8 results on '"Deblangy, Claude"'
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2. Notification of Tuberculosis in a University Hospital
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Denic, Ljiljana, Lucet, Jean-Christophe, Pierre, Josiane, Deblangy, Claude, Kosmann, Marie-Jeanne, Carbonne, Anne, and Bouvet, Elisabeth
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- 1998
3. Epidemiology of Multidrug‐Resistant Bacteria in Patients With Long Hospital Stays
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Buke, Cagri, Armand‐Lefevre, Laurence, Lolom, Isabelle, Guerinot, Waafa, Deblangy, Claude, Ruimy, Raymond, Andremont, Antoine, and Lucet, Jean‐Christophe
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- 2007
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4. Successful long-term program for controlling methicillin-resistant Staphylococcus aureus in intensive care units
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Lucet, Jean-Christophe, Paoletti, Xavier, Lolom, Isabelle, Paugam-Burtz, Catherine, Trouillet, Jean-Louis, Timsit, Jean-François, Deblangy, Claude, Andremont, Antoine, and Regnier, Bernard
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- 2005
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5. 115 Results of a continuous quality improvement program on peripheral venous catheters
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Diamantis Sylvain, Bonnal Christine, Bouvet Elisabeth, Lucet Jean Christophe, Belorgey Sabine, Lolom Isabelle, Barry Beatrix, and Deblangy Claude
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Gynecology ,medicine.medical_specialty ,Pediatrics ,Medical staff ,Nursing staff ,business.industry ,Health Policy ,Antiseptic Agent ,University hospital ,Bloodstream infection ,Medicine ,Infectious risk ,business ,Catheter placement ,Skin preparation - Abstract
Peripheral veinous catheter (PVC) is the most frequent invasive procedure in healthcare care institutions. However the infectious risk including bacteraemia associated with this short-term procedure has been rarely investigated, and may be underestimated by the medical and nursing staff. We engaged in 1996 a quality management program in our 1000-bed university hospital. The program included (1) an initial evaluation of infectious risk associated with PVC, (2) education and awareness, (3) regular prevalence surveys and surveillance of PVC-related bacteraemia. Two studies of incidence and risk factors for PVC colonisation in 1996 (3 months in four units) and 1999 (3 months in four units) confirmed the higher risk with PVC duration longer than 3 days. An audit indicated that the technique of catheter placement was suboptimal. We therefore decided to focus on insertion technique and the limitation of catheter duration at a maximum of 3 days. To measure the impact of the intervention, we performed a yearly cross-sectional survey of all CVPs in place in the hospital, evaluating few simple performance indicators: duration of CVP, type and adherence of CVP dressing, inscription of the dressing9s date on the dressing. Since 2004, nurses were asked during the survey to report which antiseptic technique they use for CVP insertion. A surveillance of healthcare-associated bacteraemia was started in 2002, with the portal of entry collected for all bacteraemia, after discussion at the bedside with the medical staff. Parallel to these interventions, we developed education sessions, using local surveillance data. The yearly cross-sectional surveys (130 to 170 PVCs observed) showed that between 15 to 20% of prevalent CVPs were in place for more than 3 days in 1996–2002. From 2002, the prevalence of long CVP duration steadily decreased, and was 7% in 2008. Performance indicators at the dressing site showed marked improvement, with a correct type of dressing and adherence at 96 and 92%, respectively. In 1999, the inscription of the CVP insertion day was present on 3% of dressings, and was 65% in 2008. Sixty-eight per cent of the nursing staff declared using an alcoholic antiseptic agent (either polividone iodine or chlorhexidine) for CVP insertion in 2004, according to national recommendations. This proportion was 84% in 2008. However, only 47% declared performing skin cleansing with soap before antisepsis in 2008. The initial incidence rate of CVP-related bloodstream infection was 0.7/1000 PVC days in 1996 and 1999, similar to data from the literature. However, the yearly number of CVP-related bloodstream infection was 23 in 2002, and was 6–8 in 2006–2008. Integrating recommendations in the everyday life is a long-term and difficult task, and positive results may be late. However, a sustainable improvement of the practices related to the PVC management was obtained. These positive results probably reflect in a higher awareness for preventing CVP infection, with a decrease of CVP-related bloodstream infection. Repeated one-day cross-sectional surveys focussing on major preventive measures are easy to perform and provide relevant, reproducible and valid performance indicators. The other critical elements of our approach was the annual feedback of prevalence surveys, updating of our insertion protocol in line with recommendations, and rapid and direct intervention in the ward after each CVP-related bacteraemia. The CVP-related infectious risk could be further decreased, with improvement of preventive technique (skin preparation) at CVP insertion. We aim to maintain awareness for preventing CVP infection by repeated yearly cross-sectional surveys. La pose d9un catheter veineux peripherique (CVP) est la procedure invasive la plus frequente en milieu de soin. Cependant le risque infectieux y compris bacteriemique associe a ce geste de courte duree est mal connu, voire sous-estime par les equipes paramedicales et medicales. Notre hopital (CHU de 1000 lits d9adultes) s9est engage depuis 1996 dans un programme d9evaluation, d9amelioration et de suivi de la qualite des soins lie aux CVP. La demarche initiale entre 1996 et 1999 a consiste a evaluer les pratiques de soins et a preciser le risque infectieux par un audit des pratiques de pose et d9entretien (6 services), deux etudes d9incidence et de facteurs de risque de colonisation/infection (4 services), et de prevalence sur la duree de maintien (hopital entier). Les axes de travail ont porte sur la technique de pose suite aux ecarts de pratiques observes et sur une duree de maintien du dispositif inferieure a 3 jours, principal facteur de risque de la colonisation. Depuis 2000, la realisation annuelle d9enquetes de prevalence ciblees sur la duree de maintien des CVP couplee a des indicateurs de pratiques de soins au site d9insertion (fixation du CVP, type de pansement, adherence, inscription de la date de pose) permet d9evaluer l9impact des actions entreprises. Une surveillance des bacteriemies nosocomiales avec evaluation des portes d9entree est en place depuis 2002, et depuis 5 ans le personnel infirmier est interroge sur leurs pratiques a la pose du dispositif (detersion, antisepsie) au moment du passage des enqueteurs. En parrallele de chacune de ces etapes, des actions de formation et de sensibilisation des equipes basees sur les donnees recueillies complete ce programme d9action. Les enquetes de prevalence sur la duree de maintien (130 a 170 CVP inclus par enquete) montraient un taux de 15 a 20% des CVP avec une duree superieure a 3 jours entre 1996 et 2002, taux en diminution reguliere et proche de 7% en 2008. Les pratiques au site d9insertion (type de pansement, adherence) sont conformes aux recommandations dans respectivement 96% et 92% des CVP observes. En 1999, la date de pose du CVP sur le pansement est inscrite dans seulement 3% des cas, et se situe en 2008 aux alentours de 65%. 84% du personnel infirmier declarent utiliser la Betadine® alcoolique ou Hibitane® champ pour l9antisepsie cutanee (68% en 2004), mais seulement 47% d9entre eux declarent realiser systematiquement une detersion avant l9antisepsie. Les taux de colonisation et d9infection observes en 1996 et 1999 (0,7 bacteriemie/1000 jours de CVP) etaient conformes aux donnees de la litterature. Le nombre de bacteriemies a point de depart CVP etait de 23 en 2002, il est aux alentours de 6 par an en 2006-2008. L9integration de recommandations au quotidien est une demarche de longue duree dont les benefices ne sont pas immediats. Cependant, une amelioration durable dans les pratiques liees au CVP a ete obtenue, et ces resultats traduisent probablement une meilleure prise de conscience du risque infectieux comme le suggere la reduction du nombre de bacteriemies. La realisation d9enquetes de prevalence ciblees est facile a mettre en place, rapide de realisation et permet d9obtenir un indicateur pertinent et reproductible. D9autres elements ont ete determinant dans cette demarche: restitution annuelle des donnees (globales, par service), actualisation rapide des procedures en fonction des nouvelles recommandations, utilisation de la duree de maintien comme indicateur de qualite et intervention directe dans les unites ou une bacteriemie avait ete identifie. Ces resultats peuvent encore etre ameliores, en particulier a la pose du dispositif et au niveau de la tracabilite. Afin de maintenir la vigilance des equipes autour d9un risque potentiellement grave et surtout dans une grande majorite evitable, la poursuite de ce type d9enquete se justifie d9autant plus que nos structures de soins sont maintenant confrontes a un manque de personnel et un turn over important.
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- 2010
6. Impact d’un programme prolongé d’amélioration continue de la qualité sur le risque infectieux lié aux cathéters veineux périphériques
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Lolom, Isabelle, primary, Deblangy, Claude, additional, Capelle, Annick, additional, Guerinot, Wafaa, additional, Bouvet, Elisabeth, additional, Barry, Beatrix, additional, Goyau, Katel, additional, L’heriteau, François, additional, Bonnal, Christine, additional, and Lucet, Jean-Christophe, additional
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- 2009
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7. Control of a Prolonged Outbreak of Extended-Spectrum beta-Lactamase-Producing Enterobacteriaceae in a University Hospital.
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Lucet, Jean-Christophe, Decre, Dominique, Fichelle, Anika, Joly-Guillou, Marie-Laure, Pernet, Micheline, Deblangy, Claude, Kosmann, Marie-Jeanne, and Regnier, Bernard
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ENTEROBACTERIACEAE ,PREVENTION of communicable diseases ,INTENSIVE care units - Abstract
Discusses the control of a prolonged outbreak of extended-spectrum beta-lactamase-producing enterobacteriaceae (ESBLPE) in a university hospital. Contact-isolation precautions in all intensive care units (ICU); Decrease in the incidence of ESBLPE acquisition in ICU; Comparison between the incidence of acquired cases in the septic surgical unit and other units.
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- 1999
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8. [Effect of a long-term quality improvement program on the risk of infection related to peripheral venous catheters].
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Lolom I, Deblangy C, Capelle A, Guerinot W, Bouvet E, Barry B, Goyau K, L'heriteau F, Bonnal C, and Lucet JC
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- Anti-Infective Agents, Local therapeutic use, Bacteremia prevention & control, Catheters, Indwelling microbiology, Cross-Sectional Studies, Disinfection methods, Education, Medical, Continuing, Equipment Contamination prevention & control, Hand Disinfection, Humans, Longitudinal Studies, Medical Audit, Paris, Population Surveillance, Quality Assurance, Health Care standards, Risk Factors, Time Factors, Total Quality Management, Catheter-Related Infections prevention & control, Catheterization, Peripheral adverse effects, Cross Infection prevention & control, Quality Assurance, Health Care methods
- Abstract
Introduction: Although peripheral venous catheter (PVC) placement is one of the most common invasive procedures used in hospitals, data about the infectious risk associated with it are sparse. Nurses and physicians often underestimate this risk. We describe here a 10-year continuous quality improvement program in a large university hospital., Methods: The prevention program included: 1/ an observational audit of practices of PVC insertion and maintenance (1996), 2/ two studies of incidence and risk factors for PVC-related infection (1996 and 1999), 3/ 8 annual (1996 to 2006) cross-sectional studies that collected information about duration of PVC placement and other process indicators, 4/ surveillance of nosocomial bacteremia from 2002 through 2006, and 5/ continued education sessions for healthcare workers, based on local surveillance data., Results: Rates of colonization and infection (0.7 cases of bacteremia/1000 PVC days) were similar to data from other studies. PVC that remained in place for more than three days was associated with a higher risk of catheter-related bacteremia in both incidence studies. The annual prevalence studies showed that 15 to 20% of PVCs remained in place for more than three days from 1996 through 2002, but this rate decreased thereafter; it was 6.7% in 2005 and 10.7% in 2006. Practices audits indicated room for improvement in prevention measures. The absolute number of PVC-related bacteremia decreased by more than 50% from 2002 (n=23) to 2006 (n=10)., Conclusion: This prolonged multifaceted program, including practice audits, continued medical education and monitoring of PVC-related infection, has led to a substantial decrease over time in the infectious risk related to PVC placement.
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- 2009
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