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Author: Mélanie Pagani
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
A L'hôpital Nord-Ouest Villefranche-sur-Saône, la validation des ordonnances est réalisée depuis 2009. Cependant plus d'un tiers des Interventions Pharmaceutiques (IP) restent refusées. Par ailleurs, depuis 2007, le projet High 5s a placé la Conciliation des Traitements Médicamenteux (CTM) au centre de l'actualité. Ainsi, notre étude a pour objectif d'améliorer et d'étendre nos pratiques de Pharmacie Clinique selon deux approches, d'une part en évaluant nos pratiques actuelles d'analyse d'ordonnance, et d'autre part en faisant évoluer nos activités de pharmacien clinicien vers la CTM. Afin d'optimiser les pratiques de pharmacie clinique, un staff d'Evaluation des Pratiques Professionnelles (EPP) a été initié pour évaluer la pertinence des IP selon les trois aspects du modèle ECHO (clinique, économique et humain). Deux séances de staff EPP ont eu lieu permettant d'harmoniser notre méthodologie d'IP et d'établir des supports d'aide à l'intervention, avec les Fiches d'Interventions Pharmaceutiques (FIP) antibiotiques et insuffisance rénale. Ces FIP seront par ailleurs intégrées au livret des antibiotiques de l'établissement, comme outil d'aide à la prescription. Le processus de conciliation médicamenteuse a été testé à l'admission des patients du service de Médecine Interne et Maladies Infectieuses (MIMI) sur une période de six mois. La sélection des patients à concilier a été faite sur la base du sens clinique de l'équipe médicale. Quatre-vingt-sept patients ont été inclus. Dans notre étude, 73,5% des prescriptions analysées comportaient au moins une Divergence Non Intentionnelle (DNI). Le principal type de divergence était l'omission (39.3%), et 31% des DNI concernaient les médicaments du système nerveux. Par ailleurs, 79.2% des divergences intentionnelles étaient non documentées. La cotation de l'impact clinique selon l'échelle de Hatoum d'un échantillon de 35 DNI a montré que 68.6% des DNI avaient un impact clinique, majoritairement de niveau 1 (45%). Le temps moyen d'une CTM a été évalué à 38 minutes. Ces deux approches nous ont permis d'optimiser et de mettre en place des démarches d'amélioration continue de nos pratiques de pharmacien clinicien. Le staff EPP va être intégré à la pratique quotidienne. La CTM à l'admission a, quant à elle, permis de sécuriser le parcours de soin du patient aux points de transfert. Ce processus est néanmoins chronophage, et nécessite pour sa pérennisation des ressources humaines et une amélioration des systèmes d'information
Author: Mélanie Pagani
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
A L'hôpital Nord-Ouest Villefranche-sur-Saône, la validation des ordonnances est réalisée depuis 2009. Cependant plus d'un tiers des Interventions Pharmaceutiques (IP) restent refusées. Par ailleurs, depuis 2007, le projet High 5s a placé la Conciliation des Traitements Médicamenteux (CTM) au centre de l'actualité. Ainsi, notre étude a pour objectif d'améliorer et d'étendre nos pratiques de Pharmacie Clinique selon deux approches, d'une part en évaluant nos pratiques actuelles d'analyse d'ordonnance, et d'autre part en faisant évoluer nos activités de pharmacien clinicien vers la CTM. Afin d'optimiser les pratiques de pharmacie clinique, un staff d'Evaluation des Pratiques Professionnelles (EPP) a été initié pour évaluer la pertinence des IP selon les trois aspects du modèle ECHO (clinique, économique et humain). Deux séances de staff EPP ont eu lieu permettant d'harmoniser notre méthodologie d'IP et d'établir des supports d'aide à l'intervention, avec les Fiches d'Interventions Pharmaceutiques (FIP) antibiotiques et insuffisance rénale. Ces FIP seront par ailleurs intégrées au livret des antibiotiques de l'établissement, comme outil d'aide à la prescription. Le processus de conciliation médicamenteuse a été testé à l'admission des patients du service de Médecine Interne et Maladies Infectieuses (MIMI) sur une période de six mois. La sélection des patients à concilier a été faite sur la base du sens clinique de l'équipe médicale. Quatre-vingt-sept patients ont été inclus. Dans notre étude, 73,5% des prescriptions analysées comportaient au moins une Divergence Non Intentionnelle (DNI). Le principal type de divergence était l'omission (39.3%), et 31% des DNI concernaient les médicaments du système nerveux. Par ailleurs, 79.2% des divergences intentionnelles étaient non documentées. La cotation de l'impact clinique selon l'échelle de Hatoum d'un échantillon de 35 DNI a montré que 68.6% des DNI avaient un impact clinique, majoritairement de niveau 1 (45%). Le temps moyen d'une CTM a été évalué à 38 minutes. Ces deux approches nous ont permis d'optimiser et de mettre en place des démarches d'amélioration continue de nos pratiques de pharmacien clinicien. Le staff EPP va être intégré à la pratique quotidienne. La CTM à l'admission a, quant à elle, permis de sécuriser le parcours de soin du patient aux points de transfert. Ce processus est néanmoins chronophage, et nécessite pour sa pérennisation des ressources humaines et une amélioration des systèmes d'information
Author: Abdul W. Basit
Publisher: Springer
ISBN: 3319907557
Category : Medical
Languages : en
Pages : 246
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Book Description
3D printing is forecast to revolutionise the pharmaceutical sector, changing the face of medicine development, manufacture and use. Potential applications range from pre-clinical drug development and dosage form design through to the fabrication of functionalised implants and regenerative medicine. Within clinical pharmacy practice, printing technologies may finally lead to the concept of personalised medicines becoming a reality. This volume aims to be the definitive resource for anyone thinking of developing or using 3D printing technologies in the pharmaceutical sector, with a strong focus on the translation of printing technologies to a clinical setting. This text brings together leading experts to provide extensive information on an array of 3D printing techniques, reviewing the current printing technologies in the pharmaceutical manufacturing supply chain, in particular, highlighting the state-of-the-art applications in medicine and discussing modern drug product manufacture from a regulatory perspective. This book is a highly valuable resource for a range of demographics, including academic researchers and the pharmaceutical industry, providing a comprehensive inventory detailing the current and future applications of 3D printing in pharmaceuticals. Abdul W. Basit is Professor of Pharmaceutics at the UCL School of Pharmacy, University College London. Abdul’s research sits at the interface between pharmaceutical science and gastroenterology, forging links between basic science and clinical outcomes. He leads a large and multidisciplinary research group, and the goal of his work is to further the understanding of gastrointestinal physiology by fundamental research. So far, this knowledge has been translated into the design of new technologies and improved disease treatments, many of which are currently in late-stage clinical trials. He has published over 350 papers, book chapters and abstracts and delivered more than 250 invited research presentations. Abdul is also a serial entrepreneur and has filed 25 patents and founded 3 pharmaceutical companies (Kuecept, Intract Pharma, FabRx). Abdul is a frequent speaker at international conferences, serves as a consultant to many pharmaceutical companies and is on the advisory boards of scientific journals, healthcare organisations and charitable bodies. He is the European Editor of the International Journal of Pharmaceutics. Abdul was the recipient of the Young Investigator Award in Pharmaceutics and Pharmaceutical Technology from the American Association of Pharmaceutical Scientists (AAPS) and is the only non-North American scientist to receive this award. He was also the recipient of the Academy of Pharmaceutical Sciences (APS) award. Simon Gaisford holds a Chair in Pharmaceutics and is Head of the Department of Pharmaceutics at the UCL School of Pharmacy, University College London. He has published 110 papers, 8 book chapters and 4 authored books. His research is focused on novel technologies for manufacturing medicines, particularly using ink-jet printing and 3D printing, and he is an expert in the physico-chemical characterisation of compounds and formulations with thermal methods and calorimetry.
Author: World Health Organization
Publisher: World Health Organization
ISBN: 9241547006
Category : Health & Fitness
Languages : en
Pages : 284
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Book Description
Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
Author: Andreas Bieler
Publisher: Routledge
ISBN: 1134599315
Category : Political Science
Languages : en
Pages : 320
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Book Description
Traditionally in International Relations, power and authority were considered to rest with states. But recently, in the light of changes associated with globalisation, this has come under scrutiny both empirically and theoretically. This book analyses the continuing but changing role of states in the international arena, and their relationships with a wide range of non-state actors, which possess increasingly salient capabilities to structure global politics and economics.
Author: Asian Development Bank
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 124
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Book Description
Aiming to support the development of a framework for the analysis of risk in project design and economic analysis, this handbook outlines technical approaches to modeling risk. Also summarized is the nature and practice of sensitivity analysis in dealing with uncertain outcomes as well as the principles to consider in typical risk analysis situations sector by sector. Case studies are included to demonstrate the application of quantitative risk analysis using actual Asian Development Bank projects to help improve project design and quality. Handbook users will learn to identify factors that are the key determinants of project outcomes, determine the likelihood of an individual project's returns being unacceptable, and design measures to mitigate the risks arising from the identified key factors.
Author: Mohammed Berriane
Publisher: Routledge
ISBN: 1317215303
Category : Political Science
Languages : en
Pages : 232
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Book Description
Over the 20th century, Morocco has become one of the world’s major emigration countries. But since 2000, growing immigration and settlement of migrants from sub-Saharan Africa, the Middle East, and Europe confronts Morocco with an entirely new set of social, cultural, political and legal issues. This book explores how continued emigration and increasing immigration is transforming contemporary Moroccan society, with a particular emphasis on the way the Moroccan state is dealing with shifting migratory realities. The authors of this collective volume embark on a dialogue between theory and empirical research, showcasing how contemporary migration theories help understanding recent trends in Moroccan migration, and, vice-versa, how the specific Moroccan case enriches migration theory. This perspective helps to overcome the still predominant Western-centric research view that artificially divide the world into ‘receiving’ and ‘sending’ countries and largely disregards the dynamics of and experiences with migration in countries in the Global South. This book was previously published as a special issue of The Journal of North African Studies.
Author: Marilyn Sue Bogner
Publisher: CRC Press
ISBN: 1351440209
Category : Technology & Engineering
Languages : en
Pages : 424
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Book Description
This edited collection of articles addresses aspects of medical care in which human error is associated with unanticipated adverse outcomes. For the purposes of this book, human error encompasses mismanagement of medical care due to: * inadequacies or ambiguity in the design of a medical device or institutional setting for the delivery of medical care; * inappropriate responses to antagonistic environmental conditions such as crowding and excessive clutter in institutional settings, extremes in weather, or lack of power and water in a home or field setting; * cognitive errors of omission and commission precipitated by inadequate information and/or situational factors -- stress, fatigue, excessive cognitive workload. The first to address the subject of human error in medicine, this book considers the topic from a problem oriented, systems perspective; that is, human error is considered not as the source of the problem, but as a flag indicating that a problem exists. The focus is on the identification of the factors within the system in which an error occurs that contribute to the problem of human error. As those factors are identified, efforts to alleviate them can be instituted and reduce the likelihood of error in medical care. Human error occurs in all aspects of human activity and can have particularly grave consequences when it occurs in medicine. Nearly everyone at some point in life will be the recipient of medical care and has the possibility of experiencing the consequences of medical error. The consideration of human error in medicine is important because of the number of people that are affected, the problems incurred by such error, and the societal impact of such problems. The cost of those consequences to the individuals involved in medical error, both in the health care providers' concern and the patients' emotional and physical pain, the cost of care to alleviate the consequences of the error, and the cost to society in dollars and in lost personal contributions, mandates consideration of ways to reduce the likelihood of human error in medicine. The chapters were written by leaders in a variety of fields, including psychology, medicine, engineering, cognitive science, human factors, gerontology, and nursing. Their experience was gained through actual hands-on provision of medical care and/or research into factors contributing to error in such care. Because of the experience of the chapter authors, their systematic consideration of the issues in this book affords the reader an insightful, applied approach to human error in medicine -- an approach fortified by academic discipline.
Author: Marianne Hundt
Publisher: Rodopi
ISBN: 9042021284
Category : Computers
Languages : en
Pages : 313
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Book Description
Using the Web as Corpus is one of the recent challenges for corpus linguistics. This volume presents a current state-of-the-arts discussion of the topic. The articles address practical problems such as suitable linguistic search tools for accessing the www, the question of register variation, or they probe into methods for culling data from the web. The book also offers a wide range of case studies, covering morphology, syntax, lexis, as well as synchronic and diachronic variation in English. These case studies make use of the two approaches to the www in corpus linguistics - web-as-corpus and web-for-corpus-building. The case studies demonstrate that web data can provide useful additional evidence for a broad range of research questions.
Author: Dennis Raphael
Publisher: Canadian Scholars’ Press
ISBN: 9781551303505
Category : Health
Languages : en
Pages : 0
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Book Description
Genetics and traditional risk factors such as activity, diet, and tobacco use cannot reliably predict whether we stay healthy or become ill. What then are the primary predictors of adult-onset diabetes, heart attacks, stroke, and many other diseases? The social determinants of health provide the answer: these are the socio-economic conditions that shape the health of individuals, communities, and jurisdictions as a whole. Social determinants establish the extent to which Canadians possess the resources to identify and achieve personal aspirations, satisfy needs, and cope with the environment. This perspective is the key to understanding patterns of health and illness in Canada today. Uniting top academics and high profile experts from across the country, this contributed volume is a unique undertaking that combines analysis of the current state of the social determinants of health, with explication of their effects. The contributions take a public policy approach that sees the mainsprings of health emerging from the social distribution of resources. The collection as a whole integrates insights from the health sciences, the sociology of health, and the political economy of health. Critical areas of investigation: Aboriginal status early life, education, and literacy work and unemployment food security gender health care services housing income and its distribution social safety net social exclusion
Author: IARC Working Group on the Evaluation of Carcinogenic Risks to Humans
Publisher: World Health Organization
ISBN:
Category : Health & Fitness
Languages : en
Pages : 536
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Book Description
Evaluates the carcinogenic risks to humans posed by the use of four antiretroviral agents four DNA topoisomerase II inhibitors used in the treatment of cancer and an additional three pharmaceutical agents (hydroxyures phenolphthalein and vitamin K substances). The volume marks the first IARC evaluation of nucleoside analogs that act as antiviral agents. The evaluation responds in part to recent findings that zidovudine (AZT) an effective antiretroviral agent now being given to pregnant HIV-infected women to prevent maternal-to-fetal transmission of the virus is a transplacental carcinogen in mice. The opening monograph evaluates the carcinogenicity to humans of the antiretroviral nucleoside analogs zidovudine (AZT) zalcitabine (ddC) and didanosine (ddI) and the antiherpesvirus drug aciclovir. Of these aciclovir and didanosine could not be classified on the basis of available data. For zidovudine transplacental administration to mice resulted in an increased incidence and multiplicity of lung and liver tumours and in an increased incidence of female reproductive tract tumours in one study but not in another involving treatment at a lower dose. Despite observation of toxic effects in some studies of humans human carcinogenicity data were judged to provide inadequate evidence of carcinogenicity in humans. Zidovudine was classified as possibly carcinogenic to humans. Similar weaknesses in human carcinogenicity data for zalcitabine which consistently induces thymic lymphomas in mice resulted in its classification as possibly carcinogenic to humans. The second monograph evaluates four DNA topoisomerase II inhibitors: etoposide teniposide mitoxantrone and amsacrine. Of these etoposide - one of the most widely used and effective cytotoxic drugs in combination therapy - was classified as probably carcinogenic to humans and etoposide in combination with cisplatin and bleomycin was judged to be carcinogenic to humans. Teniposide was classified as probably carcinogenic to humans and mitoxantrone and amsacrine were classified as possibly carcinogenic to humans. Of the three pharmaceutical agents evaluated in the final monograph hydroxyurea which is widely used in cancer treatment and increasingly in combination with didanosine in HIV infection could not be classified. Phenolphthalein a widely used laxative now being withdrawn from the market in many countries because of toxicological concerns was classified as possibly carcinogenic. Vitamin K substances could not be classified on the basis of available evidence.
