Search

Background The objectives were to describe outpatients’ psychosocial characteristics and to identify the prevalences of unanticipated hospital admission immediately following outpatient surgery and of severe complications in outpatients at one month after ambulatory surgery. Methods A prospective cohort study was conducted during one month in Rouen University Hospital in January 2017. An anonymous questionnaire was administered in outpatients before hospital discharge. After another month after discharge, data regarding unanticipated hospital admission (primary endpoint) and readmission for complication related to ambulatory surgery and risk factors of readmission depending on psychosocial level (secondary endpoint) were collected from patient medical records. Data included demographic and psychosocial characteristics information on surgery and anesthesia. Results A total of 598 outpatients were included during a month, which represented 85.7% of the outpatients of the hospital unit. The mean age was 50.8 years old (SD = 19.8), the sex ratio male/female was 0.68. Among the outpatients, 93.8% had an ASA Physical Status of I or II. There were 23.5% ophthalmic surgeries, 19.0% gynecological surgeries, 17.7% orthopedic surgeries, 8.3% plastic surgeries; 47.5% of operations were carried out under general anesthesia and 16.6% under regional anesthesia. Twenty percent of outpatients lived alone and 2.6% lived alone and socially isolated; 1.6% of outpatients returned home as a pedestrian and 3.4% used public transportation; 13.7% of outpatients were not accompanied for the first night after surgery. There were 11 (1.84%) unanticipated hospital admissions (7 for medical reasons, 1 for surgery and 3 for organizational difficulty). There were 11 (1.84%) patients that returned in hospital in the 30 days that followed the surgery with 3 readmissions. There was no difference between patients with low socioeconomic status and other patients for unanticipated hospital admission or readmission (working outpatients versus not working, P = 0.42, outpatients with primary, middle or secondary education versus higher education, P = 1.00). Conclusions In our study, the prevalence of unanticipated hospital admission and readmission was low and comparable to the literature. In this work, the psychosocial level was not a risk factor of unanticipated hospital admission or readmission after ambulatory surgery.

Resume En France, la legislation impose d’informer tout patient hospitalise du risque d’infection nosocomiale (IN) et de sa survenue effective. En milieu psychiatrique, des difficultes dans l’application de cette reglementation peuvent etre attendues du fait des pathologies rencontrees. L’objet de ce travail etait d’evaluer les connaissances, l’opinion et les pratiques des professionnels de sante en psychiatrie, en matiere d’information sur les IN. Un autoquestionnaire anonyme a ete complete par 114 professionnels de sante exercant dans quatre etablissements ayant une activite psychiatrique en Haute-Normandie. Le niveau de connaissance des obligations reglementaires etait juge satisfaisant dans 7,0 % des cas. Seuls 5,3 % des professionnels declaraient informer systematiquement les patients non infectes. En cas de survenue d’une IN, l’information etait systematiquement donnee au patient par 13,2 % des professionnels. Alors que les professionnels etaient largement favorables a plus d’information sur les IN (86,0 %), le deficit de connaissances et de pratique constate dans notre etude temoigne probablement a la fois de la faible frequence et gravite des IN en psychiatrie et de difficultes specifiques de communication avec les patients : des methodes de communication adaptees a ces patients devraient etre developpees.

A multicentre practice assessment study on peripheral intravenous catheters (PVC) utilization was carried out in 920 healthcare facilities (HCF) in France in 2010. Breaches in practices were observed particularly for insertion and maintenance of PVC. The objective was to evaluate the impact of the study practices on implementation of corrective measures.

Handrubbing with alcohol-based hand rub (AHR) is a validated alternative to handwashing. The aims of this study were to compare knowledge and declared use of AHR between different categories of healthcare worker (HCW), and to assess factors associated with the use of AHR. A standardized questionnaire was sent to all HCWs in a tertiary care university hospital. The following data were collected for each HCW: job title (physician, nurse, nursing assistant or other), sources of information about AHR; knowledge and perception of AHR and declared use of AHR in daily practice instead of unmedicated or antiseptic soap. Of 5238 questionnaires, 1811 were returned. Physicians had better knowledge about AHR than other HCWs. HCWs' knowledge of AHR efficacy and skin tolerance were independently associated with the use of AHR instead of unmedicated or antiseptic soap. The declared use of AHR differed according to professional category.

The aim of this study was to compare the efficacy of surgical hand rubbing (SHR) with the efficacy of surgical hand scrubbing (SHS), and to determine the costs of both techniques for surgical hand disinfection. A review of studies reported in the literature that compared the efficacy of SHS and SHR was performed using MEDLINE. The costs of SHR and SHS were estimated based on standard hospital costs. The literature showed that SHR had immediate efficacy that was similar to that of SHS, but SHR had a more lasting effect. SHR reduced costs by 67%. In conclusion, SHR is a cost-effective alternative to SHS.

The frequent use of peripheral venous catheters (PVC) generate a significant number of infections. Since 2005, a standard recommendation edited by the French Society for Hospital Hygiene has been promoted in healthcare facilities (HCF). In 2009, the French Group for Evaluation of Practices concerning Hospital Hygiene (GREPHH) has provided an evaluation tool for PVC practices. The objective was to evaluate practices during utilisation of PVC in healthcare facilities (HCF).