Frequently Asked Questions

• Being on a ventilator for more than five days
• Recent hospitalization (last 90 days)
• Residence in a nursing home
• Prior antibiotic use (last 90 days)
• Dialysis treatment in a clinic

• Being on a ventilator for more than five days
• Recent hospitalization (last 90 days)
• Residence in a nursing home
• Prior antibiotic use (last 90 days)
• Dialysis treatment in a clinic

The most important symptoms include:

• Fever
• Low body temperature
• New purulent sputum (foul smelling infectious mucous or phlegm coughed up from the lungs or airway)
• Hypoxia (decreased amounts of oxygen in the blood)

The most important symptoms include:

• Fever
• Low body temperature
• New purulent sputum (foul smelling infectious mucous or phlegm coughed up from the lungs or airway)
• Hypoxia (decreased amounts of oxygen in the blood)

The most important symptoms include:

• Fever
• Low body temperature
• New purulent sputum (foul smelling infectious mucous or phlegm coughed up from the lungs or airway)
• Hypoxia (decreased amounts of oxygen in the blood)

• Increased soreness, pain, or tenderness at the surgical site.
• A red streak, increased redness, or swelling near the incision.
• Greenish-yellow or foul-smelling discharge from the incision.
• Fever of 101 degrees Fahrenheit (38.5 degrees Celsius) or higher

Symptoms can appear at any time from hours to days after surgery. Implants such as an artificial knee or hip can become infected up to 3 months or more after the operation.

• Increased soreness, pain, or tenderness at the surgical site.
• A red streak, increased redness, or swelling near the incision.
• Greenish-yellow or foul-smelling discharge from the incision.
• Fever of 101 degrees Fahrenheit (38.5 degrees Celsius) or higher

Symptoms can appear at any time from hours to days after surgery. Implants such as an artificial knee or hip can become infected up to 3 months or more after the operation.

• Increased soreness, pain, or tenderness at the surgical site.
• A red streak, increased redness, or swelling near the incision.
• Greenish-yellow or foul-smelling discharge from the incision.
• Fever of 101 degrees Fahrenheit (38.5 degrees Celsius) or higher

Symptoms can appear at any time from hours to days after surgery. Implants such as an artificial knee or hip can become infected up to 3 months or more after the operation.

Most infections are treated with antibiotics – the type of medication will depend on the germ causing the infection. An infected skin wound may be reopened and cleaned. If an infection occurs where an implant is placed, the implant may be removed. If the infection is deep within the body, another operation may be needed to treat it.

Ask lots of questions. Learn what steps the hospital is taking to reduce the danger of infection.

• If your doctor instructs, shower or bathe with antiseptic soap the night before and day of your surgery. You may be asked to use a special antibiotic cleanser that you don’t rinse off.
• If you smoke, stop or at least cut down. Ask your doctor about ways to quit.
• Only take antibiotics when told by a health care provider. Using antibiotics when they’re not needed can create germs that are harder to kill. If prescribed, finish all your antibiotics, even if you feel better.
• After your surgery, eat healthy foods.
• When you return home, care for your incision as instructed by your health care provider.

Health care providers should be taking the following precautions to prevent SSIs:

• Practicing proper hand-hygiene techniques. Before the operation, the surgeon and all operating room staff scrub their hands and arms with an antiseptic soap.
• Cleaning the site where your incision is made with an antiseptic solution.
• Wearing medical uniforms (scrub suits), long-sleeved surgical gowns, masks, caps, shoe covers and sterile gloves.
• Covering the patient with a sterile drape with a hole where the incision is made.
• Closely watching the patient’s blood sugar levels after surgery to make sure it stays within a normal range. High blood sugar can delay the wound from healing.
• Warming IV fluids, increasing the temperature in the operating room and providing warm-air blankets (if necessary) to ensure a normal body temperature. A lower-than-normal body temperature during or after surgery prevents oxygen from reaching the wound, making it harder for your body to fight infection.
• Clipping, not shaving any hair that has to be removed. This prevents tiny nicks and cuts through which germs can enter.
• Covering your closed wound (closed with stitches) with sterile dressing for one or two days. If your wound is open, packing it with sterile gauze and cover it with sterile dressing.

The risk of acquiring a surgical site infection is higher if you:

• Are an older adult
• Have a weakened immune system or other serious health problem such as diabetes
• Smoke
• Are malnourished
• Are very overweight
• Have a wound that is left open instead of closed with sutures

• Increased soreness, pain, or tenderness at the surgical site.
• A red streak, increased redness, or swelling near the incision.
• Greenish-yellow or foul-smelling discharge from the incision.
• Fever of 101 degrees Fahrenheit (38.5 degrees Celsius) or higher

Symptoms can appear at any time from hours to days after surgery. Implants such as an artificial knee or hip can become infected up to 3 months or more after the operation.

Surgical site infections occur when harmful germs enter your body through the surgical site (any cut the surgeon makes in the skin to perform the operation). Infections can happen because germs are everywhere – on your skin, and on things you touch. Most infections are caused by germs found on and in your body.

If you get the C. difficile germ you most often do not develop any symptoms of diarrhea at all. People, particularly those taking antibiotics, may get diarrhea. The diarrhea can range from mild to severe with many bowel movements in a day and accompanied by abdominal pain and cramps.

If you get the C. difficile germ you most often do not develop any symptoms of diarrhea at all. People, particularly those taking antibiotics, may get diarrhea. The diarrhea can range from mild to severe with many bowel movements in a day and accompanied by abdominal pain and cramps.

Clostridium difficile Infection (CDI) is often abbreviated to C. difficile or C. diff for short.

C. difficile is a germ that can be found, on occasion, in people’s bowels. It does not always cause problems or symptoms but in some cases can. In some people who are also taking antibiotics, the germ can grow because the antibiotics kill off many of the “good” and harmless germs that normally prevent the C. difficile from growing to high numbers.

C. difficile makes a toxin that damages the fragile lining of the bowel causing inflammation and loose watery bowel movements (diarrhea) and inflammation.

For more information and other related topics we recommend you visit:

• Ministry of Health and Long-Term Care - Patient Safety 
• Public Health Ontario - Regional Infection Control Networks (RICN)

It is not possible to prevent every case of C. difficile infection but each of us can protect ourselves and others by cleaning our hands often. Health-care providers in hospitals must clean their hands according the Ontario Ministry of Health and Long-Term Care’s and hygiene guidelines. If you are receiving care in a hospital it is OK to ask anyone providing care to you if they have cleaned their hands. Cleaning your own hands after using the toilet, before you eat, after blowing your nose and any time they are dirty is a basic and important step to prevent the spread of all infections including C. difficile. Taking antibiotics only as needed and as prescribed by your doctor or nurse-practitioner (advanced practice nurse) and watching out for diarrhea are also important.

Yes, in severe cases of CDI, death can occur. This is uncommon and tends to occur in those people with other severe health problems. The vast majority of people recover from CDI.

If CDI is suspected, a stool (bowel movement) sample is tested in a laboratory for the toxin it makes. The test takes several hours to perform and most hospitals do this test in their own laboratory. Those hospitals that do not do this test themselves will send the stool sample to another laboratory to do the test. Sometimes a doctor will look directly into the bowel with a special scope (called a sigmoidoscope or colonoscope) to detect abnormal changes in the lining of the bowel that mean that C. difficile is causing the diarrhea. 

If a person has diarrhea due to CDI, a doctor will prescribe a type of antibiotic that kills the C. difficile germs. The two most commonly used antibiotics to treat CDI are metronidazole and vancomycin.

C. difficile can be spread from one person to another by contact, hand hygiene is critical to preventing its spread in a health-care setting.

If a patient is positive for C. difficile they are placed on Contact Precautions.

So what are Contact Precautions?

Contact Precautions aim to limit the spread of C. difficile to other patients and to health care providers. You may be placed in a private room or with other patients who are also carrying the bacteria. A sign may be placed on your door to remind others who enter your room about these special Contact Precautions. Those caring for you as well as visitors will be asked to clean their hands, gown and glove before entering your room. Everyone who enters and leaves your room must clean their hands well. The room and equipment in the room will be cleaned and disinfected regularly.

If you get the C. difficile germ you most often do not develop any symptoms of diarrhea at all. People, particularly those taking antibiotics, may get diarrhea. The diarrhea can range from mild to severe with many bowel movements in a day and accompanied by abdominal pain and cramps.

The C. difficile germ enters your body by ingestion of C. difficile spores. This is why cleaning your hands is so important to prevent picking up C. difficile and other germs. You can pick up the C. difficile germ anywhere, but the C. difficile germ is especially common in hospitals because hospitals have many people being given antibiotics. The chances of the C. difficile germ spreading from person to person is much higher in a hospital than it is in your own home, for example.

C. difficile is one of the most common infections found in hospitals and long-term care facilities, and has been a known cause of health-care associated diarrhea for about 30 years.

Healthy people are not usually susceptible to C. difficile. Seniors and people who have other illnesses or conditions being treated with antibiotics and those who take acid-suppressing stomach medications are at greater risk of an infection from C. difficile.

If you get the C. difficile germ you most often do not develop any symptoms of diarrhea at all. People, particularly those taking antibiotics, may get diarrhea. The diarrhea can range from mild to severe with many bowel movements in a day and accompanied by abdominal pain and cramps.

Generally, people do not die if they infected with VRE. In severe cases of VRE bacteremias can lead to death. This is rare and tends to occur in those people with other severe health problems. The vast majority of people recover from VRE once their health is restored.

If a patient is simply carrying VRE, no treatment is necessary, as the organism will be cleared on its own when the person’s health is restored. If it is determined that the patient is infected (they have a blood infection, urine infection or wound infection etc.) then the patient will treated with the appropriate antibiotic as determined by a physician.

We do not routinely monitor or isolate persons who carry VRE. Patients with VRE infections are identified during their care and treated accordingly.

All infection prevention and control precautions or Routine Practices aim to limit the spread of any bacteria to other patients and to health care providers.  

Here at KGH we do not routinely place patients on precautions or isolate those who carry or are infected with VRE. Routine Practices are used because VRE, like other germs can be spread from one person to another by contact; hand hygiene is critical to preventing the spread of all infections in a healthcare setting. Health care providers are routinely required to clean their hands before, during and after patient contact. We also clean and disinfect all patient rooms and equipment to help stop the spread of VRE and other germs. 

VRE is spread from one person to another by contact, usually on the hands of health care providers (HCP). VRE can be present on the health care provider’s hands either from touching contaminated material excreted by the infected person or from touching articles contaminated by the skin of a person with VRE, such as towels, sheets and wound dressings. VRE can live on hands and objects in the environment.

Risk factors for VRE acquisition include severe underlying illness, presence of invasive devices, prior colonization with VRE, antibiotic use and longer hospital stay.

Enterococci are bacteria that are normally present in the human intestines and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called Vancomycin-resistant Enterococci (VRE).

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

For more information and other related topics we recommend you visit:

• Ministry of Health and Long-Term Care - Patient Safety 
• Public Health Ontario - Regional Infection Control Networks (RICN)

Enterococci are bacteria that are normally present in the human intestines and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called Vancomycin-resistant Enterococci (VRE).

Enterococci are bacteria that are normally present in the human intestines and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called Vancomycin-resistant Enterococci (VRE).

Enterococci are bacteria that are normally present in the human intestines and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called Vancomycin-resistant Enterococci (VRE).

Yes, referrals are required for both the non-urgent and urgent Adult Mental Health Program streams.

• The non-urgent stream requires a referral from a medical doctor or nurse practitioner. If you do not have a family physician, we accept referrals from walk-in clinics.

• Referrals from the urgent stream are ONLY accepted internally from the KGH Emergency Department, HDH Urgent Care Centre, Inpatient Mental Health & Addiction Program, and the Consult/Liaison Psychiatry Team.

Once a non-urgent referral is received, the referring practitioner will receive correspondence either accepting the referral and advising of the current wait time or recommending alternate services that may better fit your needs.

Once we have accepted your referral, you will be placed on a waitlist for a telephone call from an intake nurse, which could take up to a year, dependant on the current referral volume.  At the time of intake call, you will either be given an appointment, or be placed on our waitlist for the next available appointment.

Once an urgent referral is received, you will be contacted by an intake nurse. We aim to contact patients referred from the Emergency Department or Inpatient Mental Health Unit within 72 hours, however this may take longer depending on when the referral was received, and whether we need to obtain collateral information.

At the time of intake call, you will either be given an appointment, be placed on our waitlist for the next available appointment or be advised that your case will be discussed during interdisciplinary rounds with an outcome to follow.

You can expect various outcomes, based on your referral and the intake information gathered:

• You may be booked with psychiatry
• You may be placed on a waitlist for a future appointment
• You may be enrolled in group psychotherapy
• We may recommend services that better meet your needs
• Your referral may be closed owing to adequate services already in place for you

The Adult Mental Health Program is unable to provide the following services:

• Disability follow-up appointments as part of employment Insurance

• Canada Pension Plan

• Workplace Safety & insurance Board

• Ontario Disability Support Program requirements

• Independent Medical Evaluations for Court & Child Welfare Assessments

• Forensics or Capacity Assessments.

The non-urgent stream does not offer counseling services, crisis services, or urgent appointments.

Length of treatment is patient-specific. Some patients have just one consult visit and some may have short-term follow-up. It is not within the program’s mandate or capacity to follow patients for a significant length of time. Our model always anticipates patient care will be resumed by a primary care provider.

The urgent stream is a brief intervention service.

The AMHP sees patients in the Kingston, Frontenac, Lennox & Addington area. If you reside outside of that area and have questions about what mental health agency is in your area, please contact our clinical intake coordinator at 613-544-3400 ext. 3700 or search the Connex Ontario website.

If your psychiatrist starts you on a medication, they may prescribe it themselves or they may recommend your referring practitioner initiate the medication. Once you have been discharged from the AMHP, it will be the responsibility of your referring practitioner to continue prescribing the medication. Should you not have a family physician, we recommend attending a walk-in clinic to access refills.

We are unable to book patients for a psychiatric assessment solely for the purpose of providing medication refills.

As part of KHSC, and in collaboration with Queen’s University, St. Lawrence College and other educational institutions we often have students and learners from across many disciplines participate in our various clinics.

• Psychiatry residents (licensed medical doctor that is undergoing their psychiatry training)

• Clinical fellows (a licensed psychiatrist who is training in a specialized psychiatric field)

In the Adult Mental Health program we have both international and Canadian doctors training in sub-specialty streams.

• Clerk/Medical student present for your assessment. All psychiatric care will be provided under the supervision of AMHP Staff Psychiatrist, who you may or may not see in-person.

• Allied Health care providers - Many of our allied health care providers also provide field placements or internships for several disciplines including nursing, occupational therapy, and social work which may involve learners working in the services being provided to you by our provided.

We have very high referral volume and a lengthy waitlist; therefore, it is important that you attend your appointments. However, if you must cancel, please notify us at least 24 hours prior, so that we can fill the vacant spot. If you cancel in advance, we will gladly rebook you, however, please be advised that you may have to wait several months.

A no-show for a new patient assessment will result in an automatic file closure, and a re-referral will be required to be seen again.

A group session allows people to learn new skills and hear from others who may have similar experiences dealing with mental health concerns. Participants may share their thoughts and feelings with others if they are comfortable.

Your appointment may occur in person or virtually.  This will be discussed during your telephone intake when your email address is collected by the intake nurse.  You will be provided an appointment notice letter with this information.

For a virtual appointment, the secretary will email you a link to attend. This link may not be sent until the day before your scheduled appointment and will provide clear instructions on how to proceed. Please note that you must use the internet browser Chrome for the virtual visit to be effective. 

Other resources can be found on the Community Resources page. 

Clostridium difficile Infection (CDI) is often abbreviated to C. difficile or C. diff for short.

C. difficile is a germ that can be found, on occasion, in people’s bowels. It does not always cause problems or symptoms but in some cases can. In some people who are also taking antibiotics, the germ can grow because the antibiotics kill off many of the “good” and harmless germs that normally prevent the C. difficile from growing to high numbers.

C. difficile makes a toxin that damages the fragile lining of the bowel causing inflammation and loose watery bowel movements (diarrhea) and inflammation.

For more information and other related topics we recommend you visit:

• Ministry of Health and Long-Term Care - Patient Safety 
• Public Health Ontario - Regional Infection Control Networks (RICN)

It is not possible to prevent every case of C. difficile infection but each of us can protect ourselves and others by cleaning our hands often. Health-care providers in hospitals must clean their hands according the Ontario Ministry of Health and Long-Term Care’s and hygiene guidelines. If you are receiving care in a hospital it is OK to ask anyone providing care to you if they have cleaned their hands. Cleaning your own hands after using the toilet, before you eat, after blowing your nose and any time they are dirty is a basic and important step to prevent the spread of all infections including C. difficile. Taking antibiotics only as needed and as prescribed by your doctor or nurse-practitioner (advanced practice nurse) and watching out for diarrhea are also important.

Yes, in severe cases of CDI, death can occur. This is uncommon and tends to occur in those people with other severe health problems. The vast majority of people recover from CDI.

If CDI is suspected, a stool (bowel movement) sample is tested in a laboratory for the toxin it makes. The test takes several hours to perform and most hospitals do this test in their own laboratory. Those hospitals that do not do this test themselves will send the stool sample to another laboratory to do the test. Sometimes a doctor will look directly into the bowel with a special scope (called a sigmoidoscope or colonoscope) to detect abnormal changes in the lining of the bowel that mean that C. difficile is causing the diarrhea. 

If a person has diarrhea due to CDI, a doctor will prescribe a type of antibiotic that kills the C. difficile germs. The two most commonly used antibiotics to treat CDI are metronidazole and vancomycin.

C. difficile can be spread from one person to another by contact, hand hygiene is critical to preventing its spread in a health-care setting.

If a patient is positive for C. difficile they are placed on Contact Precautions.

So what are Contact Precautions?

Contact Precautions aim to limit the spread of C. difficile to other patients and to health care providers. You may be placed in a private room or with other patients who are also carrying the bacteria. A sign may be placed on your door to remind others who enter your room about these special Contact Precautions. Those caring for you as well as visitors will be asked to clean their hands, gown and glove before entering your room. Everyone who enters and leaves your room must clean their hands well. The room and equipment in the room will be cleaned and disinfected regularly.

If you get the C. difficile germ you most often do not develop any symptoms of diarrhea at all. People, particularly those taking antibiotics, may get diarrhea. The diarrhea can range from mild to severe with many bowel movements in a day and accompanied by abdominal pain and cramps.

The C. difficile germ enters your body by ingestion of C. difficile spores. This is why cleaning your hands is so important to prevent picking up C. difficile and other germs. You can pick up the C. difficile germ anywhere, but the C. difficile germ is especially common in hospitals because hospitals have many people being given antibiotics. The chances of the C. difficile germ spreading from person to person is much higher in a hospital than it is in your own home, for example.

C. difficile is one of the most common infections found in hospitals and long-term care facilities, and has been a known cause of health-care associated diarrhea for about 30 years.

Healthy people are not usually susceptible to C. difficile. Seniors and people who have other illnesses or conditions being treated with antibiotics and those who take acid-suppressing stomach medications are at greater risk of an infection from C. difficile.

It is not possible to prevent every case of C. difficile infection but each of us can protect ourselves and others by cleaning our hands often. Health-care providers in hospitals must clean their hands according the Ontario Ministry of Health and Long-Term Care’s and hygiene guidelines. If you are receiving care in a hospital it is OK to ask anyone providing care to you if they have cleaned their hands. Cleaning your own hands after using the toilet, before you eat, after blowing your nose and any time they are dirty is a basic and important step to prevent the spread of all infections including C. difficile. Taking antibiotics only as needed and as prescribed by your doctor or nurse-practitioner (advanced practice nurse) and watching out for diarrhea are also important.