Volunteers, religious communities and users representatives as an alternative for visiting hospitalized patients: The importance of an infection control training.

BACKGROUND: During the COVID-19 pandemic, the suspension of relatives' visits was a common measure in healthcare facilities to prevent the spread of the virus among patients. This measure caused significant adverse consequences for hospitalized patients. Volunteers' intervention was an alternative but could also lead to cross transmission events. AIMS: in order to secure their intervention with patients, we implemented an infection control training to evaluate and to improve the knowledge of volunteers about infection control measures. METHOD: We performed a before-after study in a group of five tertiary referral teaching hospitals in the suburbs of Paris. A total of 226 volunteers from three groups (religious representatives, civilian volunteers and users' representatives) were included. Basic theoretical and practical knowledge about infection control, hand hygiene, and glove and mask use were evaluated just before and immediately after a three-hour training program. The contribution of the characteristics of the volunteers to the results was studied. FINDINGS: The initial conformity rate for theoretical and practical infection control measures ranged from 53% to 68%, depending on the participants' activity status and education level. Some critical shortcomings in hand hygiene as well as mask and glove wearing putatively endangered the patients and volunteers. Surprisingly, serious gaps were also identified among volunteers who experienced care activities. Regardless of their origin, the program significantly improved both their theoretical and practical knowledge (p<0.001). Real-life observance and long-term sustainability should be monitored. CONCLUSIONS: To become a secure alternative to relatives' visits, volunteers' interventions must be preceded by the assessment of their theoretical knowledge and practical skills in infection control. Additional study, including practice audit, must confirm the implementation of the acquired knowledge in the real-life.

Telephone Consultation and Prescription in Pediatrics: Contributing Factors and Impact on Clinical Outcomes.

Objectives: To evaluate phone-based consultation practices and drug prescription profiles in pediatrics and to highlight their possible uses, contributing factors, and effects on clinical outcomes. Background: The ownership and everyday use of cell phones are increasing worldwide. Telehealth is gaining the support of health professionals for the delivery of simple healthcare measures to more complex management decisions. Despite this, in our country, doctors have been advised by concerned authorities to avoid any phone-based medical activity as the safety of such practices is still not well-established, especially among vulnerable pediatric patients. Patients and Methods: This cross-sectional study was conducted on a national level over 5 months. Phone consultations and prescription behaviors data were collected through a self-administrated questionnaire. The target population consisted of pediatric-trained physicians with at least 1 year of experience. Factors influencing telephone prescriptions were assessed using bivariate analysis. Results: Of among 120 included physicians (75.0% male), 64.2% were general pediatricians, 77.5% practiced in private clinics, and 27.5% had more than 20 years of work experience. All participants gave medical advice over the phone; 61.7% considered that they should be reimbursed for these activities and 29.2% of them reviewed 50% of their patients for the same complaint. A total of 109 participants (90.8%) prescribed drugs using a direct phone call (80.7%), SMS (27.5%), or WhatsApp application (61.5%). Antipyretics (97.2%) and cough suppressants (48.1%) were the most frequently prescribed drugs. Pharmacists' corrective interventions were seen in 40.4% of prescriptions. Fever was the only symptom that was statistically associated with phone prescriptions. Prescribers seemed to be less experienced and were more likely to consider phone-based practices as reimbursable activities. Conclusions: Consultations and prescriptions through mobile phones are extremely frequent in pediatric practices, even when restricted by responsible authorities. Our results highlight the frequency of medical prescription errors and the need for corrective interventions by pharmacists. The current practice of telemedicine may not ensure the patient's safety but exists rather as a convenience. There is a need for proper oversight with a regulatory framework and input from all stakeholders, including pediatricians and pharmacists.