October 29, 2025

 RSV Webinar

If you didn't sign up for this webinar, but want to listen, its quite interesting! They talk a lot about how vaccine is funded and how they came to decide on which to offer.  There is also a good discussion about the indigenous perspective on vaccine. 

 Click here and enter Passcode: 7DSp0$E9

SLP follow up
Please encourage families to book a follow up in the BFC after referrals are made.  We received some feedback from our partner providers that families do not have additional follow up in the BFC after receiving SLP or dentistry treatments.  When interventions are introduced, its helpful for families to continue to have the breastfeeding elements supported.  Sometimes the referrals take time, so tell the families to call for a BFC appointment once they receive their appointment with the referred service, so that we can continue to support them in a timely way post intervention.

Nipple Shields
It seems that there is still mixed opinions as to weather the 20mm or the 24mm shields are the best to stock.  We have a new method for ordering nipple shields in bulk, which makes the cost more reasonable.  However, we are  only able to order the 20mm size in bulk.  As a result, we can get the 20mm size for $2.11 each while the 24mm cost $7.50 each.  Please take this into consideration when introducing a shield.  I still have a few nipple size guides if you feel using it would be helpful to determine what might be the most appropriate size for a client.  

A few rules for nipple shield use:

1. 1 shield per client (so please make sure you choose the right size before opening packages) 
2. When possible, please have clients purchase their own.

3. Please document that you have given a shield to the client so that another nurse doesn't open an additional shield.

4.  When introducing a shield, it is important that you inform the client of the benefits and risks of nipple shield use.  Pumping to support supply or long term reliance on the tool may play a part in their decision to use a shield. 

Saskatoon Pediatric Dentistry 

We have received an update on services available to clients by Dr. Koneru at Saskatoon Pediatric Dentistry.  The consultation fee is now $80. A Sask Health card number will pay for the lazer release of either/both lip and/or tongue.  The clinic can direct bill to NIHB for the $80 as long as the baby has a treaty number.  They are not able to use the parent's treaty number.  

This may be a barrier to some NIHB clients as it takes time to obtain a treaty number (8-12 weeks after obtaining a birth certificate).  If they are able to pay upfront, the $80 can be submitted for reimbursement after the treaty number is issued. 

I don't think this is new - but they are still accepting self referrals.

MORE TcB news

Calculating the ΔTSB in newborns between 12 and 120 hours of age indicates how close the measured TSB value is to the threshold for phototherapy treatment. The smaller the ΔTSB, the closer an infant is to requiring phototherapy treatment. Transcutaneous bilirubin (TcB) values can also be used in this calculation. 

To calculate the ΔTSB - you can use the Measured TSB or TcB.  As you are aware, the TSB (when available) is the most accurate value to use, and should be used for the calculation.  In the absence of a TSB value, the TcB would be used in the equation.

These edits have been added to the Newborn Hyperbilirubinemia Record for future printing (but may not appear in charts immediately). 

Free Workshop

We often hear online that breastfeeding and maternal mental health don’t mix, that it adds stress, pressure, or guilt. But that’s not what the research, or many moms’ lived experiences tell us.

When we listen to our bodies and our babies, we find that connection, rhythm, and responsive care can actually support maternal mental health.

Join us for a free virtual workshop exploring the relationship between Maternal Mental Health and Breastfeeding.
We’ll unpack what the research says, reflect on our own experiences, and explore how connection and community help families thrive.

Dates: Wednesday, November 26
Time: 11:00 AM–1:00 PM CT
Cost: Free
Format: Virtual via Google Meet
Register here:  www.lllc.ca/maternal-mental-health

 

October 22, 2025

I received an email this week that is worth sharing and celebrating.  I think this sentiment could have come from MANY clients. It was so nice that she took the time to send an email. 

Good morning, 

We just wanted to pass along our gratitude and compliments about the healthy in home program and in particular the wonderfulness of the nurses we had. The care we received was fantastic and it was so nice to be able to receive it in the comfort of our home as we adjusted to life with a newborn.

As first time parents we had many questions, some of which we felt might have been silly but each and every question was received and every answer provided with the most respect, care, and thorough response. It was very clear that the team is passionate about what they do and the people they care for.

Thank you to the Healthy in Home team! 
Have a great day!

Stats

Please save documenting stats at the bottom of the flow sheets until the parent and baby are discharged.  It is part of the discharge process to go through and ensure that data is accurate.  When its entered prematurely, it can get overlooked at discharge, and it causes crossing out or creates confusion.  Thanks!

Interesting video

The author of the Canadian Paediatric hyperbilirubinemia guidelines that we are now implementing was on a webinar.  He offers some good information and very simple language that may be helpful to hear and use in our discussions with parents about jaundice.  Its less than 30 mins long.  Here's the YouTube link

Its flu season!

I have asked public health and so far there is no plan to have a dedicated flu clinic at WWPHC this year.  You can, however book your own flu appointment @ 4flu.ca.  There are 2 staff immunization clinics that are available to you:

November 6 at Idylwyld Centre from 1030 to 1700 in the Conference Room. 

November 7 at Market Mall CHC from 1030 to 1700 in room 111.

There are also clinics at all the acute care sites - below are the dates and times.  

Sanctum 1.5

The nurse at Sanctum 1.5 has requested that we send her a short report if we go there to do a visit and she is not on site.  I have attached the new work standard here and will update the binder near the TL desk.  Please ensure that you get verbal consent from the client before the report to ensure that sharing that information is acceptable.  It helps the nurse to inform her care for the dyad and update the chart to reflect what has happened.  

Head Lice Policy Update

The management of head lice has changed across the SHA and now follows Routine Precautions only. Previously, a patient with head lice was placed on Contact Precautions and asked to wear a hairnet and shoe covers. However, those processes were not best practice and must be stopped immediately.

Head lice are spread through direct head-to-head (hair-to-hair) contact, and the indirect spread by personal items (combs, brushes, hats) is unlikely to occur. Head lice do not hop or fly, and they do not transmit disease.

Cutting hair to treat lice is no longer a recommended practice. Treatment includes topical pediculicides, oral medication, and other natural remedies.

If you are caring for a patient with head lice, use Routine Practices and conduct a Point of Care Risk Assessment (a copy is posted on the Infection Control board near the Manager’s office). No hairnets or shoe covers are needed.

Please refer to the Healthy and Home Clinical Resource Manual for more information. 

The Saskatchewan RSV Program
Since October 1^st, the RSV injection has been offered to all newborns born in Saskatchewan prior to discharge from the hospital. You will now see it documented on the PPCR.

Nirsevimab (RSV injection) can be provided right after birth, up until the day of discharge and it is important to note that it will only be available in hospital.  Newborns cannot get the RSV injection if they did not get it during their hospital stay.

Nirsevimab is given as a one-time injection, only during a newborn’s first RSV season and it provides protection for at least 5 months.

All newborns will continue to be offered the RSV injection prior to hospital discharge until RSV season is over on March 31^st.

If parents want further information on the Saskatchewan RSV program, you can refer them to the MomsandKidsSask website. https://momsandkidssask.saskhealthauthority.ca/infant-child-health/specialty-care/respiratory-syncytial-virus-program

October 15, 2025

 RSV Webinar

RSV continues to be a leading cause of hospitalization for infants, especially those born prematurely. The good news is that we now have new tools, like monoclonal antibodies and vaccines, that bring real hope for protecting our babies. But access isn’t equal across the country, and too many families still face barriers.  Register Here

Newborn Hyperbilirubinemia Update:

Thank you for your continued feedback as we implement the new guidelines!

1. To decrease confusion when charting our ΔTSB values, we have made more edits to the Newborn Hyperbilirubinemia Record. The record is now divided into two sections.

The section on the left is for TcB screenings and resulting ΔTSB.

The section on the right is for TSB screenings and resulting ΔTSB.

You only have one ΔTSB to report at each home visit. 

2. There was a great point brought up this week regarding albumin and neurotoxicity risk factors. 

Scenario:      

• Baby born at 38+2 weeks
•  No initial neurotoxicity risk factors
• TcB at 83 hrs old was ≥250 µmol/L
• TSB, albumin & DAT were drawn
• Albumin was 28 g/L & DAT was negative 

If a baby’s serum albumin is < 30 g/L it is considered hypoalbuminemia and this is a neurotoxicity risk factor. For all future TcB screenings, the baby will have a neurotoxicity risk factor, and this must be entered in the hyperbili.com tool. 

You will find a new line on our Newborn Hyperbilirubinemia Record. Beside where the DAT and albumin results are documented, you will see a section that states: 
Neurotoxicity risk factors? Y/N.  This should serve as a helpful way of alerting us to neurotoxicity risk factors when they become present.

Remember:

·         Higher albumin levels = neuroprotective
·         Lower albumin levels = neurotoxic

FIT Testing:

Miranda Braun will be running two Fit testing clinics in November for those staff that are due.  The clinics will take place on November 17^th and 26^th from 1000-1430.

You will find a sign-up sheet posted outside the Educator’s cubicle. Please sign up for a time that works for you.  If you are working either of those days, try and book your fit test in the morning slots if possible.  If you are not working, you will get paid to come in for 4 hours to complete your Fit testing. You can let Kerry know if you’d like to be available for home visits before/after your Fit test.

Please refer to the sign-up sheets for the Fit testing location.

MORE staff! 

As we move towards increasing our baseline staff, we will be seeking out more casual employees.  If you know of an experienced nurse who is interested in becoming an IBCLC, there is an upcoming free webinar sponsored by GOLD on October 23 that will inform them on the process for becoming an IBCLC.  Here is the link.

October 8, 2025

 West Winds Baby Cafe 

The new location and time of our Cafe is THRIVING! Look at these happy moms & babes.

Kid's First

As a follow up to their visit at the H&H Team Meeting on September 23, I received the following email that I wanted to share with all of you.  

Thanks again for having us to your staff meeting. It was good to see that the team was so engaged, and that they had questions and feedback during the session. I look forward to hearing more from your team. 

I did neglect to mention a couple of significant things that I hope you can pass along to the H&H team.

• Saskatoon has the highest IHBQ completion rate percentage of all sites that are collecting IHBQs in the province.
• KFS has significantly higher rates of admission to KF through via the IHBQ than other sites.
• We have already seen recommendations from the info session being put into practice on IHBQs received in the last couple of weeks.

This really speaks volumes to the H&H team’s commitment to quality practice!

We have included the following documents for your team to reference.

1. KidsFirst referral form (available in the grey cabinet near TL desk)
2. IHBQ with scoring guide (copies in the KF clip board and cubicle)
3. An optional resource list that you can give to families or use for recommendations (Click Here)
4. An additional IHBQ info sheet with the following (Click Here)
1. An optional script guide for introducing the IHBQ
2. Extra tips for the scoring
3. A basic intro to KidsFirst Saskatoon. 

We realized we are running very low on KF info cards. We are going to update our design and print new cards. We will provide H&H with new cards that they can distribute as deemed appropriate.

Some questions and feedback that we heard in the session:

Q: How is the data used by the Ministry of Education?

A: The Ministry of Education uses this data to determine where and what kind of supports may be required to support child development and school readiness. KidsFirst is an example of a targeted program that is available to some families.  There are several Ministry of Education programs that are included in its Early Years branch. Other programs include ECIP, licensed childcare, Pre-K, Early Years Family Resource Centres, Mobile Early Learning (formerly called Regional KidsFirst). The data collected in the IHBQ can be useful not only to targeted KF but to all of these early years initiatives. 

Q: Who sees the IHBQ data?

A: The IHBQs are distributed to the following:

• our local/regional Public Health offices for their information and use in determining postnatal follow-up. For example, a baby is born in JPCH and lives in Duck Lake. Rosthern PH will receive a copy of the IHBQ.
• HMHB receives a copy of an IHBQ for parents on their caseload (unless declined or missed/discharged)
• Other KF sites if the family lives in that community. For example, a family from Meadow Lake has a baby at JPHC. Their IHBQ would go to KF in Meadow Lake as they may be eligible for KF services there.

The IHBQ data is entered into a Microsoft Office Access Database. Names are not entered into the database. The Ministry of Education collects this data on a regular basis. In addition, the former SHR Public Health Observatory would collect this data for local use. It is unclear if the current SHA Population Health department is aware of this data.

              Q: Can information be noted on the IHBQ that is from the chart or reported from a ward nurse?

              A: Yes

Feedback we heard:

• Administering the tool at such a sensitive time is not ideal. It is an emotional, exhausting and stressful time to answer such personal questions.
• Many of the questions are not trauma-informed and can open painful conversations. There is not time to adequately support a family if they disclose a current risk or previous trauma. For example, the last question on the IHBQ is about previous neonatal death. If a parent discloses the death of a child, it is difficult and inappropriate to complete the questionnaire and move on. This pertains to many questions on the form. When using trauma-informed practice, it would be best practice for the IHBQ administrator to have the time and resources to support the family with the disclosure. This would include time for empathetic listening and options for further support for the family.
• The IHBQ questions can be trauma triggering for families but also can have an impact on IHBQ administrators. IHBQ administrators can be mentally and emotionally impacted by the information disclosed during the IHBQ. This can lead to secondary trauma.
• Much of the language used in the IHBQ is outdated and/or ambiguous (e.g. “Aboriginal”, “mentally challenged”, “PPD”, etc.) 

I would be very happy to receive more feedback from your team on their experience with the IHBQ. For example, I would love to hear from staff why they do or do not ask the optional question on page 1 about “aboriginal descent”. I am also very interested in feedback from staff about increasing number of “declined” IHBQs.

As I mentioned in the session, I do report back to the Ministry of Education on our concerns about the IHBQ. My hope is that there is growing traction for a review of this tool at a provincial level, and that this would benefit both staff and families. 

Party Time!

Flower arranging at Dutch growers for Nov 26th from 6-8pm has been booked. The arrangements take about 45 minutes and then afterwards we thought each person could bring an appy or some kind of bevy (no booze, we need a license for that and it would have costed more) and have some snacks and visits. We need at least 10 people and the deadline to signup and pay is Nov 10th to Chelsea O.

A sign up sheet for what you are bringing is on the white board so that we don't end up with too much doubling.  

Tcb News

As was expected, when a new tool is put to use, there are some kinks to work out.  The staff feedback has been very good.  Thank you for your feedback and for the ways that you help each other problem solve.  I'm always so proud of how the team bands together to embrace new initiatives! 💖

 

Here are some of the things that have been discussion points this week:

1.  There were some questions about discharging babies whose ∆ falls between 61 - 89 after a serum collection.  Although the discharge guidelines were not printed in the box on the TSB table, they still apply to the serum values the same as with the Tcb values.  On the next print out of the record, we will include the guidelines on both tables.  

2. We have discovered that you don't get a ∆ value if your Tcb is high enough to warrant a serum collection.  We thought this only happened if babe had phototherapy.  We have since discovered that is not the case. Its ok, we don't need the ∆ in this instance.  Collect the serum. (Remember, if the Tcb reading is within 50 µmol of the phototherapy threshold, it will prompt a serum collection.) 

If the Tcb value indicates a serum collection is warranted, and the reading is >250, collect an Albumin (if one has not yet been collected), a DAT (prn) and a TSB.  When you enter the TSB value into hyperbili.com it will give you a ∆ value➡️  consult the TSB table.  

3. Please remember that DAT + is a risk for neurotoxicity.  That requires a 'yes' answer the 1st question on the initial page of hyperbili.com.  Last week we had 3 DAT+ babies discharged from JPCH in the red zone.  2 of them were over phototherapy threshold prior to discharge.  I don't think the DAT + element was factored in.  We re admitted all three babies for phototherapy.  A safety report was filed. 

 

October 1, 2025

Truth & Reconciliation

Orange shirt day was well represented by H&H!❤️ 

Let's remember that our work includes doing our part to heal relationships for generations to come. We are encouraged to wear our orange shirts on the last Friday of every month. 

Transfusion Medicine

We received a call from Transfusions.  They have noticed an increase in DAT samples drawn on babies who have already had a DAT collected in hospital.  Its largely the Rh- moms where this is happening.  Please remember that ALL babies of Rh- moms have a DAT collected at birth from the cord blood sample.  It may not be marked on the PPCR, but we should keep a look out when triaging those charts or when we look over the chart prior to a home visit and make sure the results are documented on the Newborn Hyperbilirubinemia Record.  

Upcoming Webinar
The Saskatchewan Prevention Institute is honoured to host the webinar If These Walls Could Talk: The Hidden Toll of Intimate Partner Violence on Children, presented by Dr. Lise Milne, on Tuesday, November 25, 2025, from 10:00 a.m. to 11:30 a.m. CST.
In this session, Dr. Milne will examine the profound and lasting effects of intimate partner violence (IPV) on children who witness or experience exposure to it. Beyond the immediate risks to physical safety, the presentation will explore the emotional, psychological, neurobiological, developmental, and economic impacts of IPV that can influence a child’s well-being and future outcomes. Participants will be invited to deepen their understanding, foster empathy, and consider actions that can help break the cycle of violence and promote safer environments for children and families.
To register, please visit: https://skprevention.ca/event/if-these-walls-could-talk-the-hidden-toll-of-intimate-partner-violence-on-children/.  This webinar will be recorded, and the recording will be shared with all registrants. We encourage you to share this opportunity with your networks.

Newborn Hyperbilirubinemia Program Update

Thank you to everyone for your patience as we roll out the changes to the  newborn jaundice program.  Your feedback is so valuable.  You are the ones who work with these documents and follow this work flow daily.  Please let Kerry or Nicole know if you have questions or suggestions on how we can continue to integrate the necessary changes in the best way possible to facilitate your work.  

You will now find the Newborn Hyperbilirubinemia Record in the all the client charts starting today. This will replace our old Transcutaneous Bilirubin (TcB) nomogram. If your chart does not have the new record, please put it in the chart and use the updated documents from now on. 

It is important to note that the hyperbili.com tool is a universal tool that was developed to be used in centers without access to transcutaneous bilirubin screening. In those centers, TSB values will guide practice.  At Healthy and Home, our practice has not changed; TcB monitoring always precedes TSB collection. TSB is only necessary if indicated by the TSB screening guidelines.

The new record will clarify discharge guidelines:                                         
Discharge guidelines: 
Preterm (<38 weeks), ≥96 hrs & ΔTSB 61-89, may discharge from jaundice monitoring program.

Term (≥38 weeks), ≥48 hrs & ΔTSB  61-89, may discharge from jaundice monitoring program. 

Post phototherapy, hyperbili.com will not calculate the ∆TSB nor will it give a recommendation for follow up. You will need to manually calculate the ΔTSB for those babies. Remember we CAN now monitor with TcB if > 18 hours post phototherapy.  Once you enter the TcB value and the birth date into hyperbili.com, it will calculate the phototherapy threshold for you.                                                                  

ΔTSB = Phototherapy threshold – Measured TcB

We will also move to implementing the new language on the white cards.  Because JPCH has not implemented the new guidelines, when a chart is triaged, we will still note the jaundice level by color in the bottom right of the white card.  When sending your update to the Team Lead,  please report the delta value (∆) she will then replace the color on the white card with the delta value.  There is a large font laminated card on the white board for easy reference as we learn and implement the new language.  

All the iphones now have the greek alphabet keyboard installed to make this easier.  When you wan to insert the ∆ press the globe symbol in the bottom left corner below the keyboard. Press the ∆ and then the globe again to return to the regular keyboard.