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Monique Elseviers

Publications and source records attributed to Monique Elseviers.

9 recordsLinked to original sources
PubMedDate not supplied

Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.

BACKGROUND: Resistance to antibiotics is a major public-health problem and antibiotic use is being increasingly recognised as the main selective pressure driving this resistance. Our aim was to assess outpatient use of antibiotics and the association with resistance. METHODS: We investigated outpatient antibiotic use in 26 countries in Europe that provided internationally comparable distribution or reimbursement data, between Jan 1, 1997, and Dec 31, 2002, by calculating the number of defined daily doses (DDD) per 1000 inhabitants per day, according to WHO anatomic therapeutic chemical classification and DDD measurement methodology. We assessed the ecological association between antibiotic use and antibiotic resistance rates using Spearman's correlation coefficients. FINDINGS: Prescription of antibiotics in primary care in Europe varied greatly; the highest rate was in France (32.2 DDD per 1000 inhabitants daily) and the lowest was in the Netherlands (10.0 DDD per 1000 inhabitants daily). We noted a shift from the old narrow-spectrum antibiotics to the new broad-spectrum antibiotics. We also recorded striking seasonal fluctuations with heightened winter peaks in countries with high yearly use of antibiotics. We showed higher rates of antibiotic resistance in high consuming countries, probably related to the higher consumption in southern and eastern Europe than in northern Europe. INTERPRETATION: These data might provide a useful method for assessing public-health strategies that aim to reduce antibiotic use and resistance levels.

Ambulatory Care↗
PubMedDate not supplied

The Research Board of the European Dialysis and Transplantation Nurses Association/European Renal Care Association (EDTNA/ERCA).

The Research Board (RB) of EDTNA/ERCA is a multidisciplinary group, established by the participation of renal care centres all around Europe. The RB also works with the association's Special Interest Groups (SIGs) on developing guidelines for implementing safe renal clinical practice. It is composed of six permanent members, with co-opted experts from specific fields. This article describes how the RB works and the projects implemented since 1996.

Advisory Committees↗
PubMedDate not supplied

European Practice Database: comparative results of the year 1 pilot project.

The European Practice Database (EPD) project, developed by the Research Board (RB) of EDTNA/ERCA, intended to collect data on renal practice at centre level in different European countries. During the pilot phase of the project (2002-2003), Czech Republic, Italy (North East) and England (North) participated with two thirds of all their eligible dialysis centres. Comparative results presented in this paper focus on centre size and patient characteristics, peritoneal and haemodialysis techniques, transplantation, infection control and the employment of technicians, dietitians and social workers in dialysis centres. At centre level, EPD results will enable in-depth evaluation of personal practice. International comparison of the results will stimulate further research and the development of new guidelines.

Ambulatory Care Facilities↗
PubMedDate not supplied

European Practice Database in the Czech Republic.

The EDTNA/ERCA European Practice Database (EPD) Project has been launched with the aim to collect data on professional practice and outcome of dialysis treatment throughout Europe. The Czech Republic had the privilege of taking part in the pilot phase together with Northern England and part of Italy. We first became involved in the EPD project during the annual EDTNA/ERCA conference in Nice, France. At this time the Research Board started to prepare an EPD questionnaire for the pilot phase. The project was officially launched in the Czech Republic during the Multidisciplinary Conference in Brno organised jointly by the Czech Association of Nurses and the EDTNA/ERCA in 2003. A presentation by Jean Yves De Vos, the EPD Co-ordinator, who introduced the final EPD questionnaire in detail, was the best promotion of the project.

Adolescent↗
PubMedDate not supplied

Management of renal anaemia: comparison of practice in the Czech Republic and Northern England.

The EDTNA/ERCA European Practice Database (EPD) questionnaire was piloted in the Czech Republic (CZ), Northern Italy and Northern England (N-ENG) in early 2003. The questionnaire used in the CZ and N-ENG featured additional questions on the use of erythropoetin (EPO) and intravenous (IV) iron. There were significant differences in the policies for anaemia management in the CZ and N-ENG, reflecting the higher level of funding available to centres in the UK. There was also a wide variation in practice between the CZ centres, but not those in N-ENG, possibly due to the adoption of guidelines that are currently unrealistic. Some centres, particularly those in the CZ, could improve outcomes or reduce overall costs by adopting a more aggressive policy for the use of intravenous iron.

Anemia↗
PubMedDate not supplied

European study on epidemiology and the management of HCV in the haemodialysis population--Part 1: centre policy.

Haemodialysis patients are known to be at risk of infection of Hepatitis C Virus (HCV) through nosocomial spread. This paper presents the first part of a study on epidemiology and management of HCV, in a haemodialysis population, conducted by the EDTNA/ERCA Research Board. Data on HCV management and infection control procedures was collected from 136 European centres using an electronic questionnaire. The study identifies a number of possible risk factors for transmission of the virus: failing to disinfect devices between patients, sharing of single-use vials to prepare drugs or infusions for different patients, inadequate sterilisation or cleaning of machines between dialysis sessions, unsatisfactory environmental cleaning and distance less than one metre between chairs.

Ambulatory Care Facilities↗
PubMedDate not supplied

Post insertion catheter care in peritoneal dialysis (PD) centres across Europe--Part 2: complication rates and individual patient outcomes.

The first part of this report, which looked at centre policy, showed that there was no consensus on the best way to manage a patient in the rest period between PD catheter insertion and the first use of the catheter for dialysis. This paper intends to investigate if the differences in policy had any effect on complication rate and individual patient outcomes. Data were included from 298 patients of 49 participating centres. The results revealed a high rate of catheter related complications, with half of the patients having been treated for complications including leakage (29%), malfunction (23%) or infection (10%), and a quarter of patients having been hospitalised for catheter problems. Leakage was more frequently observed in lean and obese patients and if the catheter was only immobilized for a short time period. Diabetes, having constipation at first use and having rested for less than 6 hours after catheter insertion were significant risk factors for malfunction. Infection seemed to be related to the type of catheter used and hygienic precautions (not significant) and showed a significant relationship with the frequency of dressing changes. There is still an important lack of evidence on which to develop an optimal protocol for PD catheter insertion and care before first use.

Adolescent↗
PubMedDate not supplied

EDTNA/ERCA vascular access recommendations for nephrology nurses.

In 1989, SJ. Schwab stated that providing satisfactory vascular access for haemodialysis remains one of the most challenging problems confronting the nephrology team (1). Successful long-term haemodialysis in patients with end-stage renal failure depends to a large extent upon a trouble-free vascular access. Unfortunately, the creation as well as the use, maintenance and the treatment of vascular access complications nowadays still remain a serious clinical problem despite pharmacological and technical advances during the last decade (2). Even today, vascular access failure and complications form a major cause of morbidity leading to a high percentage (20 to 30 %) of hospitalization in the dialysis population (3). Moreover, we are confronted all over the world with a clinically complicated patient population, such as diabetics, patients with advanced atherosclerosis, cardiac and peripheral vascular diseases. Also the increased blood viscosity due to the systematic use of erythropoietin and the use of high blood flows in modern dialysis therapy necessitates a vascular access of excellent quality.

Arteriovenous Shunt, Surgical↗