Archives par mot-clé : Infirmier

DU Recherche Paramédicale en santé _ Angers _ Cession 2021

Ce diplôme d’université, porté par l’université d’Angers, a été élaboré pour permettre à chaque professionnel paramédicaux qui le souhaite de pouvoir acquérir les connaissances minimales requises pour envisager une implication professionnelle dans le domaine de la recherche clinique.

Les objectifs de cette formation sont de fournir aux participants les connaissances théoriques et les habiletés nécessaires à la conduite d’un projet de recherche, du questionnement initial à la rédaction de la trame détaillée d’un protocole de recherche conforme aux attentes des principaux appels d’offre nationaux.

Continuer la lecture de DU Recherche Paramédicale en santé _ Angers _ Cession 2021

Effets d’un programme multimodal sur les conditions de travail des infirmières dans des unités de soins intensifs

JAMA. 2018 Nov 20;320(19):1988-1997. doi: 10.1001/jama.2018.14284.

Effects of a Multimodal Program Including Simulation on Job Strain Among Nurses Working in Intensive Care Units: A Randomized Clinical Trial.

El Khamali R1Mouaci A1Valera S1, et al.

1 Infirmières de l’Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Réanimation des Détresses Respiratoires et des Infections Sévères, Marseille, France.

L’article

https://www.ncbi.nlm.nih.gov/pubmed/?term=elkhamali

En bref…

Abstract

IMPORTANCE:

Nurses working in an intensive care unit (ICU) are exposed to occupational stressors that can increase the risk of stress reactions, long-term absenteeism, and turnover.

OBJECTIVE:

To evaluate the effects of a program including simulation in reducing work-related stress and work-related outcomes among ICU nurses.

DESIGN, SETTING, AND PARTICIPANTS:

Multicenter randomized clinical trial performed at 8 adult ICUs in France from February 8, 2016, through April 29, 2017. A total of 198 ICU nurses were included and followed up for 1 year until April 30, 2018.

INTERVENTIONS:

The ICU nurses who had at least 6 months of ICU experience were randomized to the intervention group (n = 101) or to the control group (n = 97). The nurses randomized to the intervention group received a 5-day course involving a nursing theory recap and situational role-play using simulated scenarios (based on technical dexterity, clinical approach, decision making, aptitude to teamwork, and task prioritization), which were followed by debriefing sessions on attitude and discussion of practices.

MAIN OUTCOMES AND MEASURES:

The primary outcome was the prevalence of job strain assessed by combining a psychological demand score greater than 21 (score range, 9 [best] to 36 [worst]) with a decision latitude score less than 72 (score range, 24 [worst] to 96 [best]) using the Job Content Questionnaire and evaluated at 6 months. There were 7 secondary outcomes including absenteeism and turnover.

RESULTS:

Among 198 ICU nurses who were randomized (95 aged ≤30 years [48%] and 115 women [58%]), 182 (92%) completed the trial for the primary outcome. The trial was stopped for efficacy at the scheduled interim analysis after enrollment of 198 participants. The prevalence of job strain at 6 months was lower in the intervention group than in the control group (13% vs 67%, respectively; between-group difference, 54% [95% CI, 40%-64%]; P < .001). Absenteeism during the 6-month follow-up period was 1% in the intervention group compared with 8% in the control group (between-group difference, 7% [95% CI, 1%-15%]; P = .03). Four nurses (4%) from the intervention group left the ICU during the 6-month follow-up period compared with 12 nurses (12%) from the control group (between-group difference, 8% [95% CI, 0%-17%]; P = .04).

CONCLUSIONS AND RELEVANCE:

Among ICU nurses, an intervention that included education, role-play, and debriefing resulted in a lower prevalence of job strain at 6 months compared with nurses who did not undergo this program. Further research is needed to understand which components of the program may have contributed to this result and to evaluate whether this program is cost-effective.

TRIAL REGISTRATION:

ClinicalTrials.gov Identifier: NCT02672072.

Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial

THE LANCET  VOLUME 392, ISSUE 10145P419-430, AUGUST 04, 2018

Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial

Prof Claire M Rickard, Nicole Marsh, Prof Joan Webster, Naomi Runnegar, Emily Larsen,  Matthew R McGrail

Published:July 26, 2018
Summary
Background
Two billion peripheral intravenous catheters (PIVCs) are used globally each year, but optimal dressing and securement methods are not well established. We aimed to compare the efficacy and costs of three alternative approaches to standard non-bordered polyurethane dressings.
Methods
We did a pragmatic, randomised controlled, parallel-group superiority trial at two hospitals in Queensland, Australia. Eligible patients were aged 18 years or older and required PIVC insertion for clinical treatment, which was expected to be required for longer than 24 h. Patients were randomly assigned (1:1:1:1) via a centralised web-based randomisation service using random block sizes, stratified by hospital, to receive tissue adhesive with polyurethane dressing, bordered polyurethane dressing, a securement device with polyurethane dressing, or polyurethane dressing (control). Randomisation was concealed before allocation. Patients, clinicians, and research staff were not masked because of the nature of the intervention, but infections were adjudicated by a physician who was masked to treatment allocation. The primary outcome was all-cause PIVC failure (as a composite of complete dislodgement, occlusion, phlebitis, and infection [primary bloodstream infection or local infection]). Analysis was by modified intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000769987.
Findings
Between March 18, 2013, and Sept 9, 2014, we randomly assigned 1807 patients to receive tissue adhesive with polyurethane (n=446), bordered polyurethane (n=454), securement device with polyurethane (n=453), or polyurethane (n=454); 1697 patients comprised the modified intention-to-treat population. 163 (38%) of 427 patients in the tissue adhesive with polyurethane group (absolute risk difference −4·5% [95% CI −11·1 to 2·1%], p=0·19), 169 (40%) of 423 of patients in the bordered polyurethane group (–2·7% [–9·3 to 3·9%] p=0·44), 176 (41%) of 425 patients in the securement device with poplyurethane group (–1·2% [–7·9% to 5·4%], p=0·73), and 180 (43%) of 422 patients in the polyurethane group had PIVC failure. 17 patients in the tissue adhesive with polyurethane group, two patients in the bordered polyurethane group, eight patients in the securement device with polyurethane group, and seven patients in the polyurethane group had skin adverse events. Total costs of the trial interventions did not differ significantly between groups.
Interpretation
Current dressing and securement methods are commonly associated with PIVC failure and poor durability, with simultaneous use of multiple products commonly required. Cost is currently the main factor that determines product choice. Innovations to achieve effective, durable dressings and securements, and randomised controlled trials assessing their effectiveness are urgently needed.
Funding
Australian National Health and Medical Research Council.

DU Recherche, clinique, formation, encadrement en sciences infirmières et paramédicales _ Nantes

Les sciences infirmières portent sur la compréhension des réactions singulières de l’être humain face à ses expériences de santé et de maladie au regard de son propre cadre de référence. Cette compréhension guide les interventions infirmières et peuvent guider également les autres professions paramédicales.
Cette formation vise à acquérir une culture scientifique pour être en capacité de répondre en équipe pluri-professionnelle à des appels d’offre nationaux de type programme hospitalier de recherche infirmière et paramédicale.

Objectifs

  • Situer les enjeux politique, économique et social de la recherche en sciences infirmières et paramédicales
  • Appréhender les étapes de la recherche (description de la situation d’appel, problématisation, cadre de référence, méthodes, analyse des résultats, interprétation, discussion, diffusion des résultats)
  • Élaborer une réponse à d’appel d’offres en incluant les éléments financiers
Continuer la lecture de DU Recherche, clinique, formation, encadrement en sciences infirmières et paramédicales _ Nantes

DU Recherche Paramédicale en santé _ Angers

Ce diplôme d’université, porté par l’université d’Angers, a été élaboré pour permettre à chaque professionnel paramédicaux qui le souhaite de pouvoir acquérir les connaissances minimales requises pour envisager une implication professionnelle dans le domaine de la recherche clinique.

Les objectifs de cette formation sont de fournir aux participants les connaissances théoriques et les habiletés nécessaires à la conduite d’un projet de recherche, du questionnement initial à la rédaction de la trame détaillée d’un protocole de recherche conforme aux attentes des principaux appels d’offre nationaux.

Continuer la lecture de DU Recherche Paramédicale en santé _ Angers