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Clinical pharmacist’s place in appropriate use of infusion medical devices: 1) Clinical practices assessment, improvement program


Journal de Pharmacie Clinique. Volume 26, Number 4, 229-40, octobre-novembre-décembre 2007, article original

Résumé   Article gratuit  

Author(s) : H Brun, T Caruba, E Rossignol, G Lada-Jung, P Prognon, J Pineau

Summary : The occurrence of infusion incidents related to the misuse of medical devices recently raised concerns about patients safety in our hospital. Consequently, local infusion practices assessment were required by the pharmacy department, the medical devices committee, the care policy Direction and the infection control Unit. Two types of questionnaires were submitted to Head Nurses (n\=27) and nurses (IDE, n\=73) respectively. Data were collected by a Pharmacy student. Drug infusion from glass vials is the major cause of incidents. Only 8% of IDE apply the guidelines from the Medical Device Vigilance system i.e. the use of infusion pumps. However this kind of administration is carried out by 74% of them. The priming technique by flexible pocket inversion is known from 74% of IDE but applied by only 37% of them. The frequency of main infusion channel renewal is highly variable (every 72 hours in half of cases). Drop count to regulate the infusion flow rate is performed by only 35% of IDE when using the control knob but never done when a flow rate regulator is used. Finally, more than 80% of the study participants are favourable to the implementation of continuing education courses for infusion. As a conclusion, the survey highlighted the great heterogeneity of infusion practices as well as the urgent need to improve them. As a consequence, new guidelines and an educational program dedicated to infusion were recently proposed to the nurses.

Keywords : medical devices, infusion, clinical practices assessment, appropriate use

 

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