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- W2022270812 abstract "Dans un objectif d’évaluation et d’amélioration des pratiques professionnelles, l’informatique semble l’outil le plus adapté. Un des principaux domaines pouvant en bénéficier serait la gestion de l’antibioprophylaxie chirurgicale. Malgré les recommandations émanant des sociétés savantes et l’intérêt démontré de leur application rigoureuse, des dysfonctionnements persistent. Disposant déjà d’un système informatique dans notre service, nous nous sommes intéressés à l’évaluation de nos pratiques et à l’impact de cet outil dans l’application de l’antibioprophylaxie. Audits cliniques avant et après mesures. Trois audits de pratique ont été réalisés : avant la mise en place du protocole service et de l’aide informatique (2322 inclus), immédiatement après la mesure (2678 inclus) et enfin à distance (2863 inclus). L’outil informatique a permis une amélioration des pratiques et de l’adéquation aux protocoles dans notre établissement (55 à 81 %, p < 0,01). Toutefois, au cours du temps, un relâchement est observé avec une réaugmentation du nombre d’oublis d’antibioprophylaxie. L’informatique se place comme un outil d’aide à la décision, de rationalisation et d’évaluation des pratiques professionnelles, mais elle doit être accompagnée de mesures éducatives régulières pour faire vivre les protocoles et bases de données. Information technologies appear to be interesting tools to assess and improve professional practices. In that setting, the management of surgical antibiotic prophylaxis represents an appropriate clinical area for using and evaluating such a tool. Despite the existence of guidelines in one hand and the demonstrated interest for a strict application of recommendations in the other hand, some irregularities in the management of surgical antibiotic prophylaxis remain in France in 2010. Since we have had computer systems in our department for several years, we performed an evaluation of practice to assess the impact of both the computer-based help and the updating of knowledge in physicians as tools to improve the application of guidelines for surgical antibiotic prophylaxis. Clinical audits. Three clinical audits have therefore been performed before an implementation of computer-based help for clinical decisions and a clinical update for physicians, immediately after, and two years after this combined procedure (2322, 2678 and 2863 patients, respectively). There was an enhancement of clinical practices and compliance to guidelines secondary to the beginning of computer-based prescription (55 to 81%, P < 0.05). However, a weaning effect was observed with longer intervals between clinical update and surgical procedure, in association with increased omissions of antibiotic prophylaxis. Computer-based help for clinical decision and prescription seems to be a useful tool for surgical antibiotic prophylaxis but it should be accompanied by direct regular educational measures to update protocols and databases." @default.
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- W2022270812 date "2013-04-01" @default.
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- W2022270812 title "Apport de l’outil informatique dans l’application de protocoles : exemple de l’antibioprophylaxie chirurgicale" @default.
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- W2022270812 doi "https://doi.org/10.1016/j.annfar.2013.01.026" @default.
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