6 results on '"Gabriel Birgand"'
Search Results
2. Bed utilisation and increased risk ofClostridium difficileinfections in acute hospitals in England in 2013/2014
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Alison Holmes, Hannah Lishman, Venanzio Vella, Nichola R. Naylor, Alice King, Gabriel Birgand, Paul Aylin, and Luke S. P. Moore
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030203 arthritis & rheumatology ,medicine.medical_specialty ,genetic structures ,business.industry ,Hospital bed ,Health Policy ,Confounding ,Health services research ,Clostridium difficile infections ,Bed Occupancy ,Hospital medicine ,03 medical and health sciences ,0302 clinical medicine ,Increased risk ,Emergency medicine ,Medicine ,Infection control ,030212 general & internal medicine ,business ,Intensive care medicine - Abstract
Background The study aimed to identify thresholds for hospital bed utilisation which are independently associated with significantly higher risks for Clostridium difficile infections (CDI) in acute hospitals in England. Method A retrospective analysis was carried out on reported data from the English National Health Service (NHS) for the financial year 2013/2014. Reported rates of CDI were used as a proxy for hospital infection rates in acute NHS hospital trusts. Multivariate linear regression was used to assess the relationship between bed utilisation values and CDI controlling for confounding factors. Hospitals were finally plotted in a Pabon Lasso graph according to their average bed occupancy rate (BOR) and bed turnover rate (BTR) per year to visualise the relationship between bed utilisation and CDI. Results Among English hospital NHS trusts, increasing BTR and decreasing BOR were associated with a decrease in CDI. However, this effect was not large, and patient mix had a larger impact on CDI rates than bed utilisation. Conclusions While policymakers and managers wishing to target healthcare providers with high CDI rates should look at bed utilisation measures, focusing on these alone is unlikely to have the desired impact. Instead, strategies to combat CDI must take a wider perspective on contributory factors at the institutional level.
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- 2016
3. Is virtual reality effective to teach prevention of surgical site infections in the operating room? study protocol for a randomised controlled multicentre trial entitled VIP Room study
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Brice Rubens-Duval, Julien Picard, Pierre Albaladejo, Pierre Gillois, Gabriel Birgand, Enrique Castro-Sánchez, Nico T. Mutters, Claire Masson, Hugo Terrisse, Caroline Landelle, Vanessa M. Eichel, Jean Luc Bosson, Alexa Comte, and Economic & Social Research Council (ESRC)
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QA75 ,LB2300 ,Operating Rooms ,Students, Medical ,education ,lcsh:Medicine ,Virtual reality ,1117 Public Health and Health Services ,surgery ,Medicine, General & Internal ,Primary outcome ,Nursing ,General & Internal Medicine ,Intervention (counseling) ,Surgical site ,Humans ,Multicenter Studies as Topic ,Surgical Wound Infection ,Medicine ,Infection control ,Randomized Controlled Trials as Topic ,Protocol (science) ,Science & Technology ,Health professionals ,business.industry ,lcsh:R ,Virtual Reality ,Ethics committee ,1103 Clinical Sciences ,General Medicine ,education & training (see medical education & training) ,infection control ,Education, Medical, Graduate ,SIMULATION ,Educational Measurement ,Public Health ,business ,Life Sciences & Biomedicine ,RA ,RD ,1199 Other Medical and Health Sciences - Abstract
IntroductionSome surgical site infections (SSI) could be prevented by following adequate infection prevention and control (IPC) measures. Poor compliance with IPC measures often occurs due to knowledge gaps and insufficient education of healthcare professionals. The education and training of SSI preventive measures does not usually take place in the operating room (OR), due to safety, and organisational and logistic issues. The proposed study aims to compare virtual reality (VR) as a tool for medical students to learn the SSI prevention measures and adequate behaviours (eg, limit movements…) in the OR, to conventional teaching.Methods and analysisThis protocol describes a randomised controlled multicentre trial comparing an educational intervention based on VR simulation to routine education. This multicentre study will be performed in three universities: Grenoble Alpes University (France), Imperial College London (UK) and University of Heidelberg (Germany). Third-year medical students of each university will be randomised in two groups. The students randomised in the intervention group will follow VR teaching. The students randomised in the control group will follow a conventional education programme. Primary outcome will be the difference between scores obtained at the IPC exam at the end of the year between the two groups. The written exam will be the same in the three countries. Secondary outcomes will be satisfaction and students’ progression for the VR group. The data will be analysed with intention-to-treat and per protocol.Ethics and disseminationThis study has been approved by the Medical Education Ethics Committee of the London Imperial College (MEEC1920-172), by the Ethical Committee for the Research of Grenoble Alpes University (CER Grenoble Alpes-Avis-2019-099-24-2) and by the Ethics Committee of the Medical Faculty of Heidelberg University (S-765/2019). Results will be published in peer-reviewed medical journals, communicated to participants, general public and all relevant stakeholders.
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- 2020
4. Universal or targeted approach to prevent the transmission of extended-spectrum beta-lactamase-producing Enterobacteriaceae in intensive care units: a cost-effectiveness analysis
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Yazdan Yazdanpanah, Pierre-Yves Boëlle, Etienne Ruppé, Camille Pelat, Gabriel Birgand, Lidia Kardaś-Słoma, Anne Perozziello, Jean-Christophe Lucet, and Antoine Andremont
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0301 basic medicine ,medicine.medical_specialty ,Cost effectiveness ,Cost-Benefit Analysis ,030106 microbiology ,Psychological intervention ,Sensitivity and Specificity ,beta-Lactamases ,law.invention ,03 medical and health sciences ,Enterobacteriaceae ,law ,Intensive care ,Health care ,medicine ,Humans ,Infection control ,Hand Hygiene ,Intensive care medicine ,cost-effectiveness ,health care economics and organizations ,Cross Infection ,Infection Control ,Cost–benefit analysis ,business.industry ,Research ,Enterobacteriaceae Infections ,General Medicine ,Cost-effectiveness analysis ,Models, Theoretical ,Intensive care unit ,Anti-Bacterial Agents ,3. Good health ,Intensive Care Units ,Infectious Diseases ,business - Abstract
ObjectiveSeveral control strategies have been used to limit the transmission of multidrug-resistant organisms in hospitals. However, their implementation is expensive and effectiveness of interventions for the control of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) spread is controversial. Here, we aim to assess the cost-effectiveness of hospital-based strategies to prevent ESBL-PE transmission and infections.DesignCost-effectiveness analysis based on dynamic, stochastic transmission model over a 1-year time horizon.Patients and settingPatients hospitalised in a hypothetical 10-bed intensive care unit (ICU)in a high-income country.InterventionsBase case scenario compared with (1) universal strategies (eg, improvement of hand hygiene (HH) among healthcare workers, antibiotic stewardship), (2) targeted strategies (eg, screening of patient for ESBL-PE at ICU admission and contact precautions or cohorting of carriers) and (3) mixed strategies (eg, targeted approaches combined with antibiotic stewardship).Main outcomes and measuresCases of ESBL-PE transmission, infections, cost of intervention, cost of infections, incremental cost per infection avoided.ResultsIn the base case scenario, 15 transmissions and five infections due to ESBL-PE occurred per 100 ICU admissions, representing a mean cost of €94 792. All control strategies improved health outcomes and reduced costs associated with ESBL-PE infections. The overall costs (cost of intervention and infections) were the lowest for HH compliance improvement from 55%/60% before/after contact with a patient to 80%/80%.ConclusionsImproved compliance with HH was the most cost-saving strategy to prevent the transmission of ESBL-PE. Antibiotic stewardship was not cost-effective. However, adding antibiotic restriction strategy to HH or screening and cohorting strategies slightly improved their effectiveness and may be worthy of consideration by decision-makers.
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- 2017
5. Costs associated with implementation of a strict policy for controlling spread of highly resistant microorganisms in France
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Bruno Fantin, Géraldine Marcade, Gabriel Birgand, Isabelle Lolom, Vincent Fihman, Céline Ciotti, Christophe Leroy, Bertrand Lecorre, Laurence Armand-Lefevre, Liem Binh Luong Nguyen, Simone Nerome, Jean-Damien Ricard, Anne Perozziello, Camille Pelat, Yazdan Yazdanpanah, Marie-Hélène Nicolas-Chanoine, and Jean-Christophe Lucet
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0301 basic medicine ,Paris ,medicine.medical_specialty ,030106 microbiology ,Drug Resistance ,Microbial Sensitivity Tests ,030501 epidemiology ,Hospitals, University ,03 medical and health sciences ,Epidemiology ,Humans ,EPIDEMIOLOGY ,Medicine ,Infection control ,Prospective Studies ,Screening cultures ,Cross Infection ,Infection Control ,Univariate analysis ,Health economics ,business.industry ,Research ,Health services research ,Outbreak ,General Medicine ,University hospital ,Infectious Diseases ,Emergency medicine ,0305 other medical science ,business - Abstract
Objective To assess costs associated with implementation of a strict ‘search and isolate’ strategy for controlling highly drug-resistant organisms (HDRO). Design Review of data from 2-year prospective surveillance (01/2012 to 12/2013) of HDRO. Setting Three university hospitals located in northern Paris. Methods Episodes were defined as single cases or outbreaks of glycopeptide-resistant enterococci (GRE) or carbapenemase-producing Enterobacteriacae (CPE) colonisation. Costs were related to staff reinforcement, costs of screening cultures, contact precautions and interruption of new admissions. Univariate analysis, along with simple and multiple linear regression analyses, was conducted to determine variables associated with cost of HDRO management. Results Overall, 41 consecutive episodes were included, 28 single cases and 13 outbreaks. The cost (mean±SD) associated with management of a single case identified within and/or 48 h after admission was €4443±11 552 and €11 445±15 743, respectively (p
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- 2016
6. Attitudes, risk of infection and behaviours in the operating room (the ARIBO Project): a prospective, cross-sectional study
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Roger Pissard-Gibollet, Gaelle Toupet, Bruno Grandbastien, Christine Azevedo, Eric Fleury, Gabriel Birgand, Jean-Christophe Lucet, Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Infection Control Unit [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Artificial movement and gait restoration (DEMAR), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Service Expérimentation et Développement (SED [Grenoble]), Inria Grenoble - Rhône-Alpes, Service d'Epidémiologie et de Santé Publique [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Dynamic Networks : Temporal and Structural Capture Approach (DANTE), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire de l'Informatique du Parallélisme (LIP), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut Rhône-Alpin des systèmes complexes (IXXI), École normale supérieure de Lyon (ENS de Lyon)-Université Lumière - Lyon 2 (UL2)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-Université Lumière - Lyon 2 (UL2)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Institut Rhône-Alpin des systèmes complexes (IXXI), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS), Azevedo Coste, Christine, École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Jean Moulin - Lyon 3 (UJML), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), SED [Grenoble], Centre National de la Recherche Scientifique (CNRS)-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-École normale supérieure - Lyon (ENS Lyon)-Centre National de la Recherche Scientifique (CNRS)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-École normale supérieure - Lyon (ENS Lyon)-Institut Rhône-Alpin des systèmes complexes (IXXI), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)
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Operating Rooms ,Multivariate analysis ,Delphi Technique ,[SPI] Engineering Sciences [physics] ,Attitude of Health Personnel ,Delphi method ,Sample (statistics) ,Risk Assessment ,[SPI]Engineering Sciences [physics] ,Task Performance and Analysis ,Health care ,Protocol ,Humans ,Surgical Wound Infection ,Medicine ,Infection Control ,business.industry ,Risk of infection ,General Medicine ,Institutional review board ,medicine.disease ,3. Good health ,Cross-Sectional Studies ,Surgery ,Observational study ,France ,Medical emergency ,business ,Surgery Department, Hospital ,Surgical Specialty - Abstract
International audience; Introduction: Inappropriate staff behaviours can lead to environmental contamination in the operating room (OR) and subsequent surgical site infection (SSI). This study will focus on the continued assessment of OR staff behaviours using a motion tracking system and their impact on the SSI risk during surgical procedures. Methods and analysis: This multicentre prospective cross-sectional study will include 10 ORs of cardiac and orthopaedic surgery in 12 healthcare facilities (HCFs). The staff behaviour will be assessed by an objective, continued and prolonged quantification of movements within the OR. A motion tracking system including eight optical cameras (VICON-Bonita) will record the movements of reflective markers placed on the surgical caps/hoods of each person entering the room. Different configurations of markers positioning will be used to distinguish between the staff category. Doors opening will be observed by means of wireless inertial sensors fixed on the doors and synchronised with the motion tracking system. We will collect information on the OR staff, surgical procedures and surgical environment characteristics. The behavioural data obtained will be compared (1) to the 'best behaviour rules' in the OR, pre-established using a Delphi method and (2) to surrogates of the infectious risk represented by microbiological air counts, particle counts, and a bacteriological sample of the wound at closing. Statistics will be performed using univariate and multivariate analysis to adjust on the aerolic and architectural characteristics of the OR. A multilevel model will allow including surgical specialty and HCFs effects. Through this study, we will develop an original approach using high technology tools associated to data processing techniques to evaluate 'automatically' the behavioural dynamics of the OR staff and their impact on the SSI risk. Ethics and dissemination: Approbation of the Institutional Review Board of Paris North Hospitals, Paris 7 University, AP-HP (no 11-113, 6 April 2012). The findings will be disseminated through peer- reviewed journals, and national and international conference presentations.
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- 2014
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