What's New!- April, 2024

The Northern Maternal Child Network (NMCN), is committed to ensuring you receive timely information regarding best practices, guidelines, resources and events.

Visit our website for more information.



Feel free to send information regarding professional development to info@nmcn.ca for future newsletters. 

Public Health Agency of Canada:

Measles Toolkit

Global health authorities are reporting a significant increase in measles in 2023 that continues into 2024, due in part to a decline in measles vaccinations during the pandemic. The World Health Organization (WHO) reported a 79% increase in the number of global measles cases in 2023 compared to 2022. While cases can occur anywhere in the world, there has been a notable recent increase in the WHO European region. Read the statement released from the Chief Public Health Officer of Canada on Global Increase in Measles and Risk to Canada on February 24, 2024.

Measles cases have recently been reported in Canada. Measles is a highly contagious, potentially fatal virus that is spread through the air and poses serious risks to children under the age of 12 months.

Since routine vaccination against measles does not start until children are 1 year of age, you can help protect them by making sure you and your family have received all your measles vaccinations. Learn more.

The general Measles public fact sheets can also be found directly at:

Measles: Symptoms and treatment - Canada.ca

Measles: Prevention and risks - Canada.ca

Measles: Monitoring - Canada.ca

Measles: Travel health advice - Canada.ca

Measles: For health professionals - Canada.ca

Public Health Ontario:

New Measles Resources

In Ontario, measles has been rare due to high immunization coverage both provincially and across the country. As a result, measles cases are usually associated with travel. Due to an increase in measles activity globally, Ontario has begun to see more cases. In response to the increase in measles cases in Ontario, and Canada, Public Health Ontario PHO is releasing multiple resources:

• Enhanced Epidemiological Summary: Measles in Ontario: this report describes the epidemiology of measles in Ontario in 2024, as well as trends over time for 2013-2023. Case information is provided by age, sex, public health unit, severity, source of infection, and immunization status. This report will be published weekly on Thursdays, with data up to the previous day.
• Technical Brief: focuses on interim infection prevention and control recommendations and use of personal protective equipment for care of individuals with suspect or confirmed measles.
• Measles: Information for Health Care Providers: provides considerations and information to assist with timely identification and management of individuals suspected to have measles, and has been updated to include more detailed information on IPAC best practices.

All their measles resources will be published on their dedicated measles page on their website.

New Report: Impact of the COVID-19 Pandemic on Young Adult Smoking, Vaping and Mental Health

Public Health Ontario (PHO) has released a new report that provides an overview of the available evidence of how the COVID-19 pandemic and the responding public health measures impacted young adults, and focuses on how young adult consumption, product use, initiation, access, and perceived risk of using commercial tobacco and nicotine products were impacted early in the COVID-19 pandemic. The findings of this report helps to support an understanding of how tobacco use and vaping may have changed during the pandemic, and highlights associations between nicotine product use and mental health symptoms during the pandemic.

New reports using the Canadian Health Survey on Children and Youth: Physical Activity, Sleep, and Sedentary Behaviour Indicators

Physical activity, sleep, and sedentary behaviour are important indicators for childhood growth and development, and are associated with long-term physical and mental health outcomes. Supporting healthy physical habits in early life promotes these behaviours across the life course. Our new reports provide information on these important behavioural determinants of health and promote their importance for children and youth in Ontario. Information in these reports is provided by socio-demographic variables, geographic regions, and age group, and is based on data from Statistics Canada’s 2019 Canadian Health Survey on Children and Youth (CHSCY).

New - Maternal and Early Congenital Syphilis in Ontario: 2020-2022

Ontario has observed a substantial increase in the incidence of early congenital syphilis in the last four years, with a total of 41 cases reported from 2019-2022. PHO’s new resource provides a comprehensive description of early congenital and maternal syphilis cases in the province, obtained from interviews with public health units where cases were reported from 2020-2022. Explore the report’s findings now!

We're pleased to share the BORN 2022-2023 Annual Report

This summary highlights how the rich, meaningful information captured in the registry fuels quality improvement, policy and research in various ways across our health system. You can also learn about some of our future directions and opportunities.

Additionally, there is an article spotlighting the Northern Maternal Child Network and one of its partners, Dr. Elaine Innes from Weeneebayko Area Health Authority (WAHA), discussing the utilization of data to comprehend the distinctive requirements in the Northern region.

BORN 2024 Perinatal Enhancement Educational Resources

On May 1, 2024, changes (called “enhancements”) will be made to the BORN Information System (BIS) to fix errors in the system, remove data elements that are no longer needed, and change or add new data elements to improve clarity and better align with clinical practice. 

They are pleased to share some educational resources to help you and your team prepare for these changes. This includes five resources, which are described in more detail below: 

1.      2024 Perinatal Enhancements Clinical Rationale document  

2.     One-page summary of key changes 

3.      Type of Labour decision tree  

4.      Customizable slide deck 

5.     Perinatal Enhancement Webinar

Resource 1 - Attachment 1 – 2024 Perinatal Enhancement Clinical Rationale Document

This document includes a description of the major changes (type of labour, type of birth, maternal/fetal blood group genotyping), a summary of all other changes affecting perinatal, neonatal intensive care, and midwifery data elements, and includes helpful visuals such as screenshots of the updated data elements in the BIS. Please read through the sections of this document that are relevant to your role and setting and save it electronically to refer to as needed for clarification.

Resource 2 – One page summary of key changes 

This document summarizes the key changes at a glance. 

Resource 3 - Type of labour decision tree

This visual can be used to identify how to enter the “type of birth” into the BIS using the new definitions. BORN encourages you to save this document electronically (or print it) to refer to as needed when retrospectively entering in type of birth into the BIS.

Resource 4 – Customizable slide deck

This PowerPoint slide deck includes general information on enhancements, a description and rationale of the major changes, an overview of all other changes, and ideas for local presentation content. While all BIS data partners are welcome to review the content of these slides, they hope that managers, educators, and BIS super-users can adapt and add to these slides for their own use to offer educational in-services with their teams.   

Resource 5 – Perinatal Enhancement Webinar (accessed via BIS Help section) 

On March 5 and 6, 2024, BORN Ontario held webinars about the upcoming changes to the BIS. A recording of the session is available in the Help Section of the BIS (you will need a BIS account to login and access it). They encourage you to view the webinar recording, if you have not already.

BORN hopes these resources will help you learn about what changes are being made and why and can be used as reference documents as you adjust to these changes. If you have questions about the changes to the BIS, please reach out to your manager, clinical educator, or super-users on your team. You may also contact your BORN Regional Coordinator (list available here) with any questions you have. 

New PCMCH Resource:

Accessible Pregnancy Care Planning Toolkit

The Provincial Council for Maternal and Child Health (PCMCH) is pleased to release an Accessible Pregnancy Care Planning Toolkit. This toolkit is now available on our website to support healthcare providers in addressing the unique challenges faced by pregnant individuals with physical disabilities and their families.

People with physical disabilities experience pregnancy at approximately the same rate as people without physical disabilities; however, they can encounter significant barriers when trying to access care. Some individuals with physical disabilities face increased pregnancy risks and complex care needs. To address these risks and need, an interdisciplinary approach is required, and measures can be implemented to enhance the quality of care for these individuals.

In 2023, PCMCH began collaborating with Dr. Anne Berndl and Elizabeth Jung from Sunnybrook Health Sciences Centre’s Accessible Care Pregnancy Clinic  to develop a toolkit for healthcare professionals caring for pregnant individuals with physical disabilities. The resources included in this toolkit were created to drive high-quality care, reduce barriers to access, and to promote inclusivity for this population.

The toolkit includes a Comprehensive Pregnancy Care Checklist and a Complex Case Conference Template. The Comprehensive Pregnancy Care Checklist can be used as a guide when considering potential aspects of care needed for individuals with physical disabilities during pregnancy. It was developed in a person-centred manner with input from people with physical disabilities, community leaders, and an interdisciplinary team of care providers. The Complex Case Conference Template is designed to guide interdisciplinary case conferences for those with medical complexity.

These resources were adapted and revised to ensure their applicability in different care settings by healthcare providers caring for pregnant individuals with physical disabilities. Recognizing that rural, remote, and community care providers may lack access to some of the resources noted in the checklist, the toolkit is designed as a guide for providers to initiate conversations and create a tailored plan for pregnancy care that that is reflective of the care needs of each pregnant individual with a physical disability. 

If you have any questions, please email info@pcmch.on.ca.

New PCMCH Resource:

Recommendations for Effective Collaboration between Home and Community Care Support Services Care Coordinators and Complex Care for Kids Ontario Nurse Practitioners

The Provincial Council for Maternal and Child Health (PCMCH) and Home and Community Care Support Services (HCCSS) are pleased to release the newly developed Practice Guidelines with Recommendations for Effective Collaboration between Home and Community Care Support Services Care Coordinators and Complex Care for Kids Ontario Nurse Practitioners. This resource is now available on the PCMCH website.

Complex Care for Kids Ontario (CCKO) is a provincial program led by PCMCH to improve service delivery, health and quality of life for children/youth with medical complexity (CMC) and their families. CCKO nurse practitioners (NPs) who provide medical care coordination in hospital settings are integral in maintaining strong connections with social support services, including working in concert with HCCSS care coordinators (CCs) to support patients and families in resource and service navigation in the community.

PCMCH and HCCSS convened a working group in June 2023 comprised of representatives from across CCKO and HCCSS to identify opportunities to enhance the partnership between CCKO NPs and CCs and develop practice guidelines intended to strengthen, align and standardize the relationship and protocols between the two key providers. The goals of the practice guidelines are to optimize equitable care; enhance patient outcomes and experience; manage expectations and streamline communication; promote complementary and collaborative work; create efficiency in supporting protocols and information exchange; improve provider experience; and demonstrate wise stewardship of limited human resources across multiple sectors.

Four recommendations were developed through collaborative discussion and provider engagement. Additional resources were also developed and included as supplementary materials to ensure successful adoption of these guidelines. These include: processes to support each recommendation’s implementation, a provider roles and responsibilities section, a CC clinic visit checklist, a medical order form minimum data set, and an example of a current regional process that has proven to be successful.

If you have any questions, please email info@pcmch.on.ca.

Key Recommendations to Right-size Pharmacare for Kids

Children’s Healthcare Canada welcomes Bill C-64, An Act respecting pharmacare, for its strides toward universal access to contraception and diabetes medication. However, the program must include comprehensive coverage of essential medications, prioritizing children and adolescents’ needs. We urge actionable commitments within the pharmacare plan to address pediatric medication coverage.

Read our key recommendations to right-size pharmacare for kids.

Upcoming SPARK Webinar:

Acute Health Care Use and Access among Canadian Children During the Pandemic: Lessons learned

Description:

The pandemic caused abrupt and important changes in the patterns of acute health care use among children and youth in Canada. In this session, the presenters will present data from a series of research studies that have explored these changes, including a focus of those populations at-risk of acute deterioration of their health status. They will discuss what we learned from these changes and how these lessons may inform mitigation strategies for future pandemics or health system disruptions.

Learning Objectives:

Understand how patterns of acute health care use changed during the pandemic for children and youth

Explore which particular subpopulation were more (and less) affected in terms of their risk of needing acute care during the pandemic

Reflect on what strategies need to be in place to support mitigating risk to children and youth in future pandemics

When: April 24, 2024 @ 11AM ET

Recent SPARK Webinar Recordings:

• Achieving Vaccine Equity for Children and Youth- March 20, 2024
• Youth in Pain- Solutions for Effective, Safe, and Equitable Medical Use of Opiods for Pain in Youth- February 28, 2024

Recent SPARK Podcasts Recordings:

• A Pediatric Student-Led Clinic: One model to help right-size children's healthcare- February 26, 2024
• Creating Equitable and Inclusive Healthcare Systems for Children and Families- january 29, 2024

Young children are facing an epidemic of vision loss, experts say. What's behind the surge in myopia?

"The vision disorder has risen dramatically in recent years, projected to impact half the world's population by 2050 — and our youngest generations will bear the brunt of the burden, eye doctors tell the Star.

"The thing that's heartbreaking is it's actually a fairly easy correction," said Dr. David Wong, ophthalmologist-in-chief at Unity Health Toronto. Here's what you need to know about the disease."

Northern Maternal Child Network

Crystal Lawrence, Regional Coordinator

Email: info@nmcn.ca

Website: www.nmcn.ca