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  1. Article ; Online: Covid-19 Surveillance Testing in Nursing Homes.

    Stall, Nathan M / Kain, Dylan C / Johnstone, Jennie

    The New England journal of medicine

    2023  Volume 388, Issue 23, Page(s) 2207

    MeSH term(s) Humans ; COVID-19 ; Nursing Homes ; COVID-19 Testing
    Language English
    Publishing date 2023-05-26
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2304781
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  2. Article ; Online: Effect of Lactobacillus rhamnosus GG on Incident Pneumonia in Critically Ill Patients-Reply.

    Johnstone, Jennie / Heels-Ansdell, Diane / Cook, Deborah

    JAMA

    2022  Volume 327, Issue 2, Page(s) 182

    MeSH term(s) Critical Illness ; Humans ; Lactobacillus rhamnosus ; Pneumonia/therapy ; Probiotics
    Language English
    Publishing date 2022-01-11
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2021.21219
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  3. Article ; Online: Dealing with coronavirus disease 2019 (COVID-19) outbreaks in long-term care homes: A protocol for room moving and cohorting.

    Kain, Dylan C / McCreight, Liz J / Johnstone, Jennie

    Infection control and hospital epidemiology

    2020  Volume 42, Issue 11, Page(s) 1402–1403

    MeSH term(s) COVID-19 ; Disease Outbreaks ; Humans ; Long-Term Care ; Nursing Homes ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-10-28
    Publishing country United States
    Document type Letter
    ZDB-ID 639378-0
    ISSN 1559-6834 ; 0195-9417 ; 0899-823X
    ISSN (online) 1559-6834
    ISSN 0195-9417 ; 0899-823X
    DOI 10.1017/ice.2020.1302
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  4. Article: Community-Acquired Pneumonia in Canada During Coronavirus Disease 2019.

    Mandell, Lionel A / Zhanel, George G / Rotstein, Coleman / Muscedere, John / Loeb, Mark / Johnstone, Jennie

    Open forum infectious diseases

    2022  Volume 9, Issue 3, Page(s) ofac043

    Abstract: Dealing with coronavirus disease 2019 (COVID-19) has been a monumental test of medical skills and resources worldwide. The management of community-acquired pneumonia (CAP) can at times be difficult, but treating CAP in the setting of COVID-19 can be ... ...

    Abstract Dealing with coronavirus disease 2019 (COVID-19) has been a monumental test of medical skills and resources worldwide. The management of community-acquired pneumonia (CAP) can at times be difficult, but treating CAP in the setting of COVID-19 can be particularly trying and confusing and raises a number of challenging questions relating to etiology, diagnosis, and treatment. This article is based on the authors' experiences and presents an overview of how CAP during COVID-19 is handled in Canada. We touch on the issues of microbial etiology in patients with CAP in the setting of COVID-19 as well as diagnostic, site of care, and treatment approaches. Published guidelines are the basis of management of CAP and are discussed in the context of Canadian data. We also outline the usual treatment approaches to COVID-19, particularly in patients who have been hospitalized.
    Language English
    Publishing date 2022-02-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2757767-3
    ISSN 2328-8957
    ISSN 2328-8957
    DOI 10.1093/ofid/ofac043
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  5. Article: The relationship between moral distress, burnout, and considering leaving a hospital job during the COVID-19 pandemic: a longitudinal survey.

    Maunder, Robert G / Heeney, Natalie D / Greenberg, Rebecca A / Jeffs, Lianne P / Wiesenfeld, Lesley A / Johnstone, Jennie / Hunter, Jonathan J

    BMC nursing

    2023  Volume 22, Issue 1, Page(s) 243

    Abstract: Background: Previous research suggests that moral distress contributes to burnout in nurses and other healthcare workers. We hypothesized that burnout both contributed to moral distress and was amplified by moral distress for hospital workers in the ... ...

    Abstract Background: Previous research suggests that moral distress contributes to burnout in nurses and other healthcare workers. We hypothesized that burnout both contributed to moral distress and was amplified by moral distress for hospital workers in the COVID-19 pandemic. This study also aimed to test if moral distress was related to considering leaving one's job.
    Methods: A cohort of 213 hospital workers completed quarterly surveys at six time-points over fifteen months that included validated measures of three dimensions of professional burnout and moral distress. Moral distress was categorized as minimal, medium, or high. Analyses using linear and ordinal regression models tested the association between burnout and other variables at Time 1 (T1), moral distress at Time 3 (T3), and burnout and considering leaving one's job at Time 6 (T6).
    Results: Moral distress was highest in nurses. Job type (nurse (co-efficient 1.99, p < .001); other healthcare professional (co-efficient 1.44, p < .001); non-professional staff with close patient contact (reference group)) and burnout-depersonalization (co-efficient 0.32, p < .001) measured at T1 accounted for an estimated 45% of the variance in moral distress at T3. Moral distress at T3 predicted burnout-depersonalization (Beta = 0.34, p < .001) and burnout-emotional exhaustion (Beta = 0.38, p < .008) at T6, and was significantly associated with considering leaving one's job or healthcare.
    Conclusion: Aspects of burnout that were associated with experiencing greater moral distress occurred both prior to and following moral distress, consistent with the hypotheses that burnout both amplifies moral distress and is increased by moral distress. This potential vicious circle, in addition to an association between moral distress and considering leaving one's job, suggests that interventions for moral distress may help mitigate a workforce that is both depleted and burdened with burnout.
    Language English
    Publishing date 2023-07-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2091496-9
    ISSN 1472-6955
    ISSN 1472-6955
    DOI 10.1186/s12912-023-01407-5
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  6. Article: The impact of respiratory infections and probiotic use on the nasal microbiota of frail residents in long-term care homes.

    Bowdish, Dawn M E / Rossi, Laura / Loeb, Mark / Johnstone, Jennie / Schenck, Louis P / Fontes, Michelle / Surette, Michael G / Whelan, Fiona J

    ERJ open research

    2023  Volume 9, Issue 5

    Abstract: Background: Residents in long-term care homes, who tend to be of advanced age and frail, are at increased risk of respiratory infections. The respiratory microbiota is known to change with age, but whether these changes contribute to the risk of ... ...

    Abstract Background: Residents in long-term care homes, who tend to be of advanced age and frail, are at increased risk of respiratory infections. The respiratory microbiota is known to change with age, but whether these changes contribute to the risk of infection is not known. Our goal was to determine how the nasal microbiota of frail older adults changes during symptoms of influenza-like illness (ILI) and how this may be impacted by enrolment in a placebo-controlled trial testing the feasibility of administering a
    Methods: The microbiome of the nasal (mid-turbinate) of 150 residents of long-term care homes was interrogated using 16S rRNA gene sequencing.
    Results: We identified a diverse and individualised microbiota which could be separated into nine distinct clusters based on Bray-Curtis distances. Samples collected during symptoms of ILI differed statistically from those collected pre- and post-cold and influenza season, and we observed decreased temporal stability (as measured by movement between clusters) in individuals who experienced ILI compared to those who did not.
    Conclusions: The use of probiotics decreased ILI-induced changes to the microbiota; however, it is not clear whether this decrease is sufficient to prevent respiratory illness.
    Language English
    Publishing date 2023-09-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2827830-6
    ISSN 2312-0541
    ISSN 2312-0541
    DOI 10.1183/23120541.00212-2023
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  7. Article ; Online: An emerging multidrug-resistant bacteria.

    Johnstone, Jennie / Patel, Samir N

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2017  Volume 189, Issue 35, Page(s) E1115

    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Bacteria/drug effects ; Bacterial Infections/drug therapy ; Bacterial Infections/microbiology ; Drug Resistance, Multiple, Bacterial ; Humans
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2017-09-06
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.170110
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  8. Article ; Online: Vancomycin-resistant enterococci (VRE) screening and isolation in the general medicine ward: a cost-effectiveness analysis.

    Mac, Stephen / Fitzpatrick, Tiffany / Johnstone, Jennie / Sander, Beate

    Antimicrobial resistance and infection control

    2019  Volume 8, Page(s) 168

    Abstract: Background: Vancomycin-resistant enterococci (VRE) are a serious antimicrobial resistant threat in the healthcare setting. We assessed the cost-effectiveness of VRE screening and isolation for patients at high-risk for colonisation on a general medicine ...

    Abstract Background: Vancomycin-resistant enterococci (VRE) are a serious antimicrobial resistant threat in the healthcare setting. We assessed the cost-effectiveness of VRE screening and isolation for patients at high-risk for colonisation on a general medicine ward compared to no VRE screening and isolation from the healthcare payer perspective.
    Methods: We developed a microsimulation model using local data and VRE literature, to simulate a 20-bed general medicine ward at a tertiary-care hospital with up to 1000 admissions, approximating 1 year. Primary outcomes were accrued over the patient's lifetime, discounted at 1.5%, and included expected health outcomes (VRE colonisations, VRE infections, VRE-related bacteremia, and deaths subsequent to VRE infection), quality-adjusted life years (QALYs), healthcare costs, and incremental cost-effectiveness ratio (ICER). Probabilistic sensitivity analysis (PSA) and scenario analyses were conducted to assess parameter uncertainty.
    Results: In our base-case analysis, VRE screening and isolation prevented six healthcare-associated VRE colonisations per 1000 admissions (6/1000), 0.6/1000 VRE-related infections, 0.2/1000 VRE-related bacteremia, and 0.1/1000 deaths subsequent to VRE infection. VRE screening and isolation accrued 0.0142 incremental QALYs at an incremental cost of $112, affording an ICER of $7850 per QALY. VRE screening and isolation practice was more likely to be cost-effective (> 50%) at a cost-effectiveness threshold of $50,000/QALY. Stochasticity (randomness) had a significant impact on the cost-effectiveness.
    Conclusion: VRE screening and isolation can be cost-effective in majority of model simulations at commonly used cost-effectiveness thresholds, and is likely economically attractive in general medicine settings. Our findings strengthen the understanding of VRE prevention strategies and are of importance to hospital program planners and infection prevention and control.
    MeSH term(s) Cost-Benefit Analysis ; Cross Infection/epidemiology ; Cross Infection/microbiology ; Cross Infection/transmission ; Gram-Positive Bacterial Infections/epidemiology ; Gram-Positive Bacterial Infections/microbiology ; Gram-Positive Bacterial Infections/transmission ; Health Care Costs ; Humans ; Ontario/epidemiology ; Patients' Rooms ; Probability ; Public Health Surveillance ; Quality-Adjusted Life Years ; Vancomycin-Resistant Enterococci/classification ; Vancomycin-Resistant Enterococci/isolation & purification
    Language English
    Publishing date 2019-10-29
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2666706-X
    ISSN 2047-2994 ; 2047-2994
    ISSN (online) 2047-2994
    ISSN 2047-2994
    DOI 10.1186/s13756-019-0628-x
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  9. Article ; Online: Health care-associated infections in Canadian hospitals: still a major problem.

    Johnstone, Jennie / Garber, Gary / Muller, Matthew

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2019  Volume 191, Issue 36, Page(s) E977–E978

    MeSH term(s) Canada ; Cross Infection ; Hospitals ; Humans ; Prevalence ; Surveys and Questionnaires
    Language English
    Publishing date 2019-05-10
    Publishing country Canada
    Document type Journal Article ; Comment
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.190948
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  10. Article ; Online: Review: pneumococcal vaccination is not effective for preventing pneumonia, bacteraemia, bronchitis, or mortality.

    Johnstone, Jennie

    Evidence-based medicine

    2009  Volume 14, Issue 4, Page(s) 109

    Language English
    Publishing date 2009-08
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 1324346-9
    ISSN 1473-6810 ; 1356-5524
    ISSN (online) 1473-6810
    ISSN 1356-5524
    DOI 10.1136/ebm.14.4.109
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