Foire aux questions

Est-ce que mon travail ou mon accouchement peut se dérouler dans l’eau?

Pour la gestion de la douleur, notre unité permet le travail et l'accouchement dans l’eau. Pour plus d'informations, visitez notre page sur les différents types d'accouchement possibles.

Vous pouvez également consulter notre brochure pour plus d'informations. 

What is Health Care Tomorrow and how does it impact this integration?

Health Care Tomorrow: Hospital Services, is a project that has been undertaken by the seven hospitals in our region (KGH, HDH, Providence Care, Quinte Health Care, Brockville General Hospital, Lennox and Addington General Hospital and Perth and Smiths Falls District Hospital) along with the South East Local Health Integration Network, the Community Care Access Centre and the Faculty of Health Sciences at Queen’s University. Together these organizations are looking for opportunities to share services on a regional level.

While the KGH and HDH integration announcement is not directly linked to the work that was started as part of Health Care Tomorrow, the project did serve as a helpful starting point for conversations as we began to look at integrating ourselves and deepening the partnership between our two hospitals. Our local integration plan is consistent with the intent of Health Care Tomorrow, which is to provide high quality, patient-centred and efficient services to patients in the South East. 

Will this impact jobs?

It is too early to know if there will be any specific impact on jobs, however we do know that we will continue to deliver all of the services we currently offer to patients and families. That means we will continue to need the individuals who currently provide this care. We do anticipate there will be a reorganization of the management structure within the new academic health sciences centre.

As this process unfolds we will regularly provide updates to our staff, unions and all our stakeholders to ensure that they are aware of changes that are taking place. We are also committed to providing them with the opportunity to ask questions and share ideas with us as the process unfolds.

Will there be any reduction in services?

There are no plans to reduce the services offered on either site. Under the new entity, each site will continue to fulfill its unique role with the KGH site providing complex-acute and specialty care and the HDH site providing acute-ambulatory care. The services currently offered by KGH and HDH will continue to be offered by the new academic health science centre and we will continue to preserve, respect and honour the unique missions and cultures of both sites as we work more closely together.

Is this being done to save money?

This is first and foremost about making a bold step for our community to improve the experience of patients and families by delivering better and more coordinated care. We believe that by integrating our hospitals we will provide more efficient care that may also result in some financial savings.

Will Hotel Dieu Hospital maintain its Catholic identity?

We remain committed to honouring the unique missions and cultures of both sites as we move forward. The Hotel Dieu site will retain its Catholic identity and mission, and KGH will remain a secular site.

Who approved this integration?

The choice to move forward with the integration was reached by both hospitals after consultation with the South East Local Health Integration Network, the Ministry of Health and Long-Term Care, as well as the Roman Catholic sponsors of Hotel Dieu Hospital, Catholic Health International. With their support and with the agreement in principle of Kingston Archbishop Brendan O’Brien there is clear consensus in moving forward with the integration. 

How quickly will this process unfold?

Over the next several months, the hospitals will begin formal planning to establish the legal and operational structures for the new academic health sciences centre. During this time, the Interim CEO at KGH, Jim Flett, and Dr. Pichora, in his role as CEO at HDH, will work closely together to develop a transition plan. A joint team will be charged with leading this process and will also be engaging with the community to seek their input. It is anticipated that it will take up to 12 months to form the new corporation, at which time Dr. Pichora will assume the role of CEO.

Who will lead the new organization?

HDH’s current Chief Executive Officer, Dr. David Pichora, will be the inaugural President and CEO of the new academic health science centre. The Boards of both hospitals and a selection committee carefully considered the needs of the new organization and felt that as a practicing physician who works at both KGH and HDH, in combination with his administrative role at HDH, Dr. Pichora was the ideal person to lead this new organization. His experience bridges both hospitals from an administrative, clinical and academic perspective and he embodies the already existing integration between the two hospitals.

Why are you integrating the hospitals?

The two Boards chose this direction as way to provide better, more integrated acute care for patients and families. This is an exciting, progressive approach to providing care. Many of our patients receive care at both HDH and KGH and we believe that the more closely we work together, the better experience we will deliver for patients, families and staff. There will also be the added benefit of a reduction in duplication between the two sites. For example, we will only need to produce one Quality Improvement Plan, one budget and undertake one accreditation process to name just a few examples.

What is taking place between KGH and Hotel Dieu?

The Board of Directors of Kingston General Hospital (KGH) and Hotel Dieu Hospital (HDH) have agreed to create a new integrated academic health sciences centre that will bring together the operations of the two hospitals. The new organization will operate as one hospital with one budget, on two separate sites, and will be overseen by one Board of Directors, Chief Executive Officer and Executive team.

What is Clostridium difficile Infection (or C. difficile)?

Clostridium difficile Infection (CDI) is often abbreviated to C. difficile or C. diff for short.

C. difficile is a germ that can be found, on occasion, in people’s bowels. It does not always cause problems or symptoms but in some cases can. In some people who are also taking antibiotics, the germ can grow because the antibiotics kill off many of the “good” and harmless germs that normally prevent the C. difficile from growing to high numbers.

C. difficile makes a toxin that damages the fragile lining of the bowel causing inflammation and loose watery bowel movements (diarrhea) and inflammation.

Où iront les renseignements concernant ma famille?

Les renseignements que vous fournissez seront inscrits à votre dossier génétique aux services de génétique médicale ou au bureau du programme d'oncologie familiale. Ces bureaux font partie du Centre des sciences de la santé de Kingston et sont régis par les lois provinciales sur la protection des renseignements personnels sur la santé. Pour de plus amples informations sur la protection de la vie privée au CSSK, veuillez cliquer ici. 

Qui paie pour la consultation génétique et / ou le dépistage génétique?

Ce service est couvert par votre assurance maladie provinciale. Vous serez informé à l'avance de toute exception.

Est-ce que le dépistage génétique est obligatoire?

La décision de procéder au dépistage génétique est très personnelle. Le conseiller en génétique ou le généticien médical vous parlera des avantages et des inconvénients du dépistage génétique et vous aidera à décider s’il s’agit d’un bon choix pour vous et votre famille. En général, le dépistage génétique se fait à l'aide d'un échantillon sanguin.

Que dois-je faire en préparation de mon rendez-vous aux services de génétique médicale?

Avant de vous rendre à votre premier rendez-vous, essayez de recueillir des informations en matière d’antécédents familiaux, d’antécédents médicaux, d’antécédents de grossesse et de problèmes génétiques. Il se peut qu’un conseiller en génétique vous contacte dans le but d’obtenir certaines de ces informations avant votre rendez-vous. Vous pourriez également recevoir un formulaire d’antécédents familiaux à remplir et à nous retourner avant votre rendez-vous. On pourrait également vous demander des photos des membres de votre famille. Toutes ces informations nous aident à mieux nous préparer pour votre rendez-vous et nous donnent plus de temps pour répondre à toutes les questions que vous pourriez avoir lors de votre rendez-vous.

Pour les personnes référées en raison d’antécédents familiaux de cancer, il se peut que vous receviez par la poste des formulaires de décharge à signer et à retourner. Cela nous permet d'obtenir des renseignements sur les diagnostics de cancer dans votre famille afin que nous puissions vous fournir les informations les plus précises et les plus à jour lors de votre rendez-vous.

À quoi dois-je m'attendre lors de mon rendez-vous?

Vous rencontrerez tout d’abord un conseiller en génétique ou un généticien médical qui examinera vos antécédents médicaux et familiaux (ou ceux de votre enfant). Si cela s’avère nécessaire, le généticien médical procédera à un examen physique. Des tests supplémentaires peuvent également être recommandés. En cas de diagnostic d’une maladie quelconque, nous examinerons les informations en lien avec cette maladie, ce que cela peut signifier pour votre famille, et discuterons des plans de gestion et de suivi.

Combien de temps durera mon rendez-vous?

Les rendez-vous durent habituellement entre 1 heure et 1 heure et demie. On vous demande de vous présenter 10 minutes à l'avance pour prévoir du temps pour l'inscription. Nous vous suggérons également de prévoir du temps supplémentaire pour trouver un espace de stationnement puisqu’il peut être difficile de trouver un endroit pour se stationner dans les environs de l'hôpital. Pour plus d'informations sur les stationnements ou pour savoir comment se rendre au CSSK, cliquez ici. 

Qui vais-je consulter?

Vous consulterez un conseiller en génétique ou un généticien médical, ou parfois les deux. Les conseillers en génétique sont des professionnels de la santé ayant une formation spécialisée en consultation et en génétique. Les généticiens médicaux sont des médecins spécialistes qui ont une formation et une certification d'experts en génétique et maladies héréditaires.

Qu'est-ce que la consultation génétique?

La consultation génétique peut vous aider à comprendre comment certaines maladies, certains handicaps ou certaines malformations congénitales peuvent vous affecter, ainsi que le reste de votre famille. Votre conseiller vous renseignera et offrira du soutien pour vous aider à prendre des décisions personnelles concernant votre santé et celle de vos enfants ou en lien avec votre grossesse.

Mon bébé se présente par le siège, que se passe-t-il?

La version céphalique externe (VCE) est une technique par laquelle un médecin tourne un bébé qui se présente par le siège dans l’utérus pour le placer la tête en bas. La procédure implique que le bébé soit tourné manuellement en exerçant une pression sur votre abdomen. La VCE est réalisée par un obstétricien avec l'aide d'un résident en obstétrique. Votre prestataire de soins peut prendre rendez-vous en votre nom avec l'un des obstétriciens qui effectue cette procédure. Nous vous demanderons de contacter l’aile Connell 5 le matin de la procédure afin de déterminer l’heure où l’intervention peut être réalisée. Le médecin discutera de la procédure et des risques avec vous. L'infirmière prendra vos signes vitaux et installera une perfusion intraveineuse. Bien que vous ressentirez l’application d’une grande pression pendant la procédure, cela ne devrait pas être douloureux. La procédure devrait durer environ cinq minutes. Si vous avez besoin de plus d'informations sur la VCE, consultez votre prestataire de soins.

Que se passera-t-il si j'ai un problème de santé sous-jacent?

L’HGK dispose d’obstétriciens qui se spécialisent dans la gestion de soins pour les grossesses à haut risque. Ils discuteront de toutes les questions ou préoccupations que vous pourriez avoir et vérifieront le bien-être de votre bébé pendant votre grossesse. La prise de médicaments pendant la grossesse présente des risques et des avantages. Si possible, discutez des médicaments que vous prenez avec votre prestataire de soins avant de devenir enceinte. Vous serez prise en charge par notre clinique de soins obstétricaux située dans l’aile Kidd 5. Pour plus d'informations, cliquez ici, puis faites défiler l’information vers le bas jusqu'à la section Soins obstétricaux pour grossesses à haut risque. 

Que se passera-t-il si mon bébé est malade ou a besoin de soins supplémentaires?

Chaque nouvelle maman espère avoir un bébé en bonne santé, mais parfois les choses ne se passent pas comme prévu. Les bébés peuvent naître prématurément, avoir un problème de santé grave ou tomber malades après l'accouchement. L'unité de soins intensifs néonatals (USIN) dispose de l’équipement nécessaire pour prendre en charge les bébés ayant besoin de soins hautement spécialisés. Pendant votre séjour parmi nous, vous et l'équipe de l'USIN travaillerez de concert avec un seul but en tête, ramener votre bébé à la maison. L'USIN est située au même étage que l'unité postnatale, ce qui vous permettra de visiter votre bébé aussi souvent que vous le désirez. Si vous souhaitez en apprendre davantage sur l'USIN, cliquez ici

Ai-je besoin d'un plan d'accouchement?

Un plan d'accouchement est un excellent moyen de clarifier vos attentes lors de la préparation à l'accouchement. Il est important de discuter avec le médecin ou la sage-femme des sujets et des préoccupations qui vous inquiètent ainsi que de vos espoirs ou angoisses en lien avec l'accouchement. Vous voudrez peut-être discuter d'autres sujets tels que la gestion de la douleur, les personnes de soutien pendant le travail, les soins et la manipulation des nourrissons, les perfusions intraveineuses, les positions pendant le travail et l'épisiotomie. Vous pouvez parler de l’un de ces sujets lors de vos visites prénatales. Votre équipe de soins discutera également des souhaits que vous avez émis dans votre plan de soins et vous fournira toutes les informations nécessaires pour vous offrir un environnement de soutien pendant le travail et l’accouchement. Nos équipes respectent vos besoins et vos choix personnels.

Qu'est-ce que l’induction du travail?

L'induction du travail est le déclenchement artificiel du travail. Cette procédure peut être réalisée à l’aide de médicaments ou en rompant la membrane amniotique. Nous pourrions avoir besoin de recourir à l’induction si vous ou votre bébé avez un problème de santé justifiant le besoin que l'accouchement se fasse plus tôt que prévu. Cela peut également être le cas si vous avez dépassé votre date prévue d’accouchement. Votre médecin ou votre sage-femme discutera avec vous du besoin possible d’avoir recours à l’induction. Pour plus d'informations, cliquez ici et rendez-vous au bas de la page. 

À quelle fréquence dois-je donner le bain à mon bébé?

Il n’est pas nécessaire de donner le bain régulièrement à votre nouveau-né tant que vous le nettoyez à chaque changement de couche. Deux à trois bains par semaine sont suffisants et stimulent votre bébé. Ces bains vous permettront également de vous sentir plus à l'aise lorsque vous manipulez votre bébé. En vieillissant et en commençant à manger des aliments solides, vous constaterez qu'ils ont probablement besoin d'un bain tous les jours.

Pour plus d'informations sur le bain de votre nouveau-né, visitez notre section Soins néonatals

Où puis-je obtenir de l'aide si je crois souffrir de dépression postnatale?

La dépression postnatale est une affection psychiatrique grave qui nécessite une attention immédiate. Vous pouvez avoir des sentiments de désespoir, de culpabilité ou d'anxiété, avoir des crises de panique, démontrer peu d'intérêt envers votre bébé ou entretenir des pensées suicidaires. Tout d'abord, informez immédiatement votre prestataire de soins. Ce dernier pourra alors vous prodiguer des soins et des conseils. Pour des soins urgents, veuillez vous rendre au service des urgences de l’HGK. Pour plus d'informations, veuillez consulter le site Web de l’Association canadienne pour la santé mentale.

J'ai de la difficulté à tomber enceinte, quand dois-je demander de l'aide?

L'infertilité est un problème courant qui touche environ 8 % des femmes. L'infertilité est décrite comme l'incapacité à tomber enceinte après un an de tentatives pour la première grossesse, ou après six mois pour les grossesses ultérieures. Bien qu'il existe cinq facteurs qui peuvent contribuer à l'infertilité, dans 30 % des cas, aucune cause spécifique ne peut être attribuable au problème d’infertilité. L’HGK exploite une clinique d'infertilité qui est à votre disposition. Vous devez cependant être référée par votre médecin de famille ou gynécologue. Si vous souhaitez obtenir plus d'informations sur les techniques que vous pouvez essayer par vous-même pour préparer votre corps à la grossesse, vous pouvez également visiter le site Web du département de l'obstétrique de l'Université Queen's.

Comment savoir quels médicaments continuer de prendre et lesquels arrêter à mon départ de l’HGK?

Lorsque vous obtiendrez votre congé de l’hôpital, votre médecin ou votre infirmière vous indiqueront les médicaments que vous devrez continuer de prendre à la maison, les médicaments que vous devrez cesser de prendre à la maison et ceux que vous devrez commencer à prendre.

Pourquoi les pilules que je reçois à l'hôpital sont-elles différentes de celles que j'ai à la maison?

Plusieurs raisons peuvent expliquer le fait que vos pilules soient différentes de celles que vous preniez pendant votre séjour à l'hôpital. Un médicament peut être fabriqué par une autre compagnie, de sorte qu'il ait un aspect légèrement différent; un médicament peut avoir été remplacé par un autre de la même classe de médicaments; ou il se peut qu’un médicament ait été arrêté et qu’un autre vous ait été prescrit pour une raison quelconque. N'hésitez pas à demander à votre infirmière ou à votre médecin de vous donner le nom du médicament que vous recevez et pour quelle raison.

Où dois-je renouveler ma prescription après avoir reçu mon congé de l’HGK?

Vous pouvez retourner à votre pharmacie habituelle. Nous vous encourageons à demander un entretien « MedsCheck» avec votre pharmacien afin d’obtenir une liste de médicaments à jour de votre pharmacie.

Dois-je me rendre à la pharmacie de l’HGK pour obtenir mes médicaments?

Non, les médicaments vous sont fournis par les infirmières.

Quels sont le poids et la taille maximaux que peut supporter la table de l’appareil d’IRM?

Le poids limite supporté par la table est de 180 kg (400 lb), la largeur maximale étant de 60 cm. Pour des images optimales, il est nécessaire que l’organe visé soit à l’intérieur de l’isocentre magnétique qui est situé directement au centre de l’appareil. Pour toute question des patients, contactez notre Service de réservation d’IRM.

Pourquoi tout mon corps se trouve-t-il dans le tunnel si vous ne prenez qu’une image de ma tête?

La partie de l’appareil qui crée les images est située au centre de l’aimant et s’appelle l’isocentre. Par conséquent, afin de prendre une image de votre tête, le haut de votre corps sera dans le tunnel. C’est aussi vrai dans le cas de la colonne vertébrale et des membres supérieurs.

Est-il possible de prendre une image du corps entier pendant que je suis dans l’appareil d’IRM?

Non. L’appareil peut prendre une image de presque n’importe quelle partie du corps, mais chaque image est limitée à un organe précis. Il faut environ 30 à 60 minutes pour prendre une image d’un organe.

Quelle est la différence entre l’imagerie par résonance magnétique (IRM) et la tomodensitométrie (TDM)?

L’IRM et la TDM créent toutes deux des tomographies (images en coupe du corps). La principale différence est que l’appareil d’IRM utilise un grand aimant et des ondes radio pour produire des images alors qu’un tomodensitomètre utilise des rayonnements ionisants.

Une IRM fera-t-elle mal?

Non. Bien que l’appareil d’IRM puisse produire du bruit pendant votre test, vous ne ressentirez aucune douleur pendant le processus.

Qu’est-ce qui cause le bruit dans l’appareil d’IRM?

Le bruit créé par l’appareil est attribuable au courant électrique qui passe dans les fils de l’aimant à gradients. Le courant dans les fils s’oppose au champ magnétique principal; plus le champ est fort, plus le bruit des gradients est fort.

Comment puis-je obtenir une copie des résultats de mon image?

Un radiologue, un médecin formé pour surveiller et interpréter les examens de radiologie, analysera les images et enverra un rapport signé à votre médecin traitant ou orienteur, qui en discutera les conclusions avec vous.

Des examens de suivi peuvent être nécessaires et votre médecin vous expliquera la raison exacte pour laquelle un autre examen est demandé. Parfois, un examen de suivi est exigé si une masse suspecte ou douteuse doit être clarifiée à l’aide d’images supplémentaires ou d’une technique d’imagerie particulière. Un examen de suivi peut également être nécessaire dans le but de surveiller au fil du temps l’évolution d’une quelconque anomalie. Les examens de suivi sont parfois le meilleur moyen de déterminer si un traitement fonctionne ou si une anomalie est stable dans le temps.

How is the VAP case count and rate calculated?

The actual number of VAP cases (case count) will be shown if the number is zero or totals five or more cases associated with that hospital site. If the number is greater than zero but less than five cases, it will be shown as <5 (less than five) in the case count column. The VAP rate is the number of new cases of VAP in the ICU per 1,000 ventilator days. To calculate this rate the total number of VAP cases in the ICU after 48 hours of mechanical ventilation in the ICU is divided by the total number of ventilator days for patients 18 years and older.

How is VAP treated?

Since VAP is caused by bacteria in the lungs, it is treated with antibiotics. 

What can patients and families do?

Ask lots of questions

  • Ask what precautions your hospital is taking to prevent VAP
  • Wash their own hands often. Use soap and water if visibly soiled or alcohol-based hand rub on all other occasions.
What are health care providers doing to prevent VAP?
  • Practising proper hand cleaning techniques
  • Keeping the patient’s head of the bed elevated to a 30-45-degree angle
  • Discontinuing mechanical ventilation as soon as safely possible
  • and good oral care.
What are the risks factors for VAP?
  • Being on a ventilator for more than five days
  • Recent hospitalization (last 90 days)
  • Residence in a nursing home
  • Prior antibiotic use (last 90 days)
  • Dialysis treatment in a clinic
What are the signs and symptoms of VAP?

The most important symptoms include:

  • Fever
  • Low body temperature
  • New purulent sputum (foul smelling infectious mucous or phlegm coughed up from the lungs or airway)
  • Hypoxia (decreased amounts of oxygen in the blood)
What is ventilator associated pneumonia (VAP)?

VAP is a serious lung infection that can occur in patients being treated in an intensive care unit (ICU) who need assisted breathing with a mechanical ventilator for at least 48 hours.

Can someone die from VRE?

Generally, people do not die if they infected with VRE. In severe cases of VRE bacteremias can lead to death. This is rare and tends to occur in those people with other severe health problems. The vast majority of people recover from VRE once their health is restored.

What is the treatment for VRE?

If a patient is simply carrying VRE, no treatment is necessary, as the organism will be cleared on its own when the person’s health is restored. If it is determined that the patient is infected (they have a blood infection, urine infection or wound infection etc.) then the patient will treated with the appropriate antibiotic as determined by a physician.

How is VRE diagnosed?

We do not routinely monitor or isolate persons who carry VRE. Patients with VRE infections are identified during their care and treated accordingly.

What are infection prevention and control precautions? How does this affect my care?

All infection prevention and control precautions or Routine Practices aim to limit the spread of any bacteria to other patients and to health care providers.  

What precautions are used to prevent the spread of VRE in the hospital?

Here at KGH we do not routinely place patients on precautions or isolate those who carry or are infected with VRE. Routine Practices are used because VRE, like other germs can be spread from one person to another by contact; hand hygiene is critical to preventing the spread of all infections in a healthcare setting. Health care providers are routinely required to clean their hands before, during and after patient contact. We also clean and disinfect all patient rooms and equipment to help stop the spread of VRE and other germs. 

How is VRE spread?

VRE is spread from one person to another by contact, usually on the hands of health care providers (HCP). VRE can be present on the health care provider’s hands either from touching contaminated material excreted by the infected person or from touching articles contaminated by the skin of a person with VRE, such as towels, sheets and wound dressings. VRE can live on hands and objects in the environment.

Who is at risk of contracting VRE?

Risk factors for VRE acquisition include severe underlying illness, presence of invasive devices, prior colonization with VRE, antibiotic use and longer hospital stay.

What are Vancomycin-resistant Enterococci (VRE)?

Enterococci are bacteria that are normally present in the human intestines and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called Vancomycin-resistant Enterococci (VRE).

How are SSIs treated?

Most infections are treated with antibiotics – the type of medication will depend on the germ causing the infection. An infected skin wound may be reopened and cleaned. If an infection occurs where an implant is placed, the implant may be removed. If the infection is deep within the body, another operation may be needed to treat it.

What can patients do to help prevent SSIs?

Ask lots of questions. Learn what steps the hospital is taking to reduce the danger of infection.

  • If your doctor instructs, shower or bathe with antiseptic soap the night before and day of your surgery. You may be asked to use a special antibiotic cleanser that you don’t rinse off.
  • If you smoke, stop or at least cut down. Ask your doctor about ways to quit.
  • Only take antibiotics when told by a health care provider. Using antibiotics when they’re not needed can create germs that are harder to kill. If prescribed, finish all your antibiotics, even if you feel better.
  • After your surgery, eat healthy foods.
  • When you return home, care for your incision as instructed by your health care provider.
What precautions are hospitals/health care providers taking to prevent SSIs?

Health care providers should be taking the following precautions to prevent SSIs:

  • Practicing proper hand-hygiene techniques. Before the operation, the surgeon and all operating room staff scrub their hands and arms with an antiseptic soap.
  • Cleaning the site where your incision is made with an antiseptic solution.
  • Wearing medical uniforms (scrub suits), long-sleeved surgical gowns, masks, caps, shoe covers and sterile gloves.
  • Covering the patient with a sterile drape with a hole where the incision is made.
  • Closely watching the patient’s blood sugar levels after surgery to make sure it stays within a normal range. High blood sugar can delay the wound from healing.
  • Warming IV fluids, increasing the temperature in the operating room and providing warm-air blankets (if necessary) to ensure a normal body temperature. A lower-than-normal body temperature during or after surgery prevents oxygen from reaching the wound, making it harder for your body to fight infection.
  • Clipping, not shaving any hair that has to be removed. This prevents tiny nicks and cuts through which germs can enter.
  • Covering your closed wound (closed with stitches) with sterile dressing for one or two days. If your wound is open, packing it with sterile gauze and cover it with sterile dressing.
What are the risk factors for SSIs?

The risk of acquiring a surgical site infection is higher if you:

  • Are an older adult
  • Have a weakened immune system or other serious health problem such as diabetes
  • Smoke
  • Are malnourished
  • Are very overweight
  • Have a wound that is left open instead of closed with sutures
What are the symptoms of SSIs?
  • Increased soreness, pain, or tenderness at the surgical site.
  • A red streak, increased redness, or swelling near the incision.
  • Greenish-yellow or foul-smelling discharge from the incision.
  • Fever of 101 degrees Fahrenheit (38.5 degrees Celsius) or higher

Symptoms can appear at any time from hours to days after surgery. Implants such as an artificial knee or hip can become infected up to 3 months or more after the operation.

What are surgical site infections (SSIs)?

Surgical site infections occur when harmful germs enter your body through the surgical site (any cut the surgeon makes in the skin to perform the operation). Infections can happen because germs are everywhere – on your skin, and on things you touch. Most infections are caused by germs found on and in your body.

Does a low rate of compliance mean that surgeries at KGH are not safe?

Patient safety is a number one priority for all KGH. There are numerous checks and balances in place to ensure the safety of our hospital but hospital care is complicated and depends on many factors. The public reporting of hospitals’ checklist compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Like other patient safety indicators, it is important to look at checklist compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

What is considered a high rate or low rate of compliance? Shouldn’t compliance always be 100%?

The public reporting of our surgical checklist percentage compliance allows us to establish a baseline from which we can track over time. We will closely monitor our rates and should they decrease, we will look closely at our operating room processes and target areas for improvement. The checklist percentage compliance measures the degree to which all three phases (i.e., a briefing, a time out, and a debriefing) of the checklist were performed correctly and appropriately for each surgical patient. We are always striving for 100 per cent compliance. 

How frequently is checklist compliance being publicly reported?

Hospitals will post their bi-annual percentage compliance at the end of July and January.

How long has KGH used a surgical safety checklist? Is this new?

KGH implemented the checklist in one surgical specialty in November 2009. The checklist was implemented in all surgeries in April 2010.

Why are hospitals publicly reporting the checklist indicator?

As part of the Ministry of Health and Long-Term Care’s public reporting of patient safety indicators initiative, eligible hospitals are legally required to post their checklist compliance percentages. KGH strongly supports the provincial government’s strategy to publicly report patient safety Indicators because we believe it will enhance patient safety and strengthen the public’s confidence in our hospitals.

Do hospitals use one standard checklist?

The Canadian Patient Safety Institute has a checklist template that has mandatory requirements for Ontario hospitals to use. KGH then adds additional items to this template that allows us to customize items to fit the type of surgeries performed here and have been declared to be important to the KGH patient population. 

Will I be asked questions to help complete a portion of a surgical safety checklist?

If you undergo a surgery at Kingston General Hospital, you can expect that the surgical safety checklist will be used as part of the procedure. As a patient, you will be asked questions by a surgical team member so that they can complete a portion of the checklist with you.  It will then be used by your surgical team members before, during and after your surgery to help the surgical team members familiarize themselves with your medical history and any special requirements that may be needed for your individual case. 

Why are checklists so important?

Operating room teams have many important steps to follow in order to ensure a safe and effective surgery for every patient. The checklist is a useful tool that helps promote good communication and teamwork among the health care team to help ensure the best outcomes for patients.

What information is included in a surgical safety checklist?

The checklist is used at three distinct stages or phases during surgery:

  • pre-induction (before the patient is put to sleep)
  • time out (just before the first incision)
  • and debriefing (during or after surgical closure)

Some examples of items contained in the checklist include:

The briefing phase:

  • Verify with patient name and procedure to be done
  • Allergy check
  • Medications check
  • Operation site, side and procedure
  • Lab tests, X-rays

The “time out” phase:

  • Patient position
  • Operation site and side and procedure
  • Antibiotics check

The debriefing phase:

  • Surgeon reviews important items
  • Anesthesiologist reviews important items
  • Nurse reviews correct counts 
What is a surgical safety checklist?

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case. In many ways, the surgical checklist is similar to an airline pilot’s checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed. 

Can someone die from MRSA?

Most people do not die if they are infected with MRSA. However in severe cases of MRSA bacteremia, death can occur. This is uncommon and tends to occur in those people with other severe health problems. The vast majority of people recover from MRSA, once their health is restored.

What is the treatment for MRSA?

If a patient is carrying MRSA, generally no treatment is necessary, as the organism is not causing an illness and often will be cleared on its own when the person’s health is restored. If it is determined that the patient is infected (they have a blood infection, skin infection or wound infection etc.) then the patient will treated with the appropriate antibiotic as determined by a physician.

How is MRSA found?

Swabs are performed when patients are admitted to the hospital and periodically for patients whom are at risk. The swabs are sent to the laboratory for analysis and if positive, the laboratory notifies infection prevention and control so that the patient can be placed on Contact Precautions.

What Contact Precautions are used to limit the spread of MRSA?

Contact Precautions aim to limit the spread of MRSA to other patients and to health care providers. You may be placed in a private room or with other patients who are also carrying the bacteria. A sign may be placed on your door to remind others who enter your room about these special contact precautions. Those caring for you as well as visitors will be asked to clean their hands, gown and glove before entering your room. Everyone who enters and leaves your room must clean their hands well. The room and equipment in the room will be cleaned and disinfected regularly.

What precautions are used to prevent the spread of MRSA in the hospital?

Because MRSA is spread from one person to another by contact, hand hygiene is critical to preventing its spread in a health-care setting. KGH actively conducts regular surveillance to find cases of MRSA infection and to identify carriers of MRSA. If a patient is positive for MRSA they are placed on Contact Precautions.

How is MRSA spread?

MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the health care provider’s hands either from touching contaminated material from infected persons or from touching articles contaminated by a person carrying MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment for extended periods of time.

Who is at risk of contracting MRSA?

Risk factors for MRSA infections include invasive procedures, prior treatment with antibiotics, prolonged hospital stay, stay in an intensive care or burn unit, surgical wound infection and close proximity to someone who is carrying MRSA. 

What is a bacteremia?

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

What is Methicillin-resistant Staphylococcus aureus (MRSA)?

Staphylococcus aureus is a germ that lives on the skin and mucous membranes of healthy people. Occasionally, Staphylococcus aureus is a  cause of human infection. When Staphylococcus aureus develops resistance to certain antibiotics, it is called Methicillin-resistant Staphylococcus aureus or MRSA.

Does an above average HSMR mean the care is not good at KGH?

No. The HSMR results should not be used as a guide of choosing where to seek care. A higher than average HSMR result does not necessarily mean that a hospital is “unsafe” – nor does a lower than average HSMR mean a hospital is “safe.” Patients should know that KGH is safe and that the care they receive is top-notch. Every effort – on behalf of everyone serving patients in a hospital – is made to ensure patients receive the highest-quality care possible. Hospital care is complicated and depends on many factors, not all of which are reflected or accounted for by HSMR. That is why many indicators must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination. To judge performance on only one indicator would be misleading.

Why is the HSMR an important measure?

The HSMR is an overall quality indicator and measurement tool that allows for comparison of an acute care hospital’s mortality rate with the overall mortality rate among peer hospitals and regions in Canada. HSMR has been used by many hospitals in several countries to assess and analyze in hospital mortality rates and to help improve quality of care and enhance patient safety. Ontario hospitals are beginning to use the HSMR for internal benchmarking purposes: to show hospitals how their HSMR has changed, where they have made progress and where they can continue to improve.


Why was a new methodology for calculating HSMR initialized?

Morbidity and mortality patterns are changing. Hospitals, like ours, have implemented a range of initiatives to reduce mortality and improve patient care. As a result, HSMR results across the country have been progressively improving. So, this year, CIHI updated the methodology used to calculate HSMR results. For example, Quebec is now included, more diagnoses are added and a new approach to logistic regression modeling is used.

What are some of the key contributing factors to KGH’s HSMR rate?

The rate reported by CIHI for KGH has included patients whose secondary diagnosis included palliative care. These are patients whose hospitalization was for the purpose of palliative care for the majority of their hospital stay. Because palliative care was not the primary diagnosis, CIHI has included these patients in their calculation for KGH’s HSMR. At KGH, palliative patients accounted for 64 per cent of deaths last year. Without these palliative care deaths, the HSMR would be lower. 

What is the Hospital Standardized Mortality Ratio (HSMR)?

The Hospital Standardized Mortality Ratio (HSMR) is an overall quality indicator and measurement tool used by all acute care hospitals and regions in Canada. HSMR has been used by many hospitals in several countries to help improve quality of care and enhance patient safety.


What can patients do to help improve their own safety?

Hand hygiene involves everyone in the hospital, including patients. Hand cleaning is one of the best ways you and your health care team can prevent the spread of many infections. Patients and their visitors should also practice good hand hygiene before and after entering patient rooms.

More information is available at:

What steps does your hospital take if your hand hygiene compliance rates are too low?

KGH works hard-to create a culture of patient safety involves everyone – health care administration, health -care professionals, and, of course, patients and families. If low hand hygiene compliance rates are identified, we will review infection prevention and control practices to ensure that they align with best practices documents, as well as the Just Clean Your Hands program and introduce educational interventions and make appropriate revisions to our program.

Why are hand hygiene compliance rates reported annually and not quarterly?

For the purpose of public reporting, data will be reported on an annual basis. The decision was made to report annually so that hospitals were able to submit enough data and that the compliance rate was statistically valid.

Do low rates mean that patients have a higher risk of catching a hospital associated infection?

Patients should know that their hospital is safe, that the care they receive is topnotch, and that every effort is made to ensure the highest quality of care possible. Public reporting of hand hygiene compliance rates is another helpful measure to ensure the care provided to Ontario patients is even safer, and continues to improve over time. 

A low reported compliance rate does not necessarily mean that health care providers are not performing hand hygiene. The audit tool measures whether health care providers are performing hand hygiene at the right times and the right way. That is why it is vital that hand hygiene compliance rates are viewed in the context of other performance indicators. That said, the analysis of these rates, over time will certainly provide helpful information that can be used to make system improvements in each hospital.


Does less than 100-per-cent compliance mean the hospital is not safe?

No. Patient safety is a number one priority for all Ontario hospitals. There are numerous checks and balances in place to ensure the safety of public hospitals but hospital care is complicated and depends on many factors. The public reporting of hospitals’ hand hygiene compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Rates can vary from hospital to hospital, month to month. Some hospitals will have lower observation opportunities because they do not have as much direct provider-to-patient care opportunities. Due to the types and patient populations (i.e. mental health) of these hospitals, their rates may seem lower. Like other indicators, it is important to look at hand hygiene compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.


If hand hygiene is so important, why is compliance not 100 per cent?

Health care providers performing hand hygiene is a practice that continues to improve as we learn more about hand hygiene best practices. Both hospitals and the health care system have invested considerable resources to improve hand hygiene in hospitals.

The Public Health Ontario provincial hand hygiene campaign, Just Clean Your Hands, was designed to help hospitals and individuals overcome barriers to proper hand hygiene and improve compliance with hand hygiene best practices. The program recognizes that health care providers are busy and require immediate access to hand hygiene products at the right time in the patient care process.

At KGH, for example, where sinks used to be located inconveniently throughout hospitals, there is now fast and easy access to more than 2,200 alcohol-based hand rubs outside all inpatient rooms and adjacent to patients’ bedsides. There are also more freestanding hand cleaning stations located at all main entrances. In addition, ongoing education sessions are held to ensure health care providers know when and where to clean their hands to ensure patient safety.


How do you track hand hygiene?

Direct observation of hand hygiene practice is done by trained observers using the provincial audit tool. The observer conducts observations openly, recording what they see, with the identity of the health care provider is kept confidential.

Why is hand hygiene so important?

The single most common transmission of healthcare-associated infections in a health care setting is via the hands of health care providers.

Health care providers acquire germs from contact with infected patients, or after handling contaminated material or equipment. Hand hygiene is an important practice for health care providers but also involves everyone in the hospital, including patients, families and visitors.

Effective hand hygiene practices in hospitals play a key role in improving patient and health care worker safety, and in preventing the spread of healthcare-associated infections.

What is hand hygiene?

Hand hygiene is the removal of visible soil and removal or killing of microorganisms from the hands. This can be accomplished using soap and water for visibly soiled hands or an alcohol-based hand rub.


Where can I get more information about this and other Patient Safety Indicators?
What can I do to protect myself from C. difficile?

It is not possible to prevent every case of C. difficile infection but each of us can protect ourselves and others by cleaning our hands often. Health-care providers in hospitals must clean their hands according the Ontario Ministry of Health and Long-Term Care’s and hygiene guidelines. If you are receiving care in a hospital it is OK to ask anyone providing care to you if they have cleaned their hands. Cleaning your own hands after using the toilet, before you eat, after blowing your nose and any time they are dirty is a basic and important step to prevent the spread of all infections including C. difficile. Taking antibiotics only as needed and as prescribed by your doctor or nurse-practitioner (advanced practice nurse) and watching out for diarrhea are also important.

Can a person die from C. difficile infection?

Yes, in severe cases of CDI, death can occur. This is uncommon and tends to occur in those people with other severe health problems. The vast majority of people recover from CDI.

How is C. difficile diarrhea detected or diagnosed?

If CDI is suspected, a stool (bowel movement) sample is tested in a laboratory for the toxin it makes. The test takes several hours to perform and most hospitals do this test in their own laboratory. Those hospitals that do not do this test themselves will send the stool sample to another laboratory to do the test. Sometimes a doctor will look directly into the bowel with a special scope (called a sigmoidoscope or colonoscope) to detect abnormal changes in the lining of the bowel that mean that C. difficle is causing the diarrhea. 

What is the treatment for C. difficile infection (CDI)?

If a person has diarrhea due to CDI, a doctor will prescribe a type of antibiotic that kills the C. difficle germs. The two most commonly used antibiotics to treat CDI are metronidazole and vancomycin.


What precautions are used to prevent the spread of C. difficile in the hospital?

C. difficile can be spread from one person to another by contact, hand hygiene is critical to preventing its spread in a health-care setting.

If a patient is positive for C. difficile they are placed on Contact Precautions.

So what are Contact Precautions?

Contact Precautions aim to limit the spread of C. difficile to other patients and to health care providers. You may be placed in a private room or with other patients who are also carrying the bacteria. A sign may be placed on your door to remind others who enter your room about these special Contact Precautions. Those caring for you as well as visitors will be asked to clean their hands, gown and glove before entering your room. Everyone who enters and leaves your room must clean their hands well. The room and equipment in the room will be cleaned and disinfected regularly.

What are the symptoms?

If you get the C. difficile germ you most often do not develop any symptoms of diarrhea at all. People, particularly those taking antibiotics, may get diarrhea. The diarrhea can range from mild to severe with many bowel movements in a day and accompanied by abdominal pain and cramps.

How does someone get C. difficile?

The C. difficile germ enters your body by ingestion of C. difficile spores. This is why cleaning your hands is so important to prevent picking up C. difficile and other germs. You can pick up the C. difficile germ anywhere, but the C. difficile germ is especially common in hospitals because hospitals have many people being given antibiotics. The chances of the C. difficile germ spreading from person to person is much higher in a hospital than it is in your own home, for example.

C. difficile is one of the most common infections found in hospitals and long-term care facilities, and has been a known cause of health-care associated diarrhea for about 30 years.

Who is at risk of contracting C. difficile?

Healthy people are not usually susceptible to C. difficile. Seniors and people who have other illnesses or conditions being treated with antibiotics and those who take acid-suppressing stomach medications are at greater risk of an infection from C. difficile.

What Does the FAW Block Look Like?

Here is an example of what this block looks like when placed on a page. 

What can patients do to help reduce their chances of infection in general?

Patients should always follow instructions given to them by your health care team.  Frequent hand cleaning is another way to prevent the spread of infection. Hand hygiene involves everyone in the hospital, including patients.

How is a central line associated bloodstream infection (CLI) treated?

Treatment depends on the type of catheter, the severity of the infection and the patient’s overall health. Generally, your doctor will prescribe antibiotics to fight the infection and the central line may need to be removed. In some cases, the line is flushed with high doses of antibiotics to kill the germs causing the infection so that the line does not have to be removed. 

What can patients do to prevent a central line associated bloodstream infection (CLI)?
  • Ask lots of questions.
  • Find out why you need the line and where it will be placed.
  • Learn what steps the hospital is taking to reduce the danger of infection.
  • Wash your own hands often. Use soap and water or an alcohol-based hand rub containing at least 60 per cent alcohol.
  • Try not to touch your line or dressing. 
What are health care providers doing to prevent a central line associated bloodstream infection (CLI)?
  • All health care providers should practice proper hand cleaning techniques.
  • Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
  • Wear sterile clothing – a mask, gloves and hair covering – when putting in the line.
  • The patient should be covered with a sterile drape with a small hole where the line goes in.
  • The patient’s skin should be cleaned with “chlorhexidine” (a type of soap) when the line is put in.
  • Choose the most appropriate vein to insert the line.
  • Check the line every day for infection.
  • Replace the line as needed and not on a schedule.
  • Remove the line as soon as it is no longer needed.  

Health care providers who insert a central line in the vein of a patient fill out a central line insertion check list and procedure note which dates, tracks and documents the procedure.

What are some of the risk factors for a central line associated bloodstream infection (CLI)?

Anyone who has a central line can get an infection. The risk is higher if you:

  • Admitted to the ICU
  • Have a serious underlying illness or debilitation
  • Receiving bone marrow or chemotherapy
  • Have the line in for an extended time 
What are some of the symptoms of a central line associated bloodstream infection (CLI)?
  • Redness, pain or swelling at or near the catheter site
  • Pain or tenderness along the path of the catheter
  • Drainage from the skin around the catheter
  • Sudden fever or chills 
What is a central line associated bloodstream infection (CLI)?

Central line infections occur when a central venous catheter (or “line”) is placed in the patient’s vein and the line gets infected. Patients in the intensive care unit (ICU) often require a central line since they are seriously ill and require a lot of medication for a long period of time. When a patient requires long-term access to medication or fluids through an intravenous (IV), a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream. The bacteria can come from a variety of places (skin wounds, environment etc.), though it most often comes from the patient’s own skin.

What else do I need to do before my surgery?

Make sure to follow all instructions carefully about medications, food and drink, that you received from the Pre-Surgical Screening clinic.  Please call your surgeon's office if you have any questions.

In order to decrease your risk of infection, please shower or bathe before arriving for your surgery.

If your are being discharged the day of your surgery ( going home once recovered from surgery) arrange a ride home and plan to have someone stay with you for the first 24 hours after surgery.

If I have more questions about my surgery, when and who can I ask?

Your Surgeon and Anesthesiologist will speak with you and answer your questions on the day of your surgery, prior to you going to the operating room. If you have questions earlier than that, please contact your Surgeon’s office.

Can I cancel my surgery?

If for any reason you need to reschedule or cancel your surgery (you’re feeling sick, or you no  longer want to have the surgery), please call your surgeon’s office as soon as possible.

If you need to cancel or reschedule less than one week before your scheduled surgery date and you are unable to reach the surgeon's office, please call the KGH Operating Room at 613-548-7820.  

What should I bring with me to the hospital?

You should bring your Health Card, insurance information, credit card, medications in original containers as well as a housecoat and slippers. We also encourage patients to bring their CPAP or BiPAP machines from home in order to assist your breathing as you recover from surgery.

If you are staying in the hospital after your surgery and would like to have some personal belongings with you during your stay, please have a family member bring them once your surgery is complete and you have arrived in your hospital room. If your are being discharged the day of your surgery ( going home once recovered), do not bring any extra belongings with you.

Please do not bring valuables (e.g. large amounts of money, jewellery) of any kind to the hospital.  


When should I arrive for my surgery?

A member of our team will call you the night before your surgery (any time after 2:00 p.m.) to confirm the time that you are required to arrive at KGH’s Same Day Admission Centre which is located on Connell 2. 

My surgery date has been booked, what’s next?

You will soon be contacted by the Pre-Surgical Screening office which is located at Hotel Dieu Hospital to book an appointment to help prepare you for your surgery.

If you have not been contacted by the office one week before your scheduled surgery date, please call: 613-544-3400 ext. 2203

Where do I park when I come to KGH?

There are several parking options to choose from when you come to KGH. Please click here (NEED LINK TO 1.1.1) to see all the options.