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1.
Prog Urol ; 33(1): 12-20, 2023 Jan.
Article in French | MEDLINE | ID: mdl-36207247

ABSTRACT

INTRODUCTION: In 2018, the French High Authority of Health (HAS) included a "time-out" phase in the latest version of the checklist for the operating room in order to improve the safety of operated patients. The aim of this study is to evaluate the practice of French urologists concerning the check list (CL) of the operating room. MATERIAL AND METHODS: A survey of 30 items was developed by the committee of accreditation of the French Association of Urology (AFU) and other contributors. It was centered on the characteristics of the urologists, the details of application of the CL, and the evaluation of the current version. After validation, the questionnaire was emailed as an online form in July 2021 for all the members of the AFU and AFUF. RESULTS: Overall, 369 form the 1700 contacted urologists responded to the survey. The majority were more than 40 years old (70.11%) and less than 20 year of experience (54.49%). The engagement in individual or team accreditation was observed in 222 (60.7%) and 145 (39.84%) urologists, respectively. Almost half of them were present at the beginning of the CL (47.18%), and prescribed postoperative medication with the anesthesiologist (55.56%). The CL has modified the practice in 47.54%, however, with greater administrative burden, and 80% preferred that the AFU adapts the CL to the urology field. CONCLUSION: The practice of CL between urologists is variable. On multivariate analysis, the engagement in team accreditation was the only variable to influence the practice of time out.


Subject(s)
Urologists , Urology , Humans , Adult , Operating Rooms , Checklist , Surveys and Questionnaires , Practice Patterns, Physicians'
2.
Prog Urol ; 32(14): 998-1008, 2022 Nov.
Article in French | MEDLINE | ID: mdl-36410871

ABSTRACT

The first part of this article deals with accreditation of the quality of the professional practice of urologists and medical teams working in public or private health care institutions. This is a voluntary national risk management process based on the reporting and analysis of medical risk events and the development and implementation of recommendations. The fundamental objective of the system is to reduce the frequency and severity of adverse events associated with care for the patient. The second part aims to describe the mechanisms and management of surgical complications. The perception of complications by the urologist is discussed, as it may be distorted by cognitive biases leading to inappropriate actions. Two important points were also emphasized: communication with the patient following an injury, therapeutic hazard or complication following an error, and proper maintenance of the medical record. A joint effort to cultivate a culture of safety and quality in urological surgical practice should be encouraged. Collective actions by urologists in the future should help to maintain a proactive attitude: - generalization of quality accreditation of urologic physicians' professional practice; - national registry: which has demonstrated its advantages in the world of aeronautics; - creation of a specific module "Management of complications in urology" in teaching (ECU) and continuing education (SUC, website); - creation of an AFU "Complications" Committee; - management of social networks.


Subject(s)
Urologists , Urology , Humans , Urology/education , Urologic Surgical Procedures/adverse effects , Risk Management , Forecasting
6.
Prog Urol ; 3(2): 276-83, 1993 Apr.
Article in French | MEDLINE | ID: mdl-8508212

ABSTRACT

The authors report two rare cases of neoplastic vesical malakoplakia, one with an enterovesical fistula and the other with extravesical pelvic extension. The symptoms are non-specific and the diagnosis remains histological. Medical treatment, based on the suspected infectious physiopathogenesis of the disease, consists of variable combinations of antibiotics, cholinergics and vitamin C. It must be sufficiently prolonged and conservative in view of its usual efficacy, even in neoplastic forms.


Subject(s)
Malacoplakia/pathology , Urinary Bladder Diseases/pathology , Adult , Aged , Female , Follow-Up Studies , Granuloma/pathology , Humans , Ileal Diseases/pathology , Intestinal Fistula/pathology , Ureteral Diseases/pathology , Urinary Bladder Fistula/pathology , Urinary Fistula/pathology
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