High-risk drugs, which are potentially a source of serious adverse reactions, are a major concern in healthcare establishments, particularly for geriatric patients, who often have multiple medications and co-morbid conditions. With a view to continuously improving the quality and safety of care, we have embarked on a proactive approach aimed at identifying, securing and improving the management of medicines at risk in geriatric wards.

BACKGROUND: During the COVID-19 pandemic, single use medical devices\' supply (SUMD) was marked by repetitive and unforeseen interruptions. The present study aimed to determine the risks related to the processes of management of medical devices in our CHU according to a method of failure mode, effect and criticality analysis (FMECA).
METHODS: Qualified healthcare professionals were recruited to form a multidisciplinary consensus committee. By analyzing the process map, all failure modes, causes and consequences were identified through brainstorming meetings. They were then classified taking into account the criticality index (CI) calculated according to three parameters: frequency, severity, and detectability. The prioritization was carried out by considering the mean and the median values of the CI as limits. Corrective and preventive actions were then proposed.
RESULTS: A total of 49 failure modes were identified, accumulating 4466 criticality points. The most critical step is that relating to the inter-depot order with a CI equal to 783 points. An action plan was developed, allows us to control 64% of the overall criticality of the risks linked to the process. Three main lines of action have been proposed: continuous training, especially for managerial and administrative tasks, logistical improvement (architectural reorganization and implementation of systems for securing the circuit of SUMDs) and support for the digitization of hospital pharmacy.
CONCLUSIONS: The FMECA is a consensual method, which makes it possible to propose actions in order to reduce the risks linked to the process of managing medical devices. Optimizing the estimation of needs, strengthening communication with stakeholders and securing the circuit are essential to guarantee the availability of SUMDs for the benefit of the patient.

Cooperation protocols enable healthcare professionals to work together to meet patients\' needs. One of the challenges of these protocols is to offer a wider range of care by reducing the time taken to access care, while also optimising the patient\'s pathway. Four cooperation protocols have been validated for emergency services.

暂无摘要。

BACKGROUND: The COVID-19 pandemic created many challenges for in-patient care including patient isolation and limitations on hospital visitation. Although communication technology, such as video calling or texting, can reduce social isolation, there are challenges for implementation, particularly for older adults.
OBJECTIVE: This study used a mixed methodology to understand the challenges faced by in-patients and to explore the perspectives of patients, family members, and health care providers (HCPs) regarding the use of communication technology. Surveys and focus groups were used.
RESULTS: Patients who had access to communication technology perceived the COVID-19 pandemic to have more adverse impact on their well-beings but less on hospitalization outcomes, compared to those without. Most HCPs perceived that technology could improve programs offered, connectedness of patients to others, and access to transitions of care supports. Focus groups highlighted challenges with technology infrastructure in hospitals.
CONCLUSIONS: Our study findings may assist efforts in appropriately adopting communication technology to improve the quality of in-patient and transition care.

OBJECTIVE: Assess the quality of medical imaging exam requests in order to facilitate their successful completion.
METHODS: This was a prospective study, carried out at the Bouaké UniversityHospital over a period of 4 months. This study covered 3129 requests for examination. The aim was to evaluate the conformity of the different requests established by the CDEI indicator. Data analysis was carried out using Epi Info 7 software.
RESULTS: Requests for medical imaging exams were under-informed in 98.66% of cases by prescribers as defined by the CDEI indicator. The requests included the patient\'s name in 99.78% of cases, first name(s) in 98.91% of cases, age in 51.45%, and sex in 60.95% of cases. 84.79% of the reports came from the Bouaké CHU and 98.43% were dated. The patient\'s hospitalized status was not specified in 99.97% of the requests for analysis. The indication was included in 92.78% of the reports and diagnostic hypotheses were mentioned in only 94.76%. The imaging medium requested was specified in 99.78% with conventional radiography predominating in 80.88%. The anatomical region was mentioned in 92.49%. The identity and contact information of the prescribers represented 92% and 48% of the requestsrespectively.
CONCLUSIONS: The quality of writing of medical imaging examination requests was unsatisfactory overall with a high rate of non-compliance. Much effort to be made by the different actors.
OBJECTIVE: Evaluer la qualité des demandes d\'examen en imagerie médicale pour faciliter leur bonne réalisation.
UNASSIGNED: Il s\'agissait d\'une étude prospective, réalisée au CHU de Bouaké sur une période de 4 mois. Cette étude a porté sur 3129 demandes d\'examen.Il était question d\'évaluer la conformité des différentes demandes établies par l\'indicateur CDEI. Les données ont été analysées avec le logiciel Epi Info 7.
UNASSIGNED: Les demandes d\'examen d\'imagerie médicale étaient insuffisamment renseignées dans 98,66% des cas par les prescripteurs selon l\'indicateur CDEI. Les demandes comportaient le nom du patient dans 99,78% des cas, leur(s) prénom(s) dans 98,91% des cas, l\'âge dans 51,45% des cas et le sexe dans 60,95% des cas. Les demandes d\'examen provenaient du CHU de Bouaké dans 84,79% des cas et ils étaient datés dans 98,43% des cas. Le statut hospitalisé du patient n\'était pas précisé dans 99,97% des cas. L\'indication y figurait dans 92,78% et les hypothèses diagnostiques n\'étaient pas mentionnées dans 94,76%. Le moyen d\'imagerie demandé figurait dans 99,78 % avec une prédominance de la radiographie standard dans 80,88%. La région anatomique était mentionnée dans 92,49%. L\'identité et les coordonnées des prescripteurs étaient indiquées respectivement dans 92% des cas et 48% des cas sur les demandes d\'examen.
CONCLUSIONS: La qualité de rédaction des demandes d\'examen d\'imagerie médicale était insatisfaisante d\'une manière globale avec un taux élevé de non conformités. Beaucoup d\'efforts restent à faire de la part des différents acteurs.

OBJECTIVE: To meet the need for access to eye care in an area with a lack of physicians, a telemedicine workstation in ophthalmology was created. The main objective was to measure the improved access to eye care via telemedicine consultation.
METHODS: No criteria of age, sex or geographical location were defined. Depending on the cause for the consultation and the results of the examinations conducted by an ophthalmic technician physically present in the center, the patient might be given a telemedicine consultation with an ophthalmologist. Eleven indicators were defined to achieve the study objectives. Data were compared with a reference eye care center.
RESULTS: The quality, safety of care, and medical benefits of telemedicine consultation were not inferior to those of the reference center. The consultations screened 25 cases of age-related macular degeneration, 240 glaucoma, 229 cataracts and 27 diabetic retinopathy. 88.5% of patients were included in a cooperative ophthalmologist/technician protocol, compared with 27.3% in the reference center (P<0.0001).
CONCLUSIONS: The telemedicine workstation must be linked to a main center located at most a one-hour drive away. The equipment must be adapted to the use of telemedicine and to allow the technician to perform the necessary assessments and examinations. The number of emergency department visits after telemedicine consultation at the telemedicine workstation was higher than the reference center, which may lead to a subsequent study.
CONCLUSIONS: Telemedicine consultation improves access to eye care in a medically under-served area.

Foot reflexology is the use of massage and acupressure techniques on the feet, which represent each organ of the human body. The reflexologist knows precisely the anatomy of the body and the reflex points on the feet in order to relieve and treat the person\'s problems. A team from the University Hospital of Clermont-Ferrand shares a very positive experience, unfortunately interrupted by the Covid-19 health crisis.

Professor Marlene Freeman of Massachusset General Hospital\'s answer to the question \"How should I prescribe valproic acid (for psychiatric disorders) to women of childbearing age?\" is \"Don\'t do it at all.\"

Quality Standards in Old Age Psychiatry Abstract: Quality standards and regulations are becoming increasingly important and are promoted in the context of the permission to treat, to bill and via financial incentives. In this context, the regulatory frameworks focus to varying degrees on structural, process or outcome criteria. On behalf of the Swiss Society for Old Age Psychiatry and Psychotherapy (SGAP), we summarize the quality elements in this document and group the requirements derived from them based on setting (outpatient, intermediate, inpatient) and structural quality criteria (staffing ratio, infrastructure). There is a very extensive requirements matrix, and its implementation requires considerable efforts, not least because of the shortage of specialists and limited financial resources of psychiatric institutions and medical practices. The criteria of the requirements matrix must be further developed and anchored in a \"competence-based training in old age psychiatry\".
Résumé: Les normes et réglementations en matière de qualité prennent de plus en plus d’importance et sont encouragées dans le cadre de l’approbation des thérapeutiques, de la facturation et des incitations financières. Dans ce contexte, ces réglementations mettent l’accent, à des degrés divers, sur des critères de structure, de processus ou de résultats. Au nom de la Société Suisse de Psychiatrie et Psychothérapie de la Personne Âgée (SPPA) nous résumons dans ce document les éléments de qualité et regroupons les exigences qui en découlent en fonction du setting (ambulatoire, intermédiaire, stationnaire) et des critères de qualité structurelle (clé de répartition du personnel, infrastructure). Il existe une vaste matrice d’exigences dont la mise en œuvre requiert des efforts considérables, entre autres en raison de la pénurie de personnel qualifié et des ressources financières limitées des institutions et des cabinets médicaux. Les critères définis dans la matrice d’exigences devraient être développés et ancrés dans une «formation continue en psychiatrie de la personne âgée basée sur les compétences».