Biomedical subjects

F Saillour-Glénisson

Publications and source records attributed to F Saillour-Glénisson.

3 recordsLinked to original sources

PubMed2005

[Medico-economic assessment of two methods for implementing thyroid testing guidelines].

BACKGROUND: To compare independent and combined effectiveness and cost-effectiveness of two implementation interventions of guidelines for ordering thyroid function tests. The two implementation interventions were a Memorandum Pocket Card (MPC) and a Test Request Form (TRF). Intervention groups were wards. METHODS: The study used an experimental 2*2 factorial design with matching hospitals according to size and activity and wards according to pre-intervention appropriateness for test ordering. Four ward groups were established: the dual intervention group, the order form group, the pocket card group and the control group. Physicians in all groups received guidelines and were invited to a local information meeting. The main outcome measure of effectiveness was the Guideline Conformity Rate (GCR). The cost-effectiveness ratio was the cost difference between the tested intervention and the control intervention upon effectiveness difference between the tested intervention and the control intervention. RESULTS: Six hospitals participated in the study (two middle-sized hospitals, two small-sized hospitals and two psychiatric hospitals). A total of 1412 orders for thyroid function tests were collected. GCR was 78% in the dual intervention group, 83% in the order form group, 73% in the pocket card group and 62% in the control group. The interaction between TRF and MPC was not significant (B=-0.70, p=0.21). Compared to simple information, TRF was effective in increasing GCR (OR=2.65, 95% Confidence Interval [CI]: 1.52-4.62), unlike MPC (OR=1.28, CI: 0.75-2.19). TRF was the less expensive and the most effective intervention. CONCLUSION: Using a robust design, our study shows a greater effectiveness of TRF than MPC and their association in implementing thyroid function test guidelines. The development of clinical practice improvement projects through the second procedure of accreditation in France is a good opportunity to develop a guidelines implementation research project.

Cost-Benefit Analysis↗

PubMed2002

Factors associated with nurses' poor knowledge and practice of transfusion safety procedures in Aquitaine, France.

OBJECTIVES: To (1) describe knowledge, attitudes, and reported practice of blood transfusion of nurses in Aquitaine's hospitals; (2) measure the potential threat for patient safety of poor transfusion-related knowledge and practice; and (3) identify factors associated with poor knowledge and practice. DESIGN: Survey conducted in 14 hospitals in Aquitaine (one university and 13 general hospitals). SETTING: Hospitalized care. PARTICIPANTS: A random sample of nurses. MATERIALS: Data were collected anonymously by investigators through structured individual interviews. The questionnaire contained mainly knowledge and practice questions about blood transfusion regulation. MAIN OUTCOME MEASURES: Hazardous knowledge and practice scores have been constructed, reflecting the levels of potential danger in the answers to the questionnaire. Factors associated with these scores have been studied using a random-effect linear regression. RESULTS: In our sample of 1090 nurses, poor knowledge and practice concerned mainly (1) the bedside blood compatibility test [proportion of responses (PR) with potential life threat between 12.7 and 35.5%]; (2) pre-transfusion compatibility check when receiving blood units (PR = 34.5%); (3) delay between screening of red cell antibodies and transfusion (PR = 20.5%); (4) delay in preservation of blood unit in the ward (PR = 33.4%); and (5) recognition of abnormal reactions after transfusion (PR = 47.1%). Frequency of transfusion and training were the factors most strongly associated with hazardous knowledge and practice scores. CONCLUSION: Low training and transfusion activity were key determinants of poor transfusion-related knowledge and practice.

Attitude of Health Personnel↗

PubMed2001

[Prescription of thyroid function tests in adults as a function of clinical circumstances and of patient management].

A group of experts composed of clinicians and biologists in 7 University Hospitals in the Aquitaine and Paris regions working within the framework of the Coordination Committee for Clinical Evaluation and Quality in Aquitaine (CCECQA) have developed prescription guidelines for thyroid function tests to be performed in adults. The goal was to determine strategies for prescribing thyroid hormones (T3 and T4) and thyroid stimulating hormone (TSH) to screen for thyroid function disorders and follow thyroid function. The resulting recommendations were based on a review of the literature and a consensus among the experts. The first part of the guidelines concern recommended prescriptions in different clinical situations (early diagnosis of hypothyroidism, early diagnosis of hyperthyroidism, follow-up of anti-thyroid drug treatments, follow-up of levothyroxin replacement therapy, institution and follow-up of treatments susceptible of inducing dysthyroidism, pregnancy and post-partum dysthyroidism, palpation of a thyroid nodule). The second part of the guidelines are devoted to prescriptions according to the therapeutic setting (emergency care, psychiatric care, geriatric care).

Adult↗