RCP e-News July & August 2018

Canadian Association of Perinatal & Women’s Health Nurses (CAPWHN) Newsletter - The June 2018 issue of the CAPWHN Newsletter is now available! CAPWHN newsletters are also available on the CAPWHN website. CAPWHN welcomes your comments, compliments, and suggestions. Contact them at admin@capwhn.ca.

For more information visit www.capwhn.ca.

NS Communicable Disease Medical Advisory – The Nova Scotia Department of Health and Wellness (NS DHW) has issued a medical advisory related to a significant increase in reports of new diagnosis of HIV within Nova Scotia since the beginning of 2018. NSHA Public Health and the NS DHW are working collaboratively to both closely monitor the situation and enhance efforts in case finings and follow-up. For more information and to see the full NS DHW Medical Advisory go to the RCP Website.

Public Health Agency of Canada Releases Updated Practice Guidelines Re: Care During Labour and Birth - The Public Health Agency of Canada is pleased to announce release of Chapter 4, of the Family-Centered Maternity and Newborn Care: National Guidelines. The Guidelines are dedicated to improving and creating consistency in maternal and newborn health and to inform evidence based practice across Canada. The aim of the guidelines is to positively impact health from preconception to postpartum, and throughout the life-course of children, women and families.

Released is:

  • Chapter 4: Care During Labour and Birth
    • Factsheet: Family-Centred Labour and Birth Experience
    • Infographic: Labour and Birth in Canada

PDFs of the chapters and related factsheets/infographics are available online at: https://www.canada.ca/en/public-health/services/maternity-newborn-care-guidelines.html. Over the next two years the Public Health Agency of Canada will be releasing the remaining chapters. If you have any questions about the Family-Centred Maternity and Newborn Care: National Guidelines please contact Lynn Menard at Lynn.Menard2@canada.ca.

Opposition to Breast-Feeding Resolution by U.S. Stuns World Health Officials (New York Times) - A resolution to encourage breast-feeding was expected to be quickly and easily approved by hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly.

Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes. Then the United States delegation, embracing the interests of infant formula manufacturers, upended the deliberations.

Cannabis Resources:

NS Provincial Government Launches Cannabis Public Awareness Campaign - The public awareness campaign has two key tracks: general awareness and cannabis-impaired driving, and seeks to educate Nova Scotians in an approachable and informative way. These topics were identified during numerous stakeholder engagement sessions, public consultation and focus groups with Nova Scotians. It includes ads on video, online display, billboards, radio and social media. The campaign encourages Nova Scotians to visit the new provincial cannabis website for information on cannabis and legalization.

The cannabis website provides information on a wide range of topics, including what the rules will be in Nova Scotia, information on health effects of cannabis use, driving while impaired, guidance on speaking to children and youth about cannabis, and workplace impairment. We encourage you to take a look and share this information within your organization and with your practice and social networks.  

Part Two of SOGC’s Cannabis Public Awareness Campaign - The Society of Obstetricians and Gynecologists of Canada has launched part two of a targeted public awareness campaign to inform women between the ages of 25-40 about the potential adverse effects associated with cannabis use during pregnancy and while breastfeeding. The SOGC awareness campaign is produced with educational videos and supporting social media campaigns on Facebook, Instagram, and YouTube linking to the SOGC’s website. Part two of the campaign, focuses on the concept that cannabis is “Not Just an Herb.

Weighing the Risks of Caesarean Delivery on Maternal Request – In light of the rising incidence of elective caesareans being performed to avoid vaginal birth, SOGC’s Clinical Practice Obstetrics and Guideline Management and Oversight Committee has issued a Committee Opinion. The document provides information to guide care providers in the process of counselling and decision-making with the women and as appropriate, other members of the interprofessional team.

Provincial Implementation of NACI Recommendation Re: Tdap in Pregnancy – Effective August 1, 2018 the NS Department of Health and Wellness has changed the publically funded immunization program to reflect the new 2018 NACI recommendations. The changes include offering the Tdap vaccine in every pregnancy irrespective of previous Tdap immunizations. Ideally Tdap should be offered between 27–32 weeks of gestation but may be provided from 13 weeks up to the time of delivery. Tdap in pregnancy has been shown to protect infants less than 3 months of age and no significant safety issues have been identified. Information regarding NS’s publicly funded immunization program can be found here.

Additionally, the Nova Scotia Publicly Funded Routine Immunization Schedules (Childhood, School, Adult) have been merged to a single document and updated to reflect the recent changes - Routine Immunization Schedules for Children, Youth and Adults to enable a more efficient communication tool for displaying the continuum of publicly funded immunizations throughout the lifespan.

Recent Publications of Interest – Several publications have been recently released and are now available for your review. Several titles with links have been provided below for your information and reading enjoyment:

Canadian Medical Protective Association (CMPA) and the Healthcare Insurance Reciprocal of Canada (HIROC) Release Report - The Canadian Medical Protective Association (CMPA) and the Healthcare Insurance Reciprocal of Canada (HIROC), have collaborated to create a report and infographic- Delivery in Focus: Strengthening obstetrical care in Canada.

As evident in the literature and medical-legal claims, obstetrics is a high-risk clinical area of practice in terms of the severe patient outcomes associated with patient safety incidents. The report focuses heavily on two major risk areas related to obstetrics: fetal heart rate monitoring, and induction and augmentation of labour. Suggested areas of focus for healthcare organizations within the report relate to clinical decision making, system issues and team communication. Also included in this report are results from HIROC’s Risk Assessment Checklists (RAC), an innovative tool enabling Canadian healthcare organizations and practitioners to systematically self-assess compliance with evidence-based strategies that mitigate practitioner and system-level obstetrical risks. We encourage you to share this report and discuss it with your maternal and neonatal teams as well as clinical leaders.

Vitamin K Shortage for NSHA and IWK– The IWK and NSHA are experiencing a product shortage of Sandoz Vitamin K1 Injections (in both formats). These products are manufactured by Sandoz Canada and distributed by Baxter Corporation. Unfortunately there are no direct substitutes and it is anticipated the shortage will last over the summer and into October 2018. Baxter has limited the release of these products and placed them on allocation at 50% of historical usage during the shortage and will continue to monitor inventory until the issue is resolved. IWK and NSHA Pharmacy leaders are working together with Baxter and Sandoz to find solutions to address the challenges the shortage will/has caused.

SOGC Endorses Recommendation on Screening for Asymptomatic Bacteriuria in Pregnancy - The SOGC Board of Directors has endorsed the Canadian Task Force on Preventive Health Care recommendation on screening for asymptomatic bacteriuria in pregnancy. The clinical practice guideline was released on July 9, 2018 in the Canadian Medical Association Journal (CMAJ).

The guideline recommends screening pregnant women for asymptomatic bacteriuria once during the first trimester with a urine culture. However, because of uncertainty regarding the benefits of screening as well as the various preferences of women regarding antibiotic treatment in pregnancy, physicians are urged to weigh the benefits and drawbacks of screening with their patients during their primary visit.

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