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Objective: The goal of this study was to (1) Describe the patient population of a newly implemented addiction medicine consult service (AMCS); (2) Evaluate referrals to community-based addiction support services and acute health service use, over time; (3) Provide lessons learned. Methods: A retrospective observational analysis was conducted at Health Sciences North in Sudbury, Ontario, Canada, with a newly implemented AMCS from November 2018 and July 2021. Data were collected using the hospital's electronic medical records. The outcomes measured included the number of emergency department visits, inpatient admissions, and re-visits over time. An interrupted time-series analysis was performed to measure the effect of AMCS implementation on acute health service use at Health Sciences North. Results: A total of 833 unique patients were assessed through the AMCS. A total of 1,294 referrals were made to community-based addiction support services, with the highest proportion of referrals between August and October 2020. The post-intervention trend for ED visits, ED re-visits, ED length of stay, inpatient visits, re-visits, and inpatient length of stay did not significantly differ from the pre-intervention period. Conclusion: Implementation of an AMCS provides a focused service for patients using with substance use disorders. The service resulted in a high referral rate to community-based addiction support services and limited changes in health service usage. [ABSTRACT FROM AUTHOR]

Background: Healthcare-associated infections (HAIs) continue to place a burden on patient health and safety as well as on the healthcare system. In Canada, national surveillance of HAIs at sentinel acute care hospitals is conducted by the Canadian Nosocomial Infection Surveillance Program. This article describes ten years of device and surgical procedure-related HAI epidemiology in Canada from 2011 to 2020. Methods: Data were collected from over 40 Canadian sentinel acute care hospitals between January 1, 2011, and December 31, 2020, for central line-associated bloodstream infections (CLABSIs), hip and knee surgical site infections (SSIs), cerebrospinal fluid shunt SSIs and paediatric cardiac SSIs. Case counts, rates, patient and hospital characteristics, pathogen distributions, and antimicrobial resistance are presented. Results: Between 2011 and 2020, 4,751 device and surgical procedure-related infections were reported, with CLABSIs in intensive care units (ICUs) representing 67% (n=3,185) of all reported infections. Over the surveillance period, significant rate increases were observed in adult mixed ICU CLABSIs (0.8 to 1.6 per 1,000 line days, p=0.004) while decreases were observed in neonatal ICU CLABSIs (4.0 to 1.6 per 1,000 line days, p=0.002) and SSIs following knee arthroplasty (0.69 to 0.29 infections per 100 surgeries, p=0.002). No trends were observed in the other reported HAIs. Of the 5,071 pathogens identified, the majority were gram-positive (68%), followed by gramnegative (23%) and fungi (9%). Coagulase-negative staphylococci (27%) and Staphylococcus aureus (16%) were the most frequently isolated pathogens. Conclusion: This report describes epidemiological and microbiological trends among select device and surgical procedure-related HAIs, essential for benchmarking infection rates nationally and internationally, to identify any changes in infection rates or antimicrobial resistance patterns and to help inform hospital infection prevention and control and antimicrobial stewardship policies and programs. [ABSTRACT FROM AUTHOR]