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Master Thesis

La sortie directe du patient de la réanimation vers le domicile : le point de vue du médecin traitant

Abstract : Introduction: The hospital-home transition is an important step in the journey of patientcare. This statement is even more valid for patients leaving an intensive care unit, who may then be the result of a serious pathology. The objective of our work was to identify the difficulties encountered by attending physicians following the direct discharge of their patient from the intensive care unit of the University Hospital of Guadeloupe to the home. The secondary objectives were to look for areas for improvement proposed by the doctors, as well as the impact of the fire encountered by the CHU on these difficulties. Materials and methods: We carried out a retrospective study on the doctors of patients who had been in the intensive care unit of the University Hospital of Guadeloupe. The patients concerned had left the service between 27 November 2016 and 28 November 2018, i.e. 1 year before and after the fire. A questionnaire was submitted to the doctors interviewed via a Google Forms’slink. Results: After exclusion, 60 files were analyzed for a total of 56 physicians interviewed. We obtained a response rate of 51. 8%. Of the 29 responses received, 8 reported a lack of information on the transition to resuscitation. Only 34. 5% of doctors had the hospitalization report at the time of their consultation. The decision to return home should have been discussed with them for only 17. 2% of caregivers and 68. 9% considered the discharge to be appropriate. For the improvement proposals, 19 of the doctors based them on communication; including systematic contact at the entry or exit of patients. There is little difference between the period before and after the fire. However, physicians were satisfied with the discharge conditions of their patients at 25% before the fire, compared to 47. 1% after the fire. Discussion and conclusion: Although there appears to be an improvement in the level of physician satisfaction after the fire, doctors still reveal difficulties in communication between the intensive care unit and the city. Systematic contact with the attending physician is one of the main suggestions for improvement. The organization of an exit consultation process is also one of the areas for improvement.
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Master Thesis
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Aurélie Béral. La sortie directe du patient de la réanimation vers le domicile : le point de vue du médecin traitant. Médecine humaine et pathologie. 2019. ⟨dumas-02892340⟩

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