Are you F. Roudot-Thoraval?

Claim your profile

Publications (7)6.65 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The European Society for Clinical Nutrition and Metabolism (EPSEN) guidelines on nutrition for liver disease patients has been recently updated. The aim of our study was to evaluate perioperative nutrition in cirrhotic patients waiting for liver transplantation (LT).Study designProspective electronic survey. A standardized questionnaire was sent to the anaesthesiologist of the 18 French adult LT centers. The questionnaire had closed-ended questions to evaluate nutritional practices in cirrhotic patients waiting for a LT.ResultsThe response rate was 100%. Nutritional status of the cirrhotic patients waiting for LT was assessed by anaesthesiologists (12 centres) and/or hepatologists (11 centres) and more rarely by nutrition physician, dietetics or liver surgeons. Body mass index (13 centres), weight loss (10 centres), albuminemia (10 centres) were the most frequent items used to assess the nutritional status. Before LT, preoperative oral intakes were administered in undernourished patients in only 55% of the cases. Postoperatively, nutritional support was administered between day 1 and 3 after LT.Conclusion Perioperative nutritional practices in cirrhotic patients waiting for LT are heterogeneous between centers, especially about nutrition assessment. Most of the centres did not follow the actual guidelines.
    Annales francaises d'anesthesie et de reanimation 05/2013; 32(5):302–306. · 0.77 Impact Factor
  • M. Binhas, F. Roudot-Thoraval, A. Alves, G. D’Honneur, B. Plaud
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To evaluate the short medium and long-term impact of a quality-improvement program (QIP) in a university hospital using a validated reference tool.Methods Seven surgical departments were audited before and after implementation of a QIP in postoperative pain management. Audits were conducted in 2005, 2007, 2009 and 2012. In each audit, 10 medical charts from each surgical department were analyzed for 9 quality criteria. A surgical department score (SDS) was calculated for each department (maximum score = 90). The surgical departments with a SDS < 45 received targeted training sessions.ResultsIn 2005, three surgical departments had a SDS < 45. After the first audit, a targeted training sessions was conducted in the three surgical departments, all seven departments improved their scores with a SDS > 45 in 2007. Between 2007 and 2009, all seven departments improved their scores. Conversely, between 2009 and 2012, the SDS diminished in six of the seven surgical departments and four of the nine evaluated quality criteria decreased significantly: right detailed order for postoperative pain analgesia (prescriber identifier, agent used, unit doses, mode of administration; 100% versus 53; P = 0.027), appropriate dosing of steps I and II analgesics (96% versus 80%; P = 0.041), morphine (90% versus 76%; P = 0.039), based on corresponding physician orders and monitor morphine side effects (87% versus 29; P = 0.027).Conclusion Audits should be performed regularly (at least every two years) for detecting postoperative pain management degradation. Lack of targeted training sessions can explain partially this degradation.
    Annales francaises d'anesthesie et de reanimation 10/2012; 31(10):818–820. · 0.77 Impact Factor
  • M Binhas, F Roudot-Thoraval, A Alves, G D'Honneur, B Plaud
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the short medium and long-term impact of a quality-improvement program (QIP) in a university hospital using a validated reference tool. Seven surgical departments were audited before and after implementation of a QIP in postoperative pain management. Audits were conducted in 2005, 2007, 2009 and 2012. In each audit, 10 medical charts from each surgical department were analyzed for 9 quality criteria. A surgical department score (SDS) was calculated for each department (maximum score=90). The surgical departments with a SDS<45 received targeted training sessions. In 2005, three surgical departments had a SDS<45. After the first audit, a targeted training sessions was conducted in the three surgical departments, all seven departments improved their scores with a SDS>45 in 2007. Between 2007 and 2009, all seven departments improved their scores. Conversely, between 2009 and 2012, the SDS diminished in six of the seven surgical departments and four of the nine evaluated quality criteria decreased significantly: right detailed order for postoperative pain analgesia (prescriber identifier, agent used, unit doses, mode of administration; 100% versus 53; P=0.027), appropriate dosing of steps I and II analgesics (96% versus 80%; P=0.041), morphine (90% versus 76%; P=0.039), based on corresponding physician orders and monitor morphine side effects (87% versus 29; P=0.027). Audits should be performed regularly (at least every two years) for detecting postoperative pain management degradation. Lack of targeted training sessions can explain partially this degradation.
    Annales francaises d'anesthesie et de reanimation 09/2012; 31(10):818-20. · 0.77 Impact Factor
  • Annales francaises d'anesthesie et de reanimation 06/2012; 31(6):566–568. · 0.77 Impact Factor
  • Annales francaises d'anesthesie et de reanimation 04/2012; 31(6):566-8. · 0.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We audited the seven surgical departments of a university hospital before and after implementation of a program aiming to improve practices in postoperative pain management (POPM). Audits were conducted 2 years apart. During each evaluation, 10 medical charts from each surgical department (i.e., 70 charts) were analyzed for 9 quality criteria (five concerning anesthetist practices and four nursing practices). Two scores were calculated: one per department and the other per criteria. After the first audit, the seven departments received recommendations to improve their POPM. Targeted-training sessions were instituted for the three poorest performing departments (scores <4.5 out of 9 criteria). During the period between the two audits, all seven departments improved their scores; a statistically significant improvement was observed in five departments, including the three that had received targeted-training sessions. Moreover, overall scores for seven of the nine evaluated criteria improved, significantly for three criteria. Anesthetists significantly increased their overall score from 2.5 ± 0.8 to 3.7 ± 0.6 out of 5 points (p=.018), while surgical nurses' overall score did not change significantly from 2.3 ± 0.7 to 2.9 ± 0.7 out of 4 points (p=.128). In conclusion, using a standardized and validated instrument to evaluate POPM practices enables the identification of surgical departments requiring practice improvement and those quality criteria requiring reinforcement.
    Journal for Healthcare Quality 01/2010; 33(1):7-13.
  • M Binhas, F Roudot-Thoraval, D Thominet, P Maison, J Marty
    [Show abstract] [Hide abstract]
    ABSTRACT: Because patients who are to undergo surgery must give their consent to planned postoperative care, clear and complete information on postoperative pain management should be given. The aim of this quality-of-care study was to evaluate by inquiry the impact of written information describing postoperative pain management on the quality and type of information retained, and patient participation in discussing and agreeing to the postoperative pain management programme during the presurgical anaesthesiology consultation. Prospective before and after interventional surveys, each lasting 3 weeks and conducted at a 6-month interval (time required to prepare the written information), used a standardized anonymous questionnaire given to patients after the anaesthesiology consultation. Questions requiring a 'yes' or 'no' response assessed the quality of information and what information was retained by the patient, the extent of the patient's interaction during the discussion with the anaesthesiologist and his/her agreement with the postoperative pain management programme. Among the 180 before-group patients included, 16.7% reported receiving verbal information during the anaesthesiology consultation, none retained all seven principal side-effects of morphine, 14.4% considered the information to be thorough, 20.6% understood it, 16.7% claimed that it had helped them participate in the discussion and 14.4% concurred with the postoperative pain management programme. Compared to the before inquiry, significantly higher percentages of the 107 after-group patients (given written information before the anaesthesiology consultation) responded as having received verbal information during the anaesthesiology consultation (57.0%), retained morphine's main side-effects (12.1%), deemed the information thorough (58.9%) and understandable (53.3%), had participated in the discussion (47.7%) and agreed with the postoperative pain management programme (51.4%). Written information on postoperative pain management distributed before the presurgical anaesthesiology consultation improved the quality of information retained, facilitated discussion with the anaesthesiologist and patient agreement with the postoperative pain management programme.
    European Journal of Anaesthesiology 11/2008; 25(11):884-90. · 2.79 Impact Factor