Correspondance from Manitoba Health, Seniors and Long-Term Care/Public Health – March 13, 2025

Please distribute this message to all health care providers and other relevant individuals.

Effective April 1, 2025, Manitoba Health, Seniors and Long-Term Care is updating the vaccine used for the adult tetanus booster immunization program as follows:

The Tdap Vaccine Factsheet, and Routine and Not Previously Immunized Immunization Schedules will also be updated online as of April 1, 2025.

Please ensure the correct Tariff codes are selected based on the product being administered. Existing tariffs for Tetanus, diphtheria (Td Adsorbed) will be removed at a later date. Physicians and those who shadow bill are to use the following Tariff code:

• Tdap (Adacel®, Boostrix®): 8907

Please use up your supply of Td Adsorbed vaccine. Once depleted, please order Tdap vaccine on a go-forward basis. Please ensure that you have a supply of Tdap (Adacel®, Boostrix®) to support this program change.

The change from Td to Tdap aims to protect adults from pertussis (whooping cough) and subsequently reduce risk of transmission to infants who are at highest risk of severe respiratory disease, while maintaining protection against tetanus and diphtheria.

If you have any questions, please email [email protected].

For Updates: Contact Angela Peck, Manitoba Health and provide your contact details.

Submitted by:  Loreley Fehr, Director, Health Services – Public Health-Healthy Living

Southern Health-Santé Sud Pharmacy presents an education opportunity on a review of the causes of agitation with a focus on pharmacological management strategies for the acutely agitated patient in the Emergency Department.

For more details and to join the meeting

Poster for printing and posting as deemed appropriate.

Submitted by:  Pharmacy Program

PURPOSE:
To provide guidance, information and a standardized process for health care professionals in emergency departments (ED) and inpatient units to identify and manage patients with Intermediate Risk (submassive) or High Risk (massive) Pulmonary Embolism (PE) and consulting of Pulmonary Embolism Response Team (PERT)

New CLI.4510.SG.008

Background:

• The Emergency Department Council has reviewed the following Shared Health Clinical Guideline approved them for use in SH-SS.
• The provincial PERT Clinical Practice Guideline: Treatment and Referral Guidelines for High-Risk and Intermediate-Risk Pulmonary Embolism in Adult outlines practice standards and guidance for identifying and managing patients and for consulting the Pulmonary Embolism Response Team (PERT).

Key Message:

• To provide a rapid response to manage confirmed or highly suspected acute PE in adult patients by utilizing the PERT pathway.
• To provide SH-SS physicians and nurses access via StaffNET to the Shared Health Clinical Practice Guidelines for use.

Recommendation(s)/Action Required:

• Medical Leads, site Directors, Manages and Clinical Resource Nurses familiarize yourselves with the available clinical guideline, algorithms and communications available from Shared Health.
• Ensure relevant resources are available to support teams to ensure timely access to this service.
  • Provincial Clinical Guideline: Treatment and Referral Guidelines for High-Risk and Intermediate-Risk Pulmonary Embolism in Adult Patients
  • PERT Algorithm
  • PERT Highlights Resource

Timeline: As soon as possible.

Questions:

Contact your site manager or director.

Please access the correspondence from the Manitoba Health, Seniors and Long-Term Care/Public Health dated March 7, 2025.

Please distribute this message to all health care providers and other relevant individuals.

For updates:

Contact Angela Peck, Manitoba Health and provide your contact details.

Submitted by:  Loreley Fehr, Director, Health Services – Public Health-Healthy Living

Effective March 3, 2025, the reference intervals for plasma/serum Alkaline Phosphatase (ALP) tests performed at Shared Health laboratories across province will be revised as a part of ongoing quality improvement.

Please see the Diagnostic Services Clinical Communication regarding Alkaline Phosphatase (ALP) Reference Intervals Update.

Submitted by:  Tamara Burnham, Collaborative Practice Lead

D5W non -PVC, non-DEHP 100 mL bags are currently on backorder and stock will deplete without conservation measures.

Effective immediately, D5W non-PVC, non-DEHP 100 mL bags are to be reserved for amiodarone continuous infusions only. Bags should only be available in critical care areas where patients might have amiodarone continuous infusions administered and should be removed from all other areas.

Nurses are to draw up amiodarone IV bolus and intermittent doses and prepare them in the regular D5W 100 mL minibags (contains PVC/DEHP). These should be administered immediately after preparation as amiodarone injection in PVC/DEHP containers has an expiry of 2 hours at room temperature.

Patients should be switched to oral amiodarone therapy as soon as possible, if clinically feasible.

Other medications requiring non-PVC, non-DEHP containers currently prepared in D5W 100 mL bags, should be prepared in NaCl 0.9% non-PVC, non-DEHP bags if compatible per SH-SS Parenteral Monograph.

Medications incompatible with NaCl 0.9% and requiring non-PVC, non-DEHP containers should be reviewed with pharmacy for an alternate bag size.

Thank you for your support of the ongoing efforts to manage drug supply issues. For questions, please contact your site pharmacy or please contact Rizwan Ahmed or Libby Gair

Submitted by:  Rizwan Ahmed, Director – Pharmacy and Libby Gair, Drug Distribution Supervisor

Southern Health-Santé Sud (SH-SS) clinicians are requested to review and follow directions in this Supply Chain Product Safety Alert-Bard BD Power PICC SOLO 2 (new option 2).

Submitted by:  Tamara Burnham, Collaborative Practice Lead and Tim Siran, Regional Manager-Logistics and Supply Chain Management
For more info., contact: Tim at 431-356-0217 or

PROJECT ECHO (Extension for Community Healthcare Outcomes) is a virtual gathering of health care providers, hosted by mental health experts. Presentations are given by experts and attendees that participate in case-based learning on mental health issues and topics across the lifespan. Join us beginning March 11, 2024 for the five-week CBT skills program. This course is open to people working in Manitoba in healthcare who want to integrate CBT principles and strategies into their practice. This will serve as an introduction to CBT, providing a foundation of knowledge that can be built upon. This training does not provide certification in CBT.

For more details and how to register, access Introduction to CBT Skills.

Submitted by:  Tracy Pulak, Director, Health Services – Mental Health & Addictions

Supply of hydrALAZINE 20 mg/ mL (1 mL) injection has stabilized and can now be used without restriction.

Any questions and concerns regarding inventory and stocking should be directed to your on site pharmacy staff.

Thank you for your support of the ongoing efforts to manage drug supply issues.

For questions, please contact your site pharmacy or please contact Rizwan Ahmed or Libby Gair

Submitted by:  Pharmacy Program

As many of you are aware Southern Health-Santé Sud (SHSS) is participating in the Modernization and Provincial Standardization: Pathway to Long-Term Care (LTC) Project.   On February 18, Shared Health released a Provincial Clinical Practice Change with the updated Medical Assessment form for LTC.  

 Within SHSS we are undertaking a pilot project that will commence Monday, February 24, 2025to trial when the medical assessment is completed.  The previous process asked for redundant information from physicians to confirm medical stability and the level of professional interventions required for Personal Care Home (PCH) or supportive housing care. Much of that information lives already within the Home Care system with the Home Care Case Coordinator (HCCC).

The NEW form also focuses on CONTINUITY of CARE – what medical issues still need addressing (and their relevant history and physical findings) as the patient enters a PCH. For example, a handover from the primary care provider to the PCH provider as the patient enters their new home.

HCCC will now complete the application for PCH admission with families without a medical form for clients requesting a SHSS PCH. 

As we are the first region to test this process, the clients requesting a PCH outside of SHSS will require a medical form completed.

Once an individual reaches third from the top of the PCH waitlist, the PCH will trigger the medical completion in coordination with the Long-Term Care Access Coordinator.  The individual and families will receive communication along with a copy of the medical form and be asked to visit their primary care provider to have the medical form completed. For individuals residing in acute care awaiting placement the most responsible provider will be asked to complete the medical assessment when the bed has become available for the individual

The completed form will be sent back to our Long-Term care Access Coordinator for distribution to all preferred PCHs listed on the individual’s application. This medical assessment will be valid for six (6) months.

In an effort to close the loop in communication, once an individual is admitted to a PCH the primary care provider will be notified in writing by the PCH to advise their patient has been admitted and medical care of the patient has been assumed by the PCH provider. This will allow the primary care provider to de-enroll the individual from their home clinic.

More detailed information will be sent to the primary care providers directly as well.

Any questions about the change in process can be directed to any of the project team including Debbie Harms, Marianne Woods, Kelly Kaleta, Kaleigh Balboa, Dr. Rusk or Dr. Gosselin.

Submitted by:  Stephanie Rozsa, Interim Regional Lead – Community & Continuing Care