Annales françaises d'anesthèsie et de rèanimation
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France is one of main countries affected by the HIV-outbreak in Europe with more than 120,000 cases, among which 34,600 patients having developed an AIDS. The antiretroviral combination therapies (combined antiretroviral therapy [cART]) reduced by half the mortality. A low compliance to cART alters the virologic control and increases the morbimortality. ⋯ The main restriction belongs to the protease inhibitors, which could affect the metabolic pathways of opioids, NSAIDs and benzodiazepines (over dosage risks). During the postoperative period, the follow-up should include the thromboembolism prevention (increased risk compared to main people), the cardiovascular side effects, the nutritional status and the continuation of the treatment. Moreover, the psychological status related and a close collaboration with the corresponding physician is critical.
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Ann Fr Anesth Reanim · Jun 2011
[Implementation strategy of the HAS French surgical check-list in a university hospital].
The check-list (CL) "Safety in Operating Room" has been introduced in our teaching hospital since 2009, associated to a "Quality and Prevention of Risks" program. This introduction was carried out over two distinct phases. The first one was a pilot start including five OR, allowing us to draw firm recommendations on the best way to perform the introduction, followed by a generalization to the other operating room (OR). ⋯ Indeed, the 10 items of the OR should be thought as the last check before the no-return point, which should be shared by anyone in the OR. If these conditions were fulfilled, the CL could be viewed as an actual improvement of safety in the OR. Otherwise, CL is just a supplementary form.
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Ann Fr Anesth Reanim · Jun 2011
Multicenter Study[Assessment of the French surgical checklist: the experience of 17 French cancer centres].
The use of WHO checklist has been associated to a decrease of complication incidence and mortality. This control is mandatory since January the 1st 2010. Evaluation of the quality of documentation is important and includes filling rate, which is a reflexion of participant adhesion and analysis of the circumstances where the team answers "no" during the control. ⋯ There is a large discrepancy between centres and for a given centre in reporting quality. Significant progress should be expected using target improvement. This approach implies multiple critical analysis of checklist content in each hospital and in multicentre enquiries.
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Ann Fr Anesth Reanim · Jun 2011
Editorial Comment[Safety of care: what place for proceduralization?].
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Ann Fr Anesth Reanim · Jun 2011
[One year implemention of the safe surgery checklist in France, what has been achieved so far, what could be improved?].
Despite important advances accomplished during the last ten years, patient safety in the OR remains a subject high on everyone's priority list: healthcare professionals, organisations and of course, patients. In this setting, the French National Authority for Health (Haute Autorité de santé, HAS) conducted a study with the scientific societies of professionals working in the OR. ⋯ Additionally, the organisations receive HAS certification are partners for the programme's promotion. One year after its institution, HAS is undertaking its first evaluation of the lessons and perspectives from the checklist's utilisation.