Organizational impact should be considered when assessing MDs. We show in this study that from an organizational viewpoint, there are many advantages to using single-use bronchoscopes. However, in economic impact, it is more cost-effective for our institution, with more than 1500 bronchoscopies performed annually, to use reusable devices.
BackgroundThe European Regulatory Framework of Medical Devices is constantly evolving. Soon, hospitals will have to issue to patients traceability support for the medical device they receive. Since 2015 in France, this criterion has been evaluated by health authorities. In a previous study, we observed that few suppliers insert an implant card in the packaging of their implantable medical devices (IMD) (only 28% of references contained an implant card). Therefore, hospitals have to create their own implant card.PurposeIn order to evaluate the suppliers’ knowledge and involvement about the traceability intended to patients, we conducted a supplier survey.Material and methodsAn online questionnaire was produced (Google Forms) and sent by electronic mail to 47 of the 60 IMD suppliers of our hospital. The 11 questions allowed assessment of the supplier’s offer and opinion about traceability of IMDs. The survey lasted 45 days (September to October 2015).Results23 (49%) on the 47 suppliers requested answered. 44% of the suppliers admitted that none of their implants contained support for patient traceability, 32% assured that all their implants were delivered with this support whereas 20% declared that only a few of their implants were provided with it. For the number of labels for traceability available on the box, 36% declared they supplied 4 or less labels, which can be a brake in fast transmission of information. More than one-third of the suppliers (40%) were not aware of this obligation of traceability intended for patients. A minority (12%) believed that they were not ready to provide this support. Many of the suppliers were interested in the survey and were ready to improve the situation.ConclusionA minority of the suppliers provided an implant card in their packaging. A very small number of suppliers felt concerned by the transmission of information to the patient, although it will soon be an obligation. This survey made them aware of the situation and some are ready to help us to improve the situation.References and/or acknowledgementsInstruction No DGOS/PF2/2015/200 of 15 June 2015 (French Health Ministry).No conflict of interest
BackgroundCentral venous catheters (CVC) are known to be associated with risks of complications such as infections and haemorrhages. Good practices of care and management are essential in limiting these risks. Recently, complications linked to CVC utilisation increased in the Haematology Department. We decided to carry out a survey to assess the knowledge of the nurses on the care and the management of CVC.PurposeThe aim of this study was to evaluate nurses’ knowledge about the care and management of CVC, in order to identify areas for possible improvements.Material and methodsWe developed an open-ended questionnaire, focused on the management of complications (haemorrhages, infections), the monitoring of proper functioning and the catheter dressings. The questions were asked by a pharmacy resident and a pharmacy student to each nurse of the Haematology Department individually. The responses were recorded in a spreadsheet and sorted into categories.ResultsThirty-three nurses were interviewed in September 2017. Regarding CVC complications, 97% (n=32) reported the infectious risk, and only 33% (n=11) the haemorrhagic risk. All the nurses declared checking the blood reflux, but only 48% (n=16) reported checking the flow, 27% (n=9) the ease of injection and 24% (n=8) the absence of pain. Ninety-one per cent (n=30) of the nurses check the dressings every 8 hours, 85% (n=28) declared checking the occlusiveness and cleanliness of the dressings, and only 55% (n=18) mentioned control of the peripheral skin. Seventy-six per cent (n=25) change the dressing 2 days after the placement of the CVC and 91% (n=30) change the dressing every 4 days during the following period.ConclusionThe nurses’ knowledge is quite good but this questionnaire allowed us to identify precisely the points of improvement. Pharmaceutical intervention permitted us to become aware of nurses’ difficulties. The nurses supported our questionnaire and were interested by our approach. Educational measures are currently being implemented: e-learning and training sessions for nurses and posters displayed in nursing stations. Six months after the training, the rate of side-effects linked to CVC’s complications will be evaluated and compared to those of the first period in order to assess the effectiveness of these measures.No conflict of interest
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