Frequently Asked Questions

Who do I talk to if I have concerns about my safety and COVID-19?

If you have questions or concerns about COVID-19, please reach out to your manager, a member of the Occupational Health, Safety, and Wellness, and/or the Infection Prevention and Control team.

Who do I talk to if I have concerns about my safety and COVID-19?

If you have questions or concerns about COVID-19, please reach out to your manager, a member of the Occupational Health, Safety, and Wellness, and/or the Infection Prevention and Control team.

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.

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 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.

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Where can I get more information about this and other Patient Safety Indicators?
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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.

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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.

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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. difficile is causing the diarrhea. 

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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. difficile germs. The two most commonly used antibiotics to treat CDI are metronidazole and vancomycin.

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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.

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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.

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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.

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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.

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.

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. 

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.

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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.

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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.

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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.

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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.

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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.

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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. 

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What is a bacteremia?

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

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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.

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Where can I get more information about this and other Patient Safety Indicators?
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. 

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. 

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.

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.

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.

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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.

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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.

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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.  

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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. 

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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.

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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.

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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).

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What is a bacteremia?

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

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Where can I get more information about this and other Patient Safety Indicators?
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.

Who pays for genetic counselling and/or genetic testing?

This service is covered by your provincial health insurance. Any exceptions will be discussed ahead of time.

Who will I be meeting with?

You will meet with either a genetic counsellor or medical geneticist, or sometimes both. Genetic counselors are health care professionals with specialized training in counselling and genetics. Medical Geneticists are specialist doctors who have expert training and certification in genetics and inherited diseases.

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.

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.

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.

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.

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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. 

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How frequently is checklist compliance being publicly reported?

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

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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.

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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.

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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. 

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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. 

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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.

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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 
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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.