy will send the pre-mixed bag. You will need to draw your patient's dose out of the bag and administer that patient specific dose. 

SMOF Filter - Starting May 27, you will see the "all in one" tubing with built in filter for SMOF syringes. You do not need any additional tubing or filter if you use the yellow ICU medical tubing with built in filter sent by Pharmacy.

UPDATED Forms
Tracheostomy Supply & Care Checklist - this form has been updated in collaboration with RT. It is now in all the filing cabinets and can also be found on the S-Drive. We are attempting to get this form onto FOD.
CVAD IVAD Care Checklist - previously known as the CVL Checklist. This form has been updated to reflect Provincial wording and newest best practices. It is now in all the filing cabinets and can also be found on the S-Drive. We are attempting to get this form onto FOD.

Tip of the Week - chest tube cannisters are kept in the Treatment room. Bottom shelf of the wall cupboard. We have lots of both the Infant Pleur-Evac and Adult Pleur-Evac cannisters. There is more sitting on the counter in the Treatment room as well. Our Support Staff stock this cart so if you use items, please let them know.

NEW Q-card:
HDC use on PIPD - to assist the team with caring for a patient who needs an HDC. This is in the recipe box at each Unit and on the S-Drive (active link to policy on S-drive version). 

IV Monograph Updates:

• amoxicillin/clavulin - more clarity provided in the reconstitution section.
• axaCITIDine - NEW monograph added.
• etoposide - more clarity provided in the required monitoring section.