Establishment of a European-type strain of Echinococcus multilocularis in Canadian wildlife.

In 2009, a haplotype closely related to European strains of Echinococcus multilocularis was detected in a dog from the Quesnel region of British Columbia, Canada. We now report the establishment of this same haplotype in 7 coyotes (Canis latrans) trapped within 40 km of Quesnel, BC. In addition, 3 coyotes and 1 red fox (Vulpes vulpes) harboured adult cestodes morphologically compatible with that of E. multilocularis (overall prevalence 33% in 33 carnivores). None of 156 potential intermediate hosts, including 131 representatives of two highly suitable rodent species, Peromyscus maniculatus and Microtus pennsylvanicus, trapped from a region 120-210 km south of Quesnel were infected. This report confirms the establishment and local transmission of a European-type strain of E. multilocularis (the causative agent of human alveolar hydatid disease), in wildlife in a forested region of North America where this cestode had not been previously detected, with significance for public and animal health.

The Canadian hospital pharmacy workload measurement study.

"One pharmacist for every 100 beds" has been the traditional rule of thumb used in determining hospital pharmacy staffing requirements in North America. Hospital pharmacy practice has undergone profound changes over the past 20 years. Staffing requirements for contemporary hospital pharmacy practice determined by the traditional guideline are outdated and of limited value. The Canadian government, through its National Health Research and Development Program, funded a $225,000 study to develop a Canadian Hospital Pharmacy Workload Measurement System which would provide a data base for a more accurate determination of staffing requirements for hospital pharmacies. Time studies were carried out to measure the personnel time required to perform defined activities that collectively formed a pharmacy service or function.

Establishing a clinical pharmacokinetic service for gentamicin in a community hospital.

To assess the feasibility and acceptability of a pharmacy-based clinical pharmacokinetic service for gentamicin, serum gentamicin levels were measured by radioimmunoassay in 44 patients hospitalized during a three-month period in an acute-care general hospital. Serum levels measured pre- and post-infusion were used to estimate pharmacokinetic parameters and optimum dosage regimens for individual patients. Based on serum level measurements of gentamicin, 30% of patients required no dosage adjustment, 23% an increase in dose and 47% a decrease in dose. Of the 30 changes recommended, 83% were implemented by physicians. Monitoring serum levels and adjusting dosage reduced the number of patients with sub-therapeutic and toxic serum levels. Adjusting dosage with the aid of serum levels appeared to be most useful for the elderly patient or the patient with impaired kidney function. Initial choice of dosage regimens for patients would be improved by appropriate use of the Hull and Sarubbi dosing nomogram (with certain modifications) or method of estimating pharmacokinetic parameters. The Hull and Sarubbi method was considered preferable to the dosing recommendation of 1.1 mg/kg at an interval of eight times the serum creatinine value. Excellent physician acceptance of a gentamicin serum level monitoring service was demonstrated in terms of the physician's usage of the service and implementation of the pharmacist's recommendations. A multidisciplinary approach involving medicine, pharmacy, nursing and laboratory staff was essential for successful operation of the pharmacokinetic service. However, the responsibility for the development and overall coordination of the pharmacokinetic service should remain with the pharmacist.

The development of a Canadian hospital pharmacy workload measurement system.

The aim of the proposed study is to establish a national workload measurement system for hospital pharmacy in Canada. No reliable method presently exists to determine staffing requirements for hospital pharmacy. In order to establish staffing guidelines, a method of scientifically assessing and measuring hospital pharmacy workloads is needed. It is proposed to develop worlkload measurement data for hospital pharmacy according to the Canadian Workload Recording Method of Statistics Canada. The Canadian Workload Recording Method was developed to provide a scientific basis for measuring clinical laboratory workload, thus promoting effective laboratory management. This method is now being applied to other health professions. Data for hospital pharmacy will be collected from various hospital pharmacy departments across Canada based on standardized definitions of modern hospital pharmacy practice. The proposed study will be carried out over a period of two years by a research group located at the College of Pharmacy, University of Saskatchewan, Saskatoon, in cooperation with the Canadian Society of Hospital Pharmacists. Workload measurement data of pharmacy services in Canadian hospitals will serve as a valuable management tool for hospital pharmacy directors, hospital administrators and federal-provincial funding agencies in the determination of total manpower needs and resources for hospital pharmacy. Also, information obtained will be of administrative assistance in the areas of: (a) development of standardized methods of recording hospital pharmacy management information; (b) generation of valid and reliable data to allow comparative studies of hospital pharmacy departments in terms of productivity and utilization of manpower; (c) determination of the proper staffing ratio between pharmacists and supportive personnel; and (d) development of short and long-term planning goals for the hospital pharmacy department. The Canadian Workload Recording Method was designed to reflect current practice by a system of continuous monitoring and review by the user. As new pharmaceutical services develop, additional workload studies can be conducted to establish new standards demonstrating the impact of future programs on manpower requirements.