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1.
Rev Epidemiol Sante Publique ; 64(6): 415-423, 2016 Dec.
Artigo em Francês | MEDLINE | ID: mdl-27816309

RESUMO

BACKGROUND: Flu vaccinations for healthcare professionals seems to be one of the most effective preventive actions in the face of a disease that carries a high risk of a potentially serious nosocomial epidemic in a geriatric environment. The aim of this study was to take stock of the flu vaccination status among caregivers in the geriatric units and to understand the reasons for their reluctance to be vaccinated, in order to put forward proposals to improve vaccination coverage. METHOD: A literature search of articles published since 2000 in the area of geriatrics, infectious diseases or pneumology was mainly conducted on PubMed using the keywords "caregivers", "elderly", "flu", "influenza", "nosocomial" and "vaccination". After reading all abstracts in English or French and ruling out irrelevant articles, only 64 relevant articles have been listed in bibliography section. RESULTS: Despite official recommendations, the literature reveals insufficient vaccination coverage of healthcare personnel at both the national and international level. Vaccination coverage seems to be lower among younger female non-medical staff. The factors that determine the likelihood of vaccination are the wish to protect one's self, one's family and patients/residents, as well as the experience of earlier bouts of flu. Factors that oppose vaccination are complex and related to the fear of side effects, the use of other preventive measures, the feeling that vaccination is ineffective, poor understanding of the disease and the vaccine, forgetfulness and problems of organization. Campaigns to promote vaccination that target healthcare professionals must be multidimensional and very incentive. The pedagogical message must be centered on the benefits to the individual and adjusted to socio-professional categories. Mobile strategies in the different departments to encourage staff are a pragmatic solution to this challenge. The referring doctor has an essential role to play, as does the occupational doctor in association with the hospital hygiene services. CONCLUSION: Flu vaccinations must be included in the education and training of caregivers.


Assuntos
Cuidadores/estatística & dados numéricos , Geriatria , Pessoal de Saúde/estatística & dados numéricos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Atitude do Pessoal de Saúde , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Unidades Hospitalares/estatística & dados numéricos , Humanos , Influenza Humana/epidemiologia , Masculino , Estações do Ano , Recursos Humanos
2.
Ann Cardiol Angeiol (Paris) ; 67(4): 238-243, 2018 Sep.
Artigo em Francês | MEDLINE | ID: mdl-29759801

RESUMO

INTRODUCTION: Furosemide is very often prescribed in France. It may cause important adverse effects especially in elderly persons. In order to limit its misuse and excessive expenditure for health insurance organizations, the European Society of Cardiology drafted strict guidelines for its prescription. We conducted a study in this population to determine the rate of prescription of furosemide in elderly persons outside the guidelines. METHOD: This was a prospective, single-centre, observational study bearing on elderly persons aged 75years and more admitted to a geriatric acute-care unit over a period of 6months. The prevalence of furosemide prescription and the proportion of prescriptions outside guidelines were calculated. The sociodemographic and medical characteristics of patients treated with furosemide were studied as were the modalities of furosemide prescription. RESULTS: In the 818 patients hospitalized during the period of the study, 267 were taking furosemide at admission (32.6%). Among these prescriptions, 69.2% were outside the guidelines. Arterial hypertension was the leading indication for furosemide (38.2%), followed by chronic heart failure (24.3%). CONCLUSION: This study confirmed the high prevalence of furosemide prescription and its misuse. Furosemide is often re-prescribed with no medical re-evaluation.


Assuntos
Diuréticos/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Furosemida/uso terapêutico , Hospitalização , Idoso , Idoso de 80 Anos ou mais , Feminino , França , Fidelidade a Diretrizes , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico , Masculino , Guias de Prática Clínica como Assunto , Estudos Prospectivos
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