Rockyview General Hospital (RGH) is a large hospital. It is located in the city of Calgary, Alberta, Canada, on the shores of the Glenmore Reservoir and is administered by Alberta Health Services and formerly by the Calgary Health Region.The hospital contains over 650 beds and provides medical and surgical services to Calgary and Southern Alberta. The RGH is noted for its comprehensive urology department, and is becoming the leader in Canada for urological care. It includes a 24-hour emergency department, an intensive care unit (ICU), as well as day surgery units. It offers a Maternal Newborn Program, mental health and psychiatric services, as well as senior's health and ambulatory care. The Lions Eye Bank, which is a regional centre for recovery of donated eye tissue for corneal transplants, is located at RGH.The building was designed by Culham Pedersen Valentine, and built at a cost of $90 million. It had a total surface of 69,952 m2 (752,960 sq ft), and an additional 23,000 m2 (250,000 sq ft) were added in 1995. Further expansion in 2004 added another 100 beds.The hospital underwent expansion and upgrades, with two operating theatres added to the surgical suite, and vertical expansion of the Highwood Building. The construction included an additional 100 inpatient beds, as well as three stories added to the hospital's North Tower, and five stories to the south side of the hospital. These expansions were completed in 2008.
Background: Up to 33% of methicillin-resistant Staphylococcus aureus (MRSA) colonized patients will subsequently develop an invasive MRSA infection. Intranasal treatment is necessary to eliminate MRSA in the nose, which is recognized as a primary carriage site. In our 542 bed, community, teaching hospital, we had implemented CHG daily bathing for targeted patient populations (patients in ICU and with central lines), but struggled to reduce MRSA bacteremia rates. We proposed adding nasal decolonization and expanding the target population to include MRSA-positive patients, as a method of reducing MRSA bloodstream infections. Methods: On July 21, 2025, a formal MRSA decolonization protocol, including twice daily mupirocin for five days, and daily CHG bathing was recommended for all ICU patients, regardless of MRSA history, and MRSA positive patients, on any inpatient unit. A MRSA decolonization order set went live on October 27th, 2025, and was automatically added to pre-existing ICU admission and central line maintenance order sets. Pre-and post-intervention National Healthcare Safety Network (NHSN) hospital-onset MRSA bacteremia standardized infection ratios (SIR) were compared, in addition to a monthly review of MRSA bacteremia rates per 1000 patient days and mupirocin administration. NHSN antimicrobial resistance module standardized resistant infection ratios (SRIRs), were also compared between 2024 and 2025. Result: The pre-intervention (January-June 2025) MRSA bacteremia SIR was 0.853, compared to a post-intervention (August-December 2025) MRSA bacteremia SIR of 0.405. This represents a 53% reduction in SIR (p=0.398). The outpatient MRSA BSI prevalence rate from emergency department visits stayed steady between the pre and post-intervention periods, at 0.095 and 0.094. Figure 1 shows the inverse relationship between the increase in mupirocin administration (utilizing a threshold of < 5 administered doses) and decrease in hospital-onset MRSA bacteremia. Figures 2 and 3 show the prior years’ variation and current decline in SRIRs for both MRSA bacteremia and lower respiratory tract specimens. A decreasing trendline was not observed for other organisms’ SRIRs, including vancomycin-resistant Enterococcus. Conclusion: MRSA bacteremia contributes to significant morbidity, mortality, and financial penalties for hospitals. CHG bathing alone for ICU and central line patients was inadequate to reduce MRSA bacteremia rates. A default order set for MRSA decolonization, including nasal mupirocin, added to all ICU admissions and central line maintenance orders, improved compliance with the recommended protocol. Our hospital experienced a reduction in MRSA bacteremia following the implementation of a standardized decolonization protocol, including the nares, for all ICU, central line, and MRSA positive patients.
Purpose: To present two cases of ocular toxoplasmosis diagnosed by histopathological examination of eviscerated eyes. Observations: Ocular toxoplasmosis is primarily a clinical diagnosis, however atypical presentations and limitations in serological and molecular testing make the diagnosis challenging. We report two patients who were infected by the parasite Toxoplasma gondii and underwent evisceration of their blind eye. Histopathological analysis of the intraocular contents in each case demonstrated retinal necrosis located above and below the retinal pigment epithelium (RPE), identification of tachyzoites and bradyzoites, and confirmatory immunohistochemical method for Toxoplasma gondii using monoclonal antibodies. These findings are similar to previously described histopathological criteria in enucleated eyes with ocular toxoplasmosis. Conclusion and importance: This is the first report demonstrating histopathological diagnosis of ocular toxoplasmosis using evisceration rather than enucleation in immunocompromised patients. These findings support consideration of evisceration as an alternative to enucleation and highlight three key histopathological features essential for diagnosis.
BackgroundColorectal cancer (CRC) is globally the third most prevalent cancer and a leading cause of cancer-related deaths. In Alberta, Canada, a significant portion of CRC diagnoses occur following emergency department (ED) presentations. Gaps remain in understanding patient's perspectives on CRC diagnosis after an ED visit. The aim of this study was to examine the experiences and perspectives of a group of patients diagnosed with CRC subsequent to an ED visit in Alberta and their close contacts.MethodsWe conducted a qualitative study using in-depth, semi-structured interviews with patients diagnosed with CRC after an ED visit at the Rockyview General Hospital, Calgary, and their close contacts, from November 2022 to June 2023. Interviews focused on symptom recognition, healthcare interactions, and the decision-making process leading to an ED visit. They were conducted in-person or over the phone, and analysed using thematic analysis.ResultsEighteen participants (12 patients and 6 close contacts) were interviewed, revealing four main themes: (1) variability in symptom recognition and interpretation; (2) inconsistencies in primary care consultations; (3) factors influencing decision-making leading to an ED visit; and (4) recommendations for expedited diagnosis outside of EDs.ConclusionThe findings highlight the complexity of the diagnostic journey for CRC patients in Alberta, pointing to significant gaps in symptom recognition and response by patients and healthcare providers. Improved diagnostic protocols and targeted support for healthcare providers, as well as approaches to address systemic delays may help streamline the diagnostic journey. Future research should focus on exploring innovative interventions to address the identified barriers to timely CRC diagnosis.
Sarcoidosis is a disease of unknown etiology that continues to challenge clinicians in its diagnosis and treatment. Although uncommon, cardiac involvement is fatal and is the second most prevalent cause of death in sarcoidosis patients globally. This article outlines the pathophysiology, diagnosis, and management of cardiac sarcoidosis to guide nurse practitioners.
Drug therapy for patients with systemic lupus erythematosus (SLE) aims to decrease symptom severity. Pharmacologic interventions are divided into four categories: antimalarials, glucocorticoids (GCs), immunosuppressants (ISs), and biological agents. Hydroxychloroquine, the most commonly used antimalarial treatment for this disease, is a mainstay in treating all patients with SLE. The multitude of adverse reactions of GCs has led clinicians to minimize their dosages or discontinue them whenever possible. To speed up the discontinuation or minimization of GCs, ISs are used for their steroid-sparing properties. Furthermore, certain ISs such as cyclophosphamide are recommended as maintenance agents to prevent flares and reduce the reoccurrence and severity of the disease state. Biological agents are recommended when other treatment options have failed due to intolerance or inefficacy. This article presents pharmacologic approaches for managing SLE in patients based on clinical practice guidelines and data from randomized controlled trials.
