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Le Tohic S, Muziotti C, Ferrand E, Paul F, Bailli A, Gauthier G, Boulliat C. Analyse des erreurs de préparation des piluliers dans le cadre de la DJIN destinée au service de psychiatrie à l’HIA Laveran. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2015.09.314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
IntroductionDans le cadre de la sécurisation du circuit du médicament, une EPP a été réalisée pour mettre en évidence le nombre d’erreurs identifiées lors de la préparation des piluliers dans le cadre de la DJIN des patients hospitalisés en psychiatrie.Matériels et méthodeMenée de janvier à décembre 2014, cette étude prospective a permis de recenser et de typer les erreurs identifiées lors de la préparation des piluliers. Quotidiennement et de manière aléatoire, 4 chariots sur 10 étaient entièrement contrôlés. Les 6 autres ne l’étaient que partiellement, à raison de 2 piluliers choisis au hasard par chariot. Les résultats obtenus correspondent au nombre d’erreurs rapporté au nombre d’ordonnances contrôlées, par service et par mois.Résultats et discussionEn 2014, le pourcentage d’erreurs identifiées pour le service de psychiatrie est de 6,04 %, soit 1 erreur toutes les 26 lignes. Ce résultat est conforme aux données de la littérature (6–7 %)*, contrairement à celui obtenu pour l’ensemble de l’hôpital (7,78 %). En effet, le service de psychiatrie témoigne d’une certaine stabilité en raison d’une chronicité des pathologies traitées et d’une protocolisation des prises en charge. Les patients sont ainsi souvent suivis depuis longtemps et leur traitement ne change que ponctuellement. Cependant, malgré cette sécurité apparente, la vigilance de l’équipe soignante est essentielle : sur les 1300 ordonnances non contrôlées, 79 erreurs n’auraient donc pas été interceptées par la pharmacie, si le même pourcentage d’erreurs est appliqué.ConclusionLe double contrôle lors de la préparation des traitements est essentiel. Il permet d’intercepter les erreurs à la pharmacie, mais aussi dans le service clinique. À l’heure où l’exercice de l’infirmier est à la médicalisation, l’infirmier reste le dernier verrou avant le patient.
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Ferrand E, Kimbidina R, Javelle E, Lamand V, Kraemer P, Le Tohic S, Le Garlantezec P, Gauthier G. BU-18 - Évaluation des pratiques professionnelles sur la surveillance des concentrations plasmatiques des aminosides. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Heming N, Quesnel C, Chastrusse M, Pham T, Fischler M, Ferrand E. Critically ill patients admitted in post-anaesthesia care units: a survey of current practices in France. Br J Anaesth 2014; 113:295-6. [PMID: 25038160 DOI: 10.1093/bja/aeu243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jabre P, Combes X, Marty J, Margenet A, Ferrand E. Loi no 2005-370 du 22avril 2005 relative aux droits des malades et à la fin de vie : application à un cas de médecine préhospitalière. ACTA ACUST UNITED AC 2008; 27:934-7. [DOI: 10.1016/j.annfar.2008.09.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Accepted: 09/25/2008] [Indexed: 10/21/2022]
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Chedevergne K, Cook F, Scherrer E, Marty J, Ferrand E. [The law number 2005-370 of April 22, 2005 concerning the patients' rights at the end of life: a case of polytrauma]. Ann Fr Anesth Reanim 2008; 27:747-754. [PMID: 18760895 DOI: 10.1016/j.annfar.2008.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2007] [Accepted: 06/04/2008] [Indexed: 05/26/2023]
Abstract
The law number 2005-370 of April 22, 2005 concerning the patients' rights at the end of life imposes from now the refusal of futility of care, a shared decision-making in unconscious patients and the duty of a palliative strategy. We describe a case of polytrauma, for which the shared decision-making process led to a palliative strategy after initial aggressive life-support treatments. This case underlines the need for a two-step model of decision-making process, which distinguishes between goals of care and withdrawal or withholding of life support. It suggests that implementation of written procedures could improve the quality of management at the end of life and traceability of decisions.
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Affiliation(s)
- K Chedevergne
- Service d'anesthésie-réanimation, Samu 94, hôpital Henri-Mondor, université Paris-XII, Assistance publique des Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94 010 Créteil cedex, France
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Combes X, Jabre P, Ferrand E, Margenet A, Marty J. Out-of-hospital use of intubating laryngeal mask airway for difficult intubation caused by cervical dislocation. Emerg Med J 2007; 24:e27. [PMID: 17452687 PMCID: PMC2658511 DOI: 10.1136/emj.2006.045112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- X Combes
- Prehospital Emergency Department (AP-HP), Créteil, France.
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Ferrand E, Jabre P, Fernandez-Curiel S, Morin F, Vincent-Genod C, Duvaldestin P, Lemaire F, Hervé C, Marty J. Participation of French general practitioners in end-of-life decisions for their hospitalised patients. J Med Ethics 2006; 32:683-7. [PMID: 17145904 PMCID: PMC2563354 DOI: 10.1136/jme.2005.014084] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Assuming the hypothesis that the general practitioner (GP) can and should be a key player in making end-of-life decisions for hospitalised patients, perceptions of GPs' role assigned to them by hospital doctors in making withdrawal decisions for such patients were surveyed. DESIGN Questionnaire survey. SETTING Urban (districts located near Paris) and rural (southern France) areas. PARTICIPANTS GPs. RESULTS The response rate was 32.2% (161/500), and it was observed that 70.8% of respondents believed that their participation in withdrawal decisions for their hospitalised patients was essential, whereas 42.1% believed that the hospital doctors were sufficiently skilled to make withdrawal decisions without input from the GPs. Most respondents were found to believe that they had the necessary skills (91.9%) and enough time (87.6%) to participate in withdrawal decisions. The last case of treatment withdrawal in hospital for one of their patients was described by 40% (65/161) of respondents, of whom only 40.0% (26/65) believed that they had participated actively in the decision process. The major factors in the multivariate analysis were the GP's strong belief that his or her participation was essential (p = 0.01), information on admission of the patient given to the GP by the hospital department (p = 0.007), rural practice (p = 0.03), visit to the patient dying in hospital (p = 0.02) and a request by the family to be kept informed about the patient (p = 0.003). CONCLUSION Strong interest was evinced among GPs regarding end-of-life issues, as well as considerable experience of patients dying at home. As GPs are more closely corrected to patients' families, they may be a good choice for third-party intervention in making end-of-life decisions for hospitalised patients.
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Affiliation(s)
- E Ferrand
- Service d'Anesthésie Réanimation SAMU 94, Hôpital Henri-Mondor, AP-HP 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil cedex, France.
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Lienhart A, Puybasset L, Beloucif S, Boulard G, Alazia M, Balagny E, Bazin JE, Cohen C, de La Dorie-Leroy A, Eon B, Ferrand E, Gauzit R, Jacob A, Pourriat JL, Quiviger PY, Tarot JP, Martin C. [Recommendations for good clinical practice concerning law number 2005-370 of April 22, 2005 relative to the treatment of disease at the end of life]. Ann Fr Anesth Reanim 2006; 25:912-7. [PMID: 17044142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- A Lienhart
- Département d'Anesthésie-Réanimation, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France.
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Ferrand E. [End-of-life care in the intensive care unit. Recommendations of the Société de Réanimation de Langue Française]. Rev Mal Respir 2003; 20:981-8. [PMID: 14743105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- E Ferrand
- Unité de Réanimation Chirurgicale et Traumatologique, Hôpital Henri Mondor, Créteil, France.
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Lemaire F, Azoulay E, Ferrand E. [Ethical commissions within learned societies, what for?]. Presse Med 2003; 32:627-8. [PMID: 12714900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
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Adoun M, Ferrand E, Hira M, Levillain P, Corbi P, Meurice JC, Pourrat O. [A case of atypical cryptogenic organising pneumonitis during pregnancy]. Rev Mal Respir 2002; 19:638-40. [PMID: 12473951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Cryptogenic organising pneumonitis (COP) is now a well defined clinico-pathological entity. It may be idiopathic or secondary to infection, a drug reaction or a connective tissue disorder. Corticosteroid treatment is remarkably effective. We describe a case of COP occurring during the course of an acute respiratory distress syndrome in a pregnant woman. The unusual association of blood and pulmonary eosinophilia leads us to envisage a borderline form of COP and eosinophilic pneumonitis. Other unusual features were the poor response to steroids and the rapid improvement following death of the foetus.
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Affiliation(s)
- M Adoun
- Service de pneumologie, Hôpital Jean Bernard, Poitiers, France
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Aicardi F, Valentin P, Ferrand E. On the classification of generic phenomena in one-parameter families of thermodynamic binary mixtures. Phys Chem Chem Phys 2002. [DOI: 10.1039/b109105k] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ferrand E, Bachoud-Levi AC, Rodrigues M, Maggiore S, Brun-Buisson C, Lemaire F. Decision-making capacity and surrogate designation in French ICU patients. Intensive Care Med 2001; 27:1360-4. [PMID: 11511949 DOI: 10.1007/s001340100982] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2000] [Accepted: 04/23/2001] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the capacity and willingness of French-speaking patients to designate a surrogate within 24 h of their ICU admission. French laws fail to indicate what should be done when an otherwise legally competent patient transiently loses his decision-making capacity. DESIGN Surrogate designation was prospectively evaluated during two study periods. Only conscious patients were assessed using the Glasgow Come Score in the first study period, and all admitted patients were assessed in the second period. Decision-making capacity was evaluated using the Mini Mental Status Examination (MMSE) in the second study period. SETTING Twenty six-bed intensive care unit (ICU) in a French teaching hospital. PATIENTS AND PARTICIPANTS Over a 8-month period 495 patients were included in the study, 415 in the first study period and 80 in the second. MEASUREMENTS AND RESULTS Of the 495 patients 185 (37.3%) were interviewed, and 62.7% designated a surrogate. The surrogate was the spouse in 50% of cases and a child in 28.4%. Only 25.8% were considered to have decision-making capacity; 78.1% of competent patients and 28% of the patients without decision-making capacity agreed to designate a surrogate. CONCLUSIONS Surrogate designation by a patient should be evaluated in the light of the decision-making capacity of the patient. The traditional French paternalism still practiced by many French physicians appears out of tune with the wishes of their patients. We suggest that there is a need for developing a simple and effective tool for assessing decision-making capacity in ICU patients.
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Affiliation(s)
- E Ferrand
- Surgical Intensive Care Unit of the Henri Mondor University Hospital, 51 rue du Mal de Lattre de Tassigny, 94010 Créteil cedex, France.
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Abstract
BACKGROUND In France, there are no guidelines available on withholding and withdrawal of life-sustaining treatments, and information on the frequency of such decisions is scarce. METHODS We undertook a prospective 2-month survey in 113, of a total of 220, intensive-care units (ICUs) in France to study the frequency of, and processes leading to, decisions to withhold and withdraw life-sustaining treatments. FINDINGS Life-supporting therapies were withheld or withdrawn in 807 (11.0%) of 7309 patients (withholding in 336 [4.6%] and withdrawal in 471 [6.4%], preceded in 358 by withholding). Of 1175 deaths in ICU, 628 (53%) were preceded by a decision to limit life-supporting therapies. Futility and poor expected quality of life were the most frequently cited reasons. Decisions were strongly correlated with the simplified acute physiological score, but an independent centre effect persisted after adjustment for this score. Decisions were mostly taken by all the ICU medical staff, with (54%) or without (34%) the nursing staff; however, a single physician made decisions in 12% of cases. The patient's family was involved in the decision-making process in 44% of cases. The patient's willingness to limit his or her own care was known in only 8% of the cases; only 0.5% of the patients were involved in decisions. INTERPRETATION Withholding and withdrawal of life-support therapies are widely practised in French ICUs, despite their prohibition by the French legislation. The lack of an official statement from French scientific bodies may explain several limitations on the various steps of the decision-making process.
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Affiliation(s)
- E Ferrand
- Surgical Unit, Henri-Mondor University Hospital, Créteil, France.
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Robert R, Grollier G, Doré P, Hira M, Ferrand E, Fauchère JL. Nosocomial pneumonia with isolation of anaerobic bacteria in ICU patients: therapeutic considerations and outcome. J Crit Care 1999; 14:114-9. [PMID: 10527248 DOI: 10.1016/s0883-9441(99)90023-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Evaluate the influence of the anti-anaerobic antimicrobial therapy in the outcome of patients with nosocomial pneumonia. MATERIALS AND METHODS The population study included 53 intensive care unit patients with nosocomial pneumonia in whom, using a protected specimen brush, anaerobic bacteria were isolated, which were associated or not with aerobes. Current and empirical antibiotherapies were retrospectively analyzed, regarding their efficacy against anaerobic bacteria. Since it was debated, sensitivity to cefotaxime, ceftazidime, and ciprofloxacin was determined in 38 strains of Prevotella species. Outcome was evaluated 10 days after the day of protected specimen brushes. Improvement was defined as a decrease of Murray score or ventilator weaning. RESULTS The most frequently isolated bacteria were Prevotella species, which were more frequently resistant to cefotaxime (37%), ceftazidime (50%), and ciprofloxacine (32%) than usually reported in the literature. Sixty-six percent of these strains produced beta-lactamase. The effect of empirical anti-anaerobic antibiotherapy on the outcome at day 10 was evaluable in 39 patients. Twenty-nine patients were improved and 10 patients worsened. Interestingly, patients who had received well-adapted antibiotics against anaerobes had a better outcome after 10 days (P < .02). CONCLUSIONS This study suggests that specific antianaerobic therapy may be considered in the choice of empirical antibiotherapy in patients with nosocomial pneumonia.
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Affiliation(s)
- R Robert
- Service de Réanimation Médicale, Centre Hospitalier Régional et Universitaire de Poitiers, France
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Ferrand E, Robert R, Ingrand P, and the LATERA group. Withholding and withdrawing life support: national French prospective study. Crit Care 1999. [DOI: 10.1186/cc641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Plazanet F, Hira M, Ferrand E, Rahbari F, Crevel J, Bontoux D. Aspergillus osteomyelitis. Report of a case investigated by magnetic resonance imaging. Rev Rhum Engl Ed 1998; 65:76-7. [PMID: 9523393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Ferrand E. Air quality trends in new york city. Bull N Y Acad Med 1978; 54:1025-1031. [PMID: 19312968 PMCID: PMC1807682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Eisenbud M, Ferrand E, Wolff G. General discussion: session I. Bull N Y Acad Med 1978; 54:1045-1051. [PMID: 19312970 PMCID: PMC1807691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Dong M, Locke DC, Ferrand E. High pressure liquid chromatographic method for routine analysis of major parent polycyclic aromatic hydrocarbons in suspended particulate matter. Anal Chem 1976; 48:368-72. [PMID: 1247165 DOI: 10.1021/ac60366a049] [Citation(s) in RCA: 69] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Ferrand E. Ueber die giftigen Wirkungen der Arnica. Arch Pharm (Weinheim) 1870. [DOI: 10.1002/ardp.18701910227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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