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Du Bon Usage Des Antibiotiques Evaluation Des Pratiques Au Sein Dun Service Daccueil Et Durgence
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Book Synopsis Du bon usage des antibiotiques: évaluation des pratiques au sein d'un service d'accueil et d'urgence by : Sandra Bernard
Download or read book Du bon usage des antibiotiques: évaluation des pratiques au sein d'un service d'accueil et d'urgence written by Sandra Bernard and published by . This book was released on 2005 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt: La prescription d'une antibiothérapie empirique curative devant un tableaux infectieux bactérien suspecté est complexe. L'augmentation de l'incidence de la résistance des germes aux antibiotiques couramment utilisés, notamment dans les pays à forte consommation d'antibiotiques comme la France, accroît le risque d'une prescription inadaptée source de morbidité voire de mortalité accrue. Un plan national "du bon usage des antibiotiques en vue de maîtriser les résistances bactériennes" a été mis en place en 1996. Un des axes de ce plan recommande la mise en route de protocoles d'aide à la prescription d'antibiotiques dans les services d'urgence. Au sein du SAU du CHI de Poissy, ce type de protocole a été rédigé et mis en place en 2003. L'évaluation du respect des recommandations émises dans ce protocole a fait l'objet d'uen étude observationnelle prospective d'une durée de 3 mois (4 octobre 2004 au 2 janvier 2005), incluant 624 patients. Le diagnostic de pathologie infectieuse motivant une antibiothérapie est réalisé au SAU dans 97,6% des cas et le type de foyer infectieux suspecté est confirmé a posteriori dans 87,3% des cas. Plus de 3/4 des prescriptions d'antibiotiques sont conformes au protocole. Après résultats microbiologiques, l'antibiothérapie probabiliste est mise en défaut, niquement dans 2,3% des cas. Les motifs de non-conformité de l'antibiothérapie sont l'utilisation d'une molécule et/ou d'une posologie non-adaptée (52,1%), l'absence d'indication d'une antibiothérapie (22,6%), l'indication à une association d'antibiotiques (22,6%) et l'absence d'indication à une association d'antibiotiques (2,7%). Le délai médian de mise en route de l'antibiothérapie pour les patients hospitalisés est de 6 heures. Les facteurs liés à une augmentation du délai sont la discussion sur l'indication d'une antibiothérapie dans les méningites lymphocytaires ou panachées et l'administration des antibiotiques dans un autre service que les urgences.
Book Synopsis Evaluation des prescriptions antibiotiques au service d'accueil des urgences du CHU Ambroise Paré by : Hélène Goulet
Download or read book Evaluation des prescriptions antibiotiques au service d'accueil des urgences du CHU Ambroise Paré written by Hélène Goulet and published by . This book was released on 2007 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt: L'utilisation déraisonnée des antibiotiques par son incidence sur l'évolution des résistances bactériennes représente aujourd'hui d'un véritable problème de santé publique. Cette augmentation des résistances est une menace pour l'avenir par son impact sur la morbidité et la mortalité. Depuis plus de dix ans, de nombreuses mesures ont été mises en place pour promouvoir le bon usage des antibiotiques dans les établissements de soins, notamment l'élaboration et la diffusion de recommandations locales pour l'antibiothérapie. Notre étude s'est attachée à évaluer la qualité des prescriptions antibiotiques initiées aux SAU en vérifiant son adéquation avec le référentiel local en antibiothérapie mis à la disposition des cliniciens. 104 patients consécutifs ont été inclus de façon prospective. 54 % des antibiothérapies ont été jugées adéquates par le comité d'experts, 31 % discutables et 15 % non acceptables (l'antibiothérapie n'était pas indiquée ou le choix de l'antibiotique était non acceptable). 85% des indications étaient présentes dans le référentiel, ce qui constitue un facteur prédictif de prescription adéquate (p=0,01). Cependant parmi ces indications, seulement 60% des prescriptions étaient jugées adéquates soulignant donc une sous utilisation des recommandations. 15% des indications ne figurent pas dans le référentiel, il s'agit essentiellement des antibiothérapies préemptives pour les plaies cutanées et les traumatismes ORL, situations rencontrées fréquemment aux urgences. Le guide d'aide à la prescription des antibiotiques doit donc être complété et les recommandations y figurant doivent être mieux appliquées, ce qui suppose un effort de formation et de diffusion afin qu'elles soient mieux connues et mieux comprises. Parallèlement, la mise en place prochaine d'un médecin référent en antibiothérapie, tel qu'il est recommandé dans la circulaire de mai 2002 concernant le bon usage des antibiotiques, et la réalisation d'audits à intervalles réguliers devraient permettre de contribuer à l'amélioration des prescriptions antibiotiques.
Book Synopsis Évaluation des bonnes pratiques d'antibiothérapie au service d'accueil des urgences du centre hospitalier universitaire de Nancy by : Marc Connord
Download or read book Évaluation des bonnes pratiques d'antibiothérapie au service d'accueil des urgences du centre hospitalier universitaire de Nancy written by Marc Connord and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Objectifs de l'étude : Décrire les pratiques de prescriptions d'antibiotiques du SAU et de l'UPUP du CHU de Nancy, en évaluant leur pertinence et leur conformité aux règles d'utilisations et secondairement étudier les facteurs susceptibles d'influencer cette conformité. Méthodes : Étude rétrospective et observationnelle des prescriptions antibiotiques effectuées initialement au sein du SAU, chez des patients secondairement transférés vers l'UPUP. Tous les patients examinés entre le 1er novembre 2014 et le 30 avril 2015, pour lesquels une antibiothérapie était instaurée et secondairement hospitalisés à l'UPUP, ont été inclus. L'analyse de la conformité des prescriptions aux recommandations a été faite a posteriori, avec l'utilisation des référentiels infectiologiques, en vigueur pendant la période d'inclusion. Résultats : 128 patients ont été inclus, avec une moyenne d'âge de 80 ans et un temps de passage moyen de 12 heures. 60,9% des prescriptions d'antibiotiques réalisées au SAU du CHU de Nancy étaient jugées conformes aux préconisations. Le sexe féminin et la présence d'une infection autre que celles des voies respiratoires basses ont été identifiés comme associés aux prescriptions hors recommandations de façon statistiquement significative. Discussion : Le suivi des recommandations au SAU de Nancy est dans la moyenne française. Une nouvelle évaluation, à distance de la prise en charge initiale, soumis aux mêmes référentiels, améliore la conformité aux recommandations. Un délai existe, entre parution de nouvelles recommandations et assimilation dans la pratique médicale quotidienne, et pourrait être diminué grâce à un référent infectiologue au SAU. La vigilance du médecin semble accrue lorsque le patient lui apparaît comme fragile mais aucun dépistage fiable de ce facteur n'est effectué au SAU. L'utilisation d'échelles validées pourrait être une solution afin d'adapter les urgences aux patients gériatriques.
Book Synopsis Le bon usage des antibiotiques à l'hôpital by : Mathilde Perche-Emonet
Download or read book Le bon usage des antibiotiques à l'hôpital written by Mathilde Perche-Emonet and published by . This book was released on 2004 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt: La consommation des antibiotiques en France est l'une des plus élevée au monde. Cet usage excessif contribue à l'accroissement des résistances bactériennes. En conséquence, les choix thérapeutiques deviennent incertains, et la sécurité des patients est en jeu. C'est dans ce contexte que la commission des anti infectieux du C.H.R.U. de Tours a souhaité entreprendre une évaluation de l'usage des antibiotiques au sein de l'établissement comme l'incite la réglementation. Une molécule antibiotique ainsi qu'un service de soins ont été ciblés selon la faisabilité afin de procéder à un audit rétrospectif de prescriptions. Les résultats montrent une bonne qualité de prescription pour la molécule et le service ciblé mais ils dévoilent surtout l'importance de l'expertise du clinicien infectiologue. L'évaluation des pratiques en antibiothérapie doit s'inscrire dans un processus global de gestion des antibiotiques afin de contribuer à l'obtention du bon usage des antibiotiques.
Book Synopsis Comprehensive Cervical Cancer Control by : World Health Organization
Download or read book Comprehensive Cervical Cancer Control written by World Health Organization and published by World Health Organization. This book was released on 2006 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
Book Synopsis Cancer Pain Relief by : World Health Organization
Download or read book Cancer Pain Relief written by World Health Organization and published by World Health Organization. This book was released on 1996 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of a guide, which introduced a simple, yet highly effective method for the relief of cancer pain. Thoroughly revised and updated, the new edition further refines the WHO method, which advocates the use of a small number of relatively inexpensive drugs, including morphine. Revisions draw on experiences with millions of patients around the world as well as new knowledge about the specific pain syndromes unique to cancer. Completely new are chapters describing the international system by which morphine and other opioids are made available for medical purposes. The book has two parts. Part one provides a practical guide to the relief of cancer pain, concentrating on drug treatment as the mainstay of pain management. The most extensive section sets out detailed guidelines for the selection and prescribing of non-opioid analgesics, opioid analgesics, drugs for neuropathic pain, and adjuvant drugs for the treatment of adverse effects, the enhancement of pain relief and the management of concomitant psychological disturbances. Information ranges from explanations of how specific drugs work, through the precautions to take in the presence of certain disorders, to a list of factors that influence the effectiveness of opioids. Concerning the use of opioids, readers are reminded that psychological dependence does not occur in cancer patients and that the only correct dose of morphine is the one that relieves the pain. Part two provides a guide to opioid availability. A discussion of the reasons why opioids continue to be underprescribed or difficult to obtain is followed by an explanation of the Single Convention on Narcotic Drugs.
Book Synopsis World Health Organization Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses by : World Health Organization
Download or read book World Health Organization Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses written by World Health Organization and published by . This book was released on 2012 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines have been developed to support countries to relieve pain in their paediatric populations. These guidelines address persisting pain in children caused by conditions such as cancer, HIV/AIDS, sickle-cell disease, burns, trauma, and phantom limb pain. Recommendations -- developed following a careful and transparent appraisal of available evidence -- are presented for the pharmacological treatment of mild, moderate and severe pain. The guidelines include chapters on the various systems used to classify pain and on the evaluation of pain, which reviews the available tools for routine pain measurement in children. Provision of sustainable pain relief within health care systems is covered in a separate chapter. Since morphine and other opioid analgesics -- required for the relief of moderate-to-severe pain in children -- are listed under the 1961 UN Single Convention on Narcotic Drugs, the new guidelines include an annex explaining the Convention's requirements for the handling and procurement of opioid analgesics for the relief of pain.
Book Synopsis Office Emergencies by : Marjorie A. Bowman
Download or read book Office Emergencies written by Marjorie A. Bowman and published by . This book was released on 2003 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt: Inside, you'll find practical information on how to handle the most common emergencies that present in primary care offices and urgent care centers -- whether in person or over the telephone.
Book Synopsis Cervical Cancer Screening in Developing Countries by : World Health Organization
Download or read book Cervical Cancer Screening in Developing Countries written by World Health Organization and published by World Health Organization. This book was released on 2002 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cervical cancer is the second most common cancer among women worldwide, with 80 per cent of deaths occurring in developing countries. It is an important area for cancer control programmes because of the burden of the disease and the potential for effective prevention via screening. This publication is based on a comprehensive consultation undertaken by WHO in 2001, involving leading experts in the field of cancer epidemiology, screening and treatment. It focuses on the current situation in low and middle income countries, discusses the efficacy of screening methods available, and assesses potential future developments.
Download or read book Managing Epidemics written by and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Emergency Psychiatric Care by : H. L. P. Resnik
Download or read book Emergency Psychiatric Care written by H. L. P. Resnik and published by Brady Publishing. This book was released on 1975 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Dying for Growth written by Jim Yong Kim and published by . This book was released on 2000 with total page 736 pages. Available in PDF, EPUB and Kindle. Book excerpt: Is economic growth killing the poor? The Institute for Health and Social Justice brings us the answers in Dying for Growth. An extraordinary collection of fourteen hard-hitting case studies from Haiti to the US, Dying for Growth exposes the interests behind a system that consigns a fifth of the world's population to live (and die) on less than a dollar a day. Rooted in the lives of people waging heart-wrenching struggles against a new, systemic form of poverty, these studies don't just document inequality -- they pinpoint its underlying causes.Looking at the effects of international restructuring strategies on the poor, the increasing control trans-national corporations exert over world health, and the impact of U.S. drug policy on global inequality, Dying for Growth debunks the myths of global capitalism, including: Myth: Throwing loans at developing nations will cure poverty.Fact: As shown in Sickness Amidst Recovery: Public Debt and Private Suffering in a Peruvian Shanty Town, loans can make things worse.Myth: Getting rid of big government automatically improves the standard of living.Fact: Cutting services can lead to calamity, as detailed in Neoliberal Economic Policy, State Desertion and the Russian Health Crisis. Myth: The free market is a panacea.Fact: There's nothing liberating about modern capitalism, as demonstrated in 'Todo Bajo Control': The Costs of 'Free' Trade to Mexican Maquiladora Workers.Dying for Growth concludes with an extensive section on alternatives to standard models. Included is a chapter on health and revolution in Cuba, The Threat of a Good Example, and a plan for action, Pragmatic Solidarity: What You Can Do.With passionrarely found in works of comparable analytic rigor, Dying for Growth tells the stories of people trapped in the machine of growth, and compels readers to recognize that the problem of inequality is not one of insufficient resources, nor even of inefficiency -- the problem is power.
Download or read book Thickening Fat written by May Friedman and published by Routledge. This book was released on 2019-08-30 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thickening Fat: Fat Bodies, Intersectionality, and Social Justice seeks to explore the multiple, variable, and embodied experiences of fat oppression and fat activisms. Moving beyond an analysis of fat oppression as singular, this book will aim to unpack the volatility of fat—the mutability of fat embodiments as they correlate with other embodied subjectivities, and the threshold where fat begins to be reviled, celebrated, or amended. In addition, Thickening Fat explores the full range of intersectional and liminal analyses that push beyond the simple addition of two or more subjectivities, looking instead at the complex alchemy of layered and unstable markers of difference and privilege. Cognizant that the concept of intersectionality has been filled out in a plurality of ways, Thickening Fat poses critical questions around how to render analysis of fatness intersectional and to thicken up intersectionality, where intersectionality is attenuated to the shifting and composite and material dimensions to identity, rather than reduced to an “add difference and stir” approach. The chapters in this collection ask what happens when we operationalize intersectionality in fat scholarship and politics, and we position difference at the centre and start of inquiry.
Book Synopsis Nature and Culture in the Democratic Republic of Congo by :
Download or read book Nature and Culture in the Democratic Republic of Congo written by and published by . This book was released on 2004 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Education for Critical Consciousness by : Paulo Freire
Download or read book Education for Critical Consciousness written by Paulo Freire and published by A&C Black. This book was released on 2013-06-27 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: Paulo Freire outlines the revolutionary principles behind the educational methods that have made him one of the 20th century's most influential education theorists.
Book Synopsis Bacteremia: Laboratory and Clinical Aspects by : Alex C. Sonnenwirth
Download or read book Bacteremia: Laboratory and Clinical Aspects written by Alex C. Sonnenwirth and published by Charles C. Thomas Publisher. This book was released on 1973 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Quality By Design by : Eugene C. Nelson
Download or read book Quality By Design written by Eugene C. Nelson and published by John Wiley & Sons. This book was released on 2011-01-14 with total page 507 pages. Available in PDF, EPUB and Kindle. Book excerpt: Quality by Design reflects the research and applied training conducted at Dartmouth Medical School under the leadership of Gene Nelson, Paul Batalden, and Marjorie Godfrey. The book includes the research results of high-performing clinical microsystems, illustrative case studies that highlight individual clinical programs, guiding principles that are easily applied, and tools, techniques, and methods that can be adapted by clinical practices and interdisciplinary clinical teams. The authors describe how to develop microsystems that can attain peak performance through active engagement of interdisciplinary teams in learning and applying improvement science and measurement; explore the essence of leadership for clinical Microsystems; show what mid-level leaders can do to enable peak performance at the front lines of care; outline the design and redesign of services and planning care to match patient needs with services offered; examine the issue of safety; describe the vital role of data in creating a rich and useful information environment; provide a core curriculum that can build microsystems’ capability, provide excellent care, promote a positive work environment, and contribute to the larger organization. Ancillary materials for use in classroom teaching, training, or coaching are available at https://clinicalmicrosystem.org/
