[Assessing the wearing of jewellery by French healthcare professionals]. / Évaluation du port de bijou chez des professionnels de la santé français.

OBJECTIVE: A prospective observation study was undertaken in seven medical centers, in the French region Alpes-Maritime, to assess nail hygiene of healthcare professionals and how often they wear hand jewellery. METHOD: Seven hundred and six healthcare workers in seven medical centers were interviewed from March to April 2008. RESULTS: Among the 706 professionals, 306 (43%) were wearing one or several pieces of jewellery. The nails of 81 (11.5%) were non-standard according to guidelines. Three hundred and forty-four health care professionals (49%) were wearing one or several pieces of jewellery and/or presented with non-standard nails. In univariate analysis, the wearing of jewellery was linked to the medical centre (P<0.001), to the professional category (p<0.001), to the number of times people washed their hands or used hand gel per day (ABHR) by categories (<10 times per day or ≥10 times per day) (P<0.017). In the multivariate analysis, the risk factors linked to the wearing of jewellery were the medical centers, the professional category, and the age. CONCLUSION: There are still too many healthcare professionals who do not comply to French recommendations on hand hygiene concerning the wearing of jewellery and nail hygiene standards.

[Risk factors for dryness or irritation of staff hands in nine healthcare institutions]. / Étude des facteurs de risque de sécheresse et d'irritation des mains du personnel dans neuf établissements de soins.

OBJECTIVE: We performed a prospective multicenter study to assess dryness and irritation of hands of staff in care facilities, and to show that disinfection with alcohol-based hand rub is better tolerated than classic hand washing with mild soap. METHOD: Dryness and irritation were self-evaluated by volunteers and hetero-evaluated by a team of investigators. The study took into account most of the individual and environmental risk factors of dryness and irritation (season, age, gender, use of protective agent, constitutional, personal and external factors, institution, function, number of consecutive working days). RESULTS: The results from the 1932 assessments collected showed that traditional hand washing was a risk factor for dryness or irritation, while alcohol-based hand rubs caused no skin deterioration and had a protective effect even when used intensively. COMMENT: These results should help to fight non-adherence to the use of alcohol-based hand rubs.

[How the information system can contribute to the implementation of a risk management program in a hospital?]. / Comment le système d'information peut-il aider un programme de gestion des risques en établissement de santé?

Nowadays, information system is recognised as one of the key points of the management strategy. An information system is regarded conceptualised as a mean to link 3 aspects of a firm (structure, organisation rules and staff). Its design and implementation have to meet the objectives of medical and economical evaluation, especially risk management objectives. In order to identify, analyse, reduce and prevent the occurrence of adverse events, and also to measure the efficacy and efficiency of the production of care services, the design of information systems should be based on a process analysis in order to describe and classify all the working practices within the hospital. According to various methodologies (usually top-down analysis), each process can be divided into activities. Each activity (especially each care activity) can be described according to its potential risks and expected results. For care professionals performing a task, the access to official or internal guidelines and the adverse events reporting forms has also to be defined. Putting together all the elements of such a process analysis will contribute to integrate, into daily practice, the management of risks, supported by the information system.