Sensibilisation aux bonnes pratiques de lavage

Le lavage constitue la première étape du processus de stérilisation des dispositifs médicaux réutilisables (DMR) sous responsabilité pharmaceutique. Cette étape est primordiale car elle conditionne l'efficacité de la stérilisation. Dans le cadre de la réactualisation du système de management de la qualité en 2012, le pharmacien responsable de la stérilisation du centre hospitalier de Cambrai a évalué l'état des connaissances des agents sur les bonnes pratiques de lavage puis il a révisé l'ensemble des procédures. Suite au questionnaire, 50% des agents ont répondu correctement à 9 questions sur 10 ; 75% ont répondu correctement à 6 questions sur 10. 25% des agents méconnaissent les types de DMR pouvant être lavés en laveur-désinfecteur, leur chargement correct et la tenue appropriée en zone lavage. L'agent le moins expérimenté a eu le moins de réponses correctes. Il est constaté que le temps d'utilisation recommandé du bac à ultrasons est méconnu par tous les agents. Nous avons ainsi constaté que les agents suivaient des recommandations anciennes et caduques. Ceci a pour conséquence une moindre efficacité du prélavage en bac à ultrasons. Ce questionnaire a permis de sensibiliser les agents aux bonnes pratiques et sera un outil de validation de la formation des nouveaux agents en zone lavage du service de stérilisation

Experience with Diagnostic Laparoscopy for Gynecological Indications

Context: Diagnostic laparoscopy is an endoscopy procedure; which has become indispensable in the evaluation of the female reproductive organs especially in infertility. Aim: Experience with conversion to open laparotomy is presented and ways of averting this complication are discussed. Settings and Design: A retrospective study was performed. Materials and Methods: All the 1654 diagnostic laparoscopies performed at a private fertility center over a 10-year period (January 2000 to December 2009) were analyzed for indications; cases of conversion to open laparotomy; and measures taken to prevent this complication. Statistical Analysis Used: Simple percentage method was used. Results: Infertility was the commonest indication for 1627 (98.4) procedures; while primary amenorrhoea and chronic pelvic pain were responsible for 20 (1.2) and 7 (0.4) procedures; respectively. There was no mortality in this series. There was conversion to open laparotomy due to hemorrhage in only 2 (0.12) procedures and this happened at the first year of practice. Conclusions: The low rate of conversion was attributed to the surgeons experience; proper patient selection; and the use of Palmers point for insufflation in some patients with previous pelvic surgeries and use of supraumbilical access in patients with pelvic masses. Diagnostic laparoscopy for gynecological indications is safe and wider application of this modern technology is recommended for our practice

Assessment of Existing Practices in the Operating Theatre in the Khartoum North Teaching Hospital; Sudan

This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority

Assessment of Existing Practices in the Operating Theatre in the Khartoum North Teaching Hospital; Sudan

This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51 of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority

Un cas d'echec de ligature tubaire

La ligature des trompes est pratiquee lorsqu'une sterilisation est indiquee. Cependant quelques echecs ont ete rapportes a travers le monde. Depuis 25 ans que la contraception moderne est pratiquee au Mali; nous rapportons le 1er cas d'echec connu et verifie de ligature des trompes

Post partum tubal ligation under local anaesthesia

This paper is a presentation of 100 successive tubal ligations done post partum under local anaesthesia at Mulanje Mission Hospital with an emphasis on the problems encountered

Medico-legal consideration in child spacing

Many countries introducing child spacing programmes have discovered existing law do not give guidance regarding the proper conduct of the activities and Malawi is no exception. Malawi uses the common law principle that states if an activity is not prohibited by law that it is legal; this is strengthened when government pronouncements state a particular activity is acceptible to the government. In the absence of specific laws in Malawi; the author raises points in order to guide providers of child spacing services and provide a basis for further discussion

Supervisors' manual for priority disease practices

This series; supported by the HEALTHCOM project; was designed to improve the communication skills of health workers and supervisors in child survival. The manuals were written to accompany tapes

Health workers' manual for priority disease practices

This series; supported by the HEALTHCOM Project; was designed to improve the communication skills of health workers and supervisors in child survival. The manuals were written to accompany tapes