1
|
Marc M, Rambourg P, Bussières JF. [Evaluation of pharmaceutical practice in hospitals: An exploratory study comparing processes in France and Quebec]. Ann Pharm Fr 2024; 82:560-574. [PMID: 38367934 DOI: 10.1016/j.pharma.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/15/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
CONTEXT To ensure compliance with the legal and normative framework, the professional orders, which supervise the practice of pharmacy have established a professional inspection process. In addition to this process, other external organizations also require an accreditation, authorization, certification or validation process for professional practices. OBJECTIVE The main objective is to identify and compare the methods of evaluating pharmaceutical practice in hospitals in France and Quebec. RESULTS In order to identify and compare the methods of evaluating pharmaceutical practice in hospitals in France and Quebec, our approach allowed us to identify more organizations in France (i.e., High Authority of Health, Regional Health Agencies, the National Order of Pharmacists, the Nuclear Safety Agency, the Biomedicine Agency and the National Agency for the Safety of Medicines and Health Products) than in Quebec (i.e., Accreditation Canada, Ordre des pharmaciens du Québec and Health Canada). The study highlights the legal framework and applicable standards, the surveyors, the evaluation methods and the particularities for the evaluation of the hospital, the pharmacy department and the members of the department. CONCLUSIONS This study highlights the evaluation processes of pharmaceutical practice in hospitals. In France, as in Quebec, we recognize the importance of the drug circuit in the hospital, the development and operation of a pharmacy department and the practice of pharmacy. While there are more similarities for the assessment of the drug circuit in hospitals and pharmacy department, important differences are observed for the assessment of individuals. We believe that the publication of a comparative analysis can contribute to discussions and exchanges to benefit from the best practices of each country.
Collapse
Affiliation(s)
- Manon Marc
- Unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, H3T 1C5 Montréal, Québec, Canada
| | - Patrick Rambourg
- Conseil central H de l'Ordre national des pharmaciens, 4, avenue Ruysdaël, 75379 Paris, France
| | - Jean-François Bussières
- Unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, H3T 1C5 Montréal, Québec, Canada; Faculté de pharmacie, université de Montréal, 2900, boulevard Édouard-Montpetit, H3T 1J4 Montréal, Québec, Canada.
| |
Collapse
|
2
|
Vanhaecke M, Hennion-Coussemacq M, Dervaux B, Accaoui P, Pruvost A, Ferret L, Lehmann L, Verryser F, Hiver Q. [Evaluation of a self-administration of medication practice in a rehabilitation unit]. Ann Pharm Fr 2024; 82:329-341. [PMID: 38244678 DOI: 10.1016/j.pharma.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/17/2023] [Revised: 12/05/2023] [Accepted: 01/13/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVES Self-administration consists in the administration of medications by the patient himself during his hospitalization. The order of October 10, 2022 (Arrêté du 10 octobre 2022 modifiant l'arrêté du 6 avril 2011) modified the April 6, 2011 regulation to allow and regulate self-administration practices in hospital units. This evolution opens new perspectives for patient autonomy. The objective of this study is, firstly, to evaluate the rate of medication errors from patients under self-administration and secondly, to evaluate the satisfaction of patients and caregivers. MATERIAL AND METHODS Eligible patients were recruited from a locomotor and polyvalent rehabilitation unit. After verification of eligibility, explanation given to the patient about the hospital self-administration of medication procedure and signature of the compliance agreement, patients started self-administration. Medication errors were reported during seven days. Evaluations of patient and staff satisfaction were also carried out. RESULTS Of the 83 patients admitted to the care service, 32 were able to experiment self-administered medication procedure during their hospitalization. To assess the safety of this practice, 1235 drug intakes were analyzed. Ninety-four administration errors were noted: 98% of them concerned analgesic drugs. All of these errors were omissions and none of them were rated as serious. The 20 patients questioned were all satisfied with self-administration. The 14 carers interviewed were satisfied with this change in practice. CONCLUSION The medication self-administration process set up in the rehabilitation unit did not lead to serious medication errors. Patients and caregivers reported being satisfied with this new hospital practice.
Collapse
Affiliation(s)
- Marie Vanhaecke
- Service pharmacie, centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France
| | | | - Benjamin Dervaux
- Service de rééducation locomoteur et polyvalent, centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France
| | - Paul Accaoui
- Service de rééducation locomoteur et polyvalent, centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France
| | - Amélie Pruvost
- Service pharmacie, centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France
| | - Laurie Ferret
- Service pharmacie, centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France
| | - Laura Lehmann
- Service pharmacie, centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France
| | - Frederic Verryser
- Service pharmacie, centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France
| | - Quentin Hiver
- Service pharmacie, centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France.
| |
Collapse
|
3
|
Matter-Parrat V, Lazarus P, Goldammer F, Bensa M, Ronde-Oustau C, Liverneaux PA, Facca S. Homogenization of the management of acute paronychia with abscess formation within the context of an evaluation of professional practices. Orthop Traumatol Surg Res 2021; 107:102982. [PMID: 34102333 DOI: 10.1016/j.otsr.2021.102982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/18/2020] [Accepted: 09/15/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION There is no consensus in the literature, or even within the same team, on the most appropriate treatment option for acute paronychia with abscess formation. The performance of an evaluation of professional practices (EPP) using a clinical audit measures the quality of our practices with the aim of standardizing them. Therefore, the primary objective of this study was to develop a clinical pathway for the management of acute paronychia with abscess formation. The secondary objectives were to evaluate our professional practices using a clinical audit before and after the dissemination of the clinical pathway and then recommend strategies for improving our management of acute paronychia with abscess formation. MATERIALS AND METHODS A working group was established that designed an audit grid comprised of 15 items. Thirty patients (Group 1) who had an acute paronychia with abscess formation were included and their health records were analyzed using this audit grid. The working group then developed a clinical pathway for the management of acute paronychia with abscess formation. Thirty new patients (Group 2) were included after the dissemination of this clinical pathway and their records were analyzed using the same audit grid. RESULTS Our clinical pathway for the management of acute paronychia was validated by the local infectious disease committee of our university hospital center. The difference between groups 1 and 2 was significant (p<0.05) for eight items. There was no significant difference in the rate of surgical revision between the two groups. DISCUSSION This EPP enabled us to develop a clinical pathway that detailed the processes for managing acute paronychia with abscess formation, and in particular it provided indications for antibiotic therapy and its limitations. LEVEL OF EVIDENCE IV, retrospective study.
Collapse
|
4
|
Abdel Fattah M, Demoré B, Girardeau A, Heit S, May T, Rabaud C, Henard S. Antifungal agents use in a French administrative region. Med Mal Infect 2015; 45:279-85. [PMID: 26055629 DOI: 10.1016/j.medmal.2015.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 03/27/2015] [Accepted: 04/30/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The increased use of new costly antifungal agents has led to a considerable increase in pharmaceutical expenditure. In December 2011, the Lorraine Regional Health Agency commissioned the Antibiolor network to evaluate costly antifungal agent stewardship using as reference regional, French, and international recommendations. METHODS We performed a regional retrospective multicenter study. The criteria for evaluation were the appropriateness of the indication for treatment, the choice of the agent or of a combination, compliance with dose and treatment duration, and the absence of any alternative. RESULTS One hundred and fourteen prescriptions were analyzed, in 7 intensive care units, 4 hematology units, and 1 infectious diseases unit. The indication for costly antifungal treatment was appropriate in 110 cases (96.5%), the choice of the antifungal agent in 102 cases (93%), the dose in 98 cases (89%), treatment duration in 102 cases (93%), and an alternative antifungal treatment was possible in 10 cases (9%). Eighty-two prescriptions (74.5%) complied with the marketing authorization, 19 (17%) were related to a protocol for temporary use, and 9 (8%) were considered as inappropriate. CONCLUSION Our results show a high rate of appropriate prescriptions. The easily accessible and regularly updated local recommendations probably resulted in the standardization and optimization of costly antifungal agent prescriptions.
Collapse
Affiliation(s)
- M Abdel Fattah
- Service des maladies infectieuses et tropicales, hôpital Brabois, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - B Demoré
- Pharmacie hospitalière, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France; Réseau Antibiolor, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France; SRSMC, UMR 7565, université de Lorraine, 54001 Nancy, France
| | - A Girardeau
- Pharmacie hospitalière, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - S Heit
- Pharmacie hospitalière, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - T May
- Service des maladies infectieuses et tropicales, hôpital Brabois, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France; Réseau Antibiolor, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - C Rabaud
- Service des maladies infectieuses et tropicales, hôpital Brabois, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France; Réseau Antibiolor, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - S Henard
- Service des maladies infectieuses et tropicales, hôpital Brabois, CHU de Nancy, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France; Réseau Antibiolor, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France.
| |
Collapse
|
5
|
Peix C, Vandenhende MA, Bonnet F, Lacoste D, Bernard N, Youssef J, Hessamfar M, Pometan JP, Morlat P. [Adherence between antibiotic prescriptions and guidelines in an internal medicine ward: an evaluation of professional practices]. Rev Med Interne 2013; 34:456-9. [PMID: 23318197 DOI: 10.1016/j.revmed.2012.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 11/05/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION This is an evaluation of professional practices (EPP) on antibiotic therapy in an internal medicine ward. MATERIAL AND METHODS A 6-month prospective review of antibiotic prescriptions and their comparisons with local and national guidelines (drug, daily dose, administration, and duration) were performed. RESULTS Antibiotic therapy on 227 infectious episodes was collected. According to local guidelines, we found 56% of totally respected (lower respiratory tract infections: 38%, urinary tract infections: 88% and skin infections: 73%), 33% of partially respected and 11% of non-appropriate prescriptions. Considering national guidelines for lower respiratory tract infections as references, the results were: totally respected prescriptions 81%, partially respected prescriptions 16%, and non-appropriate prescriptions 3%. CONCLUSION This evaluation of the prescriptions allowed setting up long-lasting actions to improve clinical practice. This approach anticipates the procedures of EPP that will be needed for hospital accreditation and highlights the importance of considering several guidelines for the interpretation of the results.
Collapse
Affiliation(s)
- C Peix
- Pharmacie, groupe hospitalier Saint-André, 1 rue Jean-Burguet, Bordeaux cedex, France
| | | | | | | | | | | | | | | | | |
Collapse
|