Improving the safety climate in hospitals by a vignette-based analysis of adverse events: a cluster randomised study.

Objective: To assess the impact of a vignette-based analysis of adverse events (AEs) on the safety climate (SC) of care units.

Design: Prospective, open, cluster (a unit) randomised controlled trial.

Setting: Eighteen acute care units of seven hospitals in France.

Impact of an Original Methodological Tool on the Identification of Corrective and Preventive Actions After Root Cause Analysis of Adverse Events in Health Care Facilities: Results of a Randomized Controlled Trial.

Objective: The aim of the study was to assess the effectiveness of a new methodological tool for the identification of corrective and preventive actions (CAPAs) after root cause analysis of health care-related adverse events.

Methods: From January to June 2010, we conducted a randomized controlled trial involving risk managers from 111 health care facilities of the Aquitaine Regional Center for Quality and Safety in Health Care (France). Fifty-six risk managers, randomly assigned to two groups (intervention and control), identified CAPAs in response to two sequentially presented adverse event scenarios.

Insurance statements related to regional anaesthesia: A French database analysis.

Background: Adverse events in the perioperative period remain frequent, occurring in about 30% of the hospital admission and may be avoidable in nearly 50% of cases. Improving safety needs a continuous assessment of the risk level.

Material And Methods: Data from the MACSF-Sou medical insurance company, including all the statements declared by anaesthesiologists and intensivists, were analyzed retrospectively by three experts, senior anaesthesiologists, of the SFAR, the French society of anesthesia and intensive care (Société française d'anesthésie réanimation) to describe the risk associated with regional anaesthesia.

Insurance statements from French anaesthesiologists and intensivists: A database analysis.

Background: From its origins, anaesthesia is a leading medical specialty for improving patient safety. However, perioperative adverse events remain frequent and may be preventable in 50% of cases. We conducted a collaborative retrospective study analysis of the insurance-database of the MACSF-Sou Medical insurance company to assess the perioperative risk.

A Serious Game for Massive Training and Assessment of French Soldiers Involved in Forward Combat Casualty Care (3D-SC1): Development and Deployment.

Background: The French Military Health Service has standardized its military prehospital care policy in a ''Sauvetage au Combat'' (SC) program (Forward Combat Casualty Care). A major part of the SC training program relies on simulations, which are challenging and costly when dealing with more than 80,000 soldiers. In 2014, the French Military Health Service decided to develop and deploy 3D-SC1, a serious game (SG) intended to train and assess soldiers managing the early steps of SC.

Hospital audit of delayed transfusion after orthopaedic surgery.

Background And Objectives: To understand the mechanisms related to both the onset and correction of severe anaemia after orthopaedic surgery, we analysed all the full blood counts (FBCs) for patients on one orthopaedic ward during a one-year period in an academic hospital.

Methods: FBCs were screened and the medical records of those patients for whom a postoperative haemoglobin (Hb) concentration below 8 g/dL was recorded at least once were reviewed. The onset of postoperative anaemia was determined by calculating the various time intervals delineated by surgery, the time at which the transfusion threshold was reached and the time at which the lowest Hb level (nadir) and transfusion (if any) occurred.

A simulator-based study of in-flight auscultation.

Introduction: The use of a stethoscope is essential to the delivery of continuous, supportive en route care during aeromedical evacuations. We compared the capability of 2 stethoscopes (electronic, Litmann 3000; conventional, Litmann Cardiology III) at detecting pathologic heart and lung sounds, aboard a C135, a medical transport aircraft.

Methods: Sounds were mimicked using a mannequin-based simulator SimMan.

[Specificities of war surgery, and capacities of the military health service].

In view of the recent evolution of military conflicts, particularly in the Afghan theater, and the conditions in which wounded warriors are managed in the field prior to hospitalization, the authors examine the technical specificities of medical teams, based on studies of avoidable mortality. War surgery has become a separate specialty, following the disappearance in France of the general surgical specialty, of which it was the military coun-terpart. The authors stress the role of hemorrhaging and its treatment, based on three strategies: damage control resuscitation, blood transfusion, and early evacuation within the "golden hour ".

Brief report: pulmonary auscultation in the operating room: a prospective randomized blinded trial comparing electronic and conventional stethoscopes.

Background: We compared the subjective quality of pulmonary auscultation between 2 acoustic stethoscopes (Holtex Ideal® and Littmann Cardiology III®) and an electronic stethoscope (Littmann 3200®) in the operating room.

Methods: A prospective double-blind randomized study with an evaluation during mechanical ventilation was performed in 100 patients. After each examination, the listeners using a numeric scale (0-10) rated the quality of auscultation.

[The nurse, a key player in transfusion safety].

In the chain of transfusion safety, the nurse is the last line of defence in the battery of controls to avoid transfusion errors. The final pre-transfusion test carried out at the patient's bedside is a meticulous procedure. It involves cross-referencing documents, checking the identity of the patient and determining the ABO blood group through an agglutination test.

Development of a safety culture: initial measurements at six hospitals in France.

A cross-sectional and descriptive survey of a safety culture (SC) was conducted in 20 clinical units in France. A self-administered questionnaire measuring 12 dimensions of safety culture was given to healthcare professionals. The overall response rate was 65%.

Anaphylaxis during anesthesia in France: an 8-year national survey.

Background: More attention should be paid to rare serious adverse events such as anaphylaxis to increase the safety of anesthesia.

Objective: To report the results of an 8-year survey of anaphylaxis during anesthesia in France.

Methods: Data from patients who experienced anaphylaxis between January 1, 1997, and December 31, 2004, were analyzed.