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Article ; Online: Letter to the editor regarding body mass index associated with overall complications and higher risk of delayed gastric emptying stated in the paper of Panni U et al.

Charpiat, Bruno

HPB : the official journal of the International Hepato Pancreato Biliary Association

2023 Volume 25, Issue 10, Page(s) 1278

MeSH term(s)	Humans ; Gastroparesis/etiology ; Body Mass Index ; Time Factors ; Gastric Emptying
Language	English
Publishing date	2023-06-23
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2023.06.009
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Article: Gaspillage d’héparine sodique dans un centre hospitalo-universitaire français.

Franchina, Maria Paola / Charpiat, Bruno

Annales pharmaceutiques francaises

2024 Volume 82, Issue 3, Page(s) 575–583

Abstract: Objectives: In a context of heparin shortage, we studied the wasted quantities in three intensive care units (ICU) of a university hospital where two electric syringe pump (ESP) heparin protocols coexist (20,000UI/48mL used in the cardiology ICU and 25, ... ...

Title translation	Unfractionned heparin wastage at a French university hospital.
Abstract	Objectives: In a context of heparin shortage, we studied the wasted quantities in three intensive care units (ICU) of a university hospital where two electric syringe pump (ESP) heparin protocols coexist (20,000UI/48mL used in the cardiology ICU and 25,000UI/50mL use in the medical and surgical ICUs). Method: We performed a prospective observational study of patients treated with heparin ESP. We collected the information recorded in the prescription software connected to the ESP (dosage, start time, infusion rate, interruption times, date and time of end of treatment). We observed the ESPs, noted the time of start written on the label and the quantity remaining, and questioned nurses about the constraints that lead for changing the ESPs. Results: Between 23/03/23 and 19/05/23, 164 vials of 25,000UI/5mL were used. The wasted quantity was equivalent 42 vials: 18 vials (43%) of treatment stopped, nurses practices such as changing the ESP in advance 6 vials (14%), application of the rule "discard the ESP 24hours after preparation" 9 vials (21.5%) and 9 vials (21.5%) corresponding to the 45mL discarded for the 45 ESP prepared in the cardiology ICU. Conclusion: More than a quarter of the heparin purchased is wasted. The results should lead to policy decisions concerning the medications supply chain, i.e. abandoning the 20,000UI/48mL protocol, supply of ready to use heparin syringes by industry or by the pharmacy. It is essential that these data be fed back to nurses' teams, in order to gather their suggestions before considering any changes of their practices.
MeSH term(s)	Humans ; Heparin/adverse effects ; Hospitals, University ; Intensive Care Units ; Pharmacy ; Prospective Studies
Chemical Substances	Heparin (9005-49-6)
Language	French
Publishing date	2024-02-08
Publishing country	France
Document type	Observational Study ; English Abstract ; Journal Article
ZDB-ID	307-4
ISSN	0003-4509
ISSN	0003-4509
DOI	10.1016/j.pharma.2024.02.002
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Article ; Online: Choix d'un protocole d'administration d'héparine sodique au pousse-seringue électrique par des infirmières et des prescripteurs.

Breniaux, Manon / Charpiat, Bruno

Annales de cardiologie et d'angeiologie

2023 Volume 72, Issue 4, Page(s) 101645

Abstract: Objectives: Several protocols for administering heparin by electric syringe pump can coexist within the same hospital. This puts patients at risk of medication errors. In our hospital trust, two preparation protocols coexist (20000UI/48mL and 25000UI/ ... ...

Title translation	Nurses and prescribers' choice of an electric syringe pump protocol for intravenous heparin administration.
Abstract	Objectives: Several protocols for administering heparin by electric syringe pump can coexist within the same hospital. This puts patients at risk of medication errors. In our hospital trust, two preparation protocols coexist (20000UI/48mL and 25000UI/50mL). The objective is to relate the work carried out with prescribers and nurses to retain only one protocol. Methods: We questioned prescribers and nurses about the differences between the two protocols in terms of the simplicity of implementation and the risk of error to which nurses are exposed when preparing the syringe. Contextual information (heparin shortage, waste) was given in order to support the answers. Results: According to the 96 nurses and 82 prescribers who responded, the protocol to use is 25000IU/50mL for 98% and 83% of them respectively. The 20000IU/48mL protocol was considered the riskiest due to the possibility of mistakenly collecting 5mL instead of the required 4mL. Given the heparin shortage, the waste inherent to the 20000IU/48mL protocol reinforced this choice. Conclusions: The consultation of nurses and prescribers allowed the choice of a protocol with very strong agreement. This work also brought to light what appears to be a medical misconception, namely that the non-concerted choice by physicians of a mode of administration of a drug can put nurses in a situation to make preparation errors more frequently. This emphasizes that nurses must be stakeholders in the decision-making processes that affect their practice.
Language	French
Publishing date	2023-09-01
Publishing country	France
Document type	English Abstract ; Journal Article
ZDB-ID	418425-7
ISSN	1768-3181 ; 0003-3928
ISSN (online)	1768-3181
ISSN	0003-3928
DOI	10.1016/j.ancard.2023.101645
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Zs.MO 216: Show issues

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Article: Traduction et adaptation au contexte hospitalier français d’un outil de codification des erreurs de prescription liées aux logiciels.

Videau, Manon / Charpiat, Bruno / Conort, Ornella / Janoly-Dumenil, Audrey / Bedouch, Pierrick

Annales pharmaceutiques francaises

2023 Volume 81, Issue 6, Page(s) 1054–1071

Abstract: Prescribing errors related to computerized physician order entry are current and may have serious consequences for patients. They can be detected by pharmacists during prescriptions analysis and lead to pharmacist's interventions. In France, few ... ...

Title translation	Translation and adaptation of a tool prescribing errors related to computerized physician order entry coding to the French hospital background.
Abstract	Prescribing errors related to computerized physician order entry are current and may have serious consequences for patients. They can be detected by pharmacists during prescriptions analysis and lead to pharmacist's interventions. In France, few monocentric studies have studied Pharmacist Interventions triggered by prescribing errors identified as System-Related Errors (PISREs) in French hospitals. However, their respective analysis method prevent any comparison between computerized physician order entry systems in order to identify the safest and rule out the most dangerous. A computerized physician prescribing error related to the software is characterized by its causes, consequences and mechanism of occurrence. US researchers have developed and validated a tool to classify and illustrate these three characteristics. The objectives of this article are to present this tool, to propose a French adaptation and to describe the perspectives analyze and understand prescription errors related to computerized physician order entry based on data of Act-IP©. The adaptation was performed using PISREs extracted from the Act-IP© observatory of the French Society of Clinical Pharmacy. Each item of the codification is illustrated with an example of PI. We are considering a training plan in order to allow wide use of this tool. Once adopted this tool, the next step will be to organize a prospective multicenter study including as many computerized prescription order entry systems as possible. The aim of this study will be identifying the safest systems. Consequently, it will then be possible to have arguments to qualify the most dangerous and thus propose their withdrawal from the market.
Language	French
Publishing date	2023-06-24
Publishing country	France
Document type	English Abstract ; Journal Article
ZDB-ID	307-4
ISSN	0003-4509
ISSN	0003-4509
DOI	10.1016/j.pharma.2023.06.003
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Article ; Online: The ability of a retrospective review of electronic health records to fully capture the frequency of supratherapeutic dosing of acetaminophen.

Charpiat, Bruno

JAMA internal medicine

2013 Volume 173, Issue 11, Page(s) 1035–1036

MeSH term(s)	Acetaminophen/administration & dosage ; Female ; Fever/drug therapy ; Humans ; Inpatients ; Liver Failure, Acute/chemically induced ; Male
Chemical Substances	Acetaminophen (362O9ITL9D)
Language	English
Publishing date	2013-06-10
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2699338-7
ISSN	2168-6114 ; 2168-6106
ISSN (online)	2168-6114
ISSN	2168-6106
DOI	10.1001/jamainternmed.2013.418
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Article: [No title information]

Charpiat, Bruno / Leboucher, Gilles / Maire, Pascal / Schmitt, Étienne

Recherche en soins infirmiers

2021 Volume 141, Issue 2, Page(s) 78–86

Abstract: Despite its proven dangers, the ward stock drug distribution system predominates in French hospitals. This system allows 12 million injectable ampoules of concentrated potassium chloride to circulate uncontrolled each year. Such a situation is absurd for ...

Title translation	Le potassium injectable concentré, emblématique de l’insécurité médicamenteuse des hôpitaux français.
Abstract	Despite its proven dangers, the ward stock drug distribution system predominates in French hospitals. This system allows 12 million injectable ampoules of concentrated potassium chloride to circulate uncontrolled each year. Such a situation is absurd for the following reasons : 1) injected by mistake, concentrated potassium kills within seconds ; 2) the true incidence of potassium-related fatalities and incidents is unknown ; 3) fatal intravenous injection of potassium produces no specific anatomical changes and subtle, if any, findings at autopsy ; 4) it is used for capital punishment by lethal injection in various countries ; and 5) healthcare worker serial killers benefit from the fact that potassium is not identifiable in post-mortem examinations and that investigations to find the murderer are complex and of uncertain outcome. Other medications classed as high-risk have similar characteristics to those of concentrated potassium solutions. Injectable potassium can therefore be regarded as emblematic of the lack of safety of the drug use process in French hospitals. The priority measure to protect patients from this deadly risk is to remove these drugs from uncontrolled ward stocks and to provide premixed potassium solutions. Evidence of the increased safety of the unit dose drug dispensing system should compel health policy makers to systematically implement it, thus bringing the drug use process into compliance with existing French and European regulations.
Language	French
Publishing date	2021-07-11
Publishing country	France
Document type	English Abstract ; Journal Article
ISSN	0297-2964
ISSN	0297-2964
DOI	10.3917/rsi.141.0078
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Article ; Online: Curbing proton pump inhibitor overprescribing: Multifaceted strategies in an academic hospital.

Veremme, Léo / Janoly-Dumenil, Audrey / Charpiat, Bruno

Journal of clinical pharmacy and therapeutics

2021 Volume 46, Issue 4, Page(s) 1041–1045

Abstract: What is known and objective: Proton pump inhibitors (PPI) have become essential in the management of upper gastrointestinal disorders, yet they are prescribed without an indication in up to 89% of cases and the number of prescribed PPIs is on the rise. ... ...

Abstract	What is known and objective: Proton pump inhibitors (PPI) have become essential in the management of upper gastrointestinal disorders, yet they are prescribed without an indication in up to 89% of cases and the number of prescribed PPIs is on the rise. A working group developed several multifaceted strategies in our multihospital trust to curb inappropriate PPI use. We describe herein these strategies and assess their impact on PPI consumption in a hospital belonging to this trust. Methods: From 2012 to 2019, our actions included the publication and presentation of a review of emergent PPI side effects, the development of an appropriate use leaflet, medication audits, journal club meetings, and prescription analysis. We considered that a decrease in PPI consumption could be a relevant surrogate criterion for the appropriation and acceptance of these interventions; this was assessed from 2012 to 2019 and expressed as defined daily dose (DDD)/1000 patient-days. Results and discussion: There was a clear downward trend in the consumption of PPIs, both in medical and surgical wards. The overall PPI use decreased by 17.1% (from 566 to 468 DDD/1000 patient-days). IV PPI consumption dropped by 37.7% (from 146 to 91 DDD/1000 patient-days), while oral PPIs consumption decreased by 10% (from 420 to 378 DDD/1000 patient-days). What is new and conclusion: Sustained strategies aimed at curbing PPI overprescribing led to a sustained decrease in PPI consumption in our hospital. This decrease encourages us to pursue this strategy and to diversify our actions.
MeSH term(s)	Academic Medical Centers/organization & administration ; Humans ; Inappropriate Prescribing/prevention & control ; Pharmacy Service, Hospital/organization & administration ; Practice Patterns, Physicians'/statistics & numerical data ; Proton Pump Inhibitors/administration & dosage
Chemical Substances	Proton Pump Inhibitors
Language	English
Publishing date	2021-02-24
Publishing country	England
Document type	Journal Article
ZDB-ID	639006-7
ISSN	1365-2710 ; 0269-4727
ISSN (online)	1365-2710
ISSN	0269-4727
DOI	10.1111/jcpt.13395
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Article ; Online: Proton Pump Inhibitors are Risk Factors for Viral Infections: Even for COVID-19?

Charpiat, Bruno / Bleyzac, Nathalie / Tod, Michel

Clinical drug investigation

2020 Volume 40, Issue 10, Page(s) 897–899

Abstract: During the ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more attention should be paid to the balance of risks and benefits associated with proton pump inhibitors for the following reasons. One of the main functions of ...

Abstract	During the ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more attention should be paid to the balance of risks and benefits associated with proton pump inhibitors for the following reasons. One of the main functions of gastric juice is to inactivate swallowed microorganisms, thereby inhibiting infectious agents from reaching the intestine. Studies have documented that proton pump inhibitors are a risk factor for rotavirus, influenza virus, norovirus, and Middle East respiratory syndrome coronavirus infections, and are associated with an increased risk of acute gastroenteritis during periods of highest circulation of enteric viruses. In light of the evidence for gastrointestinal infection implying a fecal-oral transmission of SARS-CoV-2 and given the magnitude of the SARS-CoV-2/coronavirus disease 2019 pandemic, associated with the widespread misuse of proton pump inhibitors, this suggests that we should not rule out the hypothesis that patients treated with proton pump inhibitors may be more at risk of being infected by SARS-CoV-2.
MeSH term(s)	Betacoronavirus/drug effects ; Betacoronavirus/physiology ; COVID-19 ; Coronavirus Infections/chemically induced ; Coronavirus Infections/epidemiology ; Gastric Acid/physiology ; Humans ; Middle East Respiratory Syndrome Coronavirus/drug effects ; Middle East Respiratory Syndrome Coronavirus/physiology ; Pandemics ; Pneumonia, Viral/chemically induced ; Pneumonia, Viral/epidemiology ; Proton Pump Inhibitors/adverse effects ; Risk Factors ; SARS-CoV-2
Chemical Substances	Proton Pump Inhibitors
Keywords	covid19
Language	English
Publishing date	2020-08-10
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	1220136-4
ISSN	1179-1918 ; 0114-2402 ; 1173-2563
ISSN (online)	1179-1918
ISSN	0114-2402 ; 1173-2563
DOI	10.1007/s40261-020-00963-x
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Article: Le potassium injectable concentré, emblématique de l’insécurité médicamenteuse des hôpitaux français.

Charpiat, Bruno / Leboucher, Gilles / Maire, Pascal / Schmitt, Étienne

Recherche en soins infirmiers

2020 , Issue 141, Page(s) 78–86

Title translation	Injectable concentrated potassium concentrate, emblematic of the lack of safety of the drug use process in French hospitals.
Abstract	Despite its proven dangers, the ward stock drug distribution system predominates in French hospitals. This system allows 12 million injectable ampoules of concentrated potassium chloride to circulate uncontrolled each year. Such a situation is absurd for the following reasons : 1) injected by mistake, concentrated potassium kills within seconds ; 2) the true incidence of potassium-related fatalities and incidents is unknown ; 3) fatal intravenous injection of potassium produces no specific anatomical changes and subtle, if any, findings at autopsy ; 4) it is used for capital punishment by lethal injection in various countries ; and 5) healthcare worker serial killers benefit from the fact that potassium is not identifiable in post-mortem examinations and that investigations to find the murderer are complex and of uncertain outcome. Other medications classed as high-risk have similar characteristics to those of concentrated potassium solutions. Injectable potassium can therefore be regarded as emblematic of the lack of safety of the drug use process in French hospitals. The priority measure to protect patients from this deadly risk is to remove these drugs from uncontrolled ward stocks and to provide premixed potassium solutions. Evidence of the increased safety of the unit dose drug dispensing system should compel health policy makers to systematically implement it, thus bringing the drug use process into compliance with existing French and European regulations.
MeSH term(s)	Drug and Narcotic Control ; France ; Hospitals ; Humans ; Injections ; Patient Safety/standards ; Potassium Chloride/administration & dosage ; Potassium Chloride/chemistry ; Potassium Chloride/poisoning
Chemical Substances	Potassium Chloride (660YQ98I10)
Language	French
Publishing date	2020-09-25
Publishing country	France
Document type	Journal Article
ISSN	0297-2964
ISSN	0297-2964
DOI	10.3917/rsi.141.0078
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Article: Incapacité des logiciels d’aide à la prescription hospitaliers à sécuriser l’utilisation des solutions concentrées de potassium injectable.

Klein, Pauline / Bonhomme, Jeremy / Bourne, Cindy / Hellot-Guersing, Magali / Marcucci, Charles / Rodier, Simon / Charpiat, Bruno

Annales pharmaceutiques francaises

2023 Volume 82, Issue 2, Page(s) 359–368

Abstract: Objectives: To determine whether hospital computerised physician order entry (CPOE) systems contribute to securing intravenous potassium chloride (KCl) prescriptions with reference to the recommendations issued by French healthcare agencies.: Methods!# ...

Title translation	Inability of hospital computerised physician order entry systems to secure the use of concentrated potassium intravenous solutions.
Abstract	Objectives: To determine whether hospital computerised physician order entry (CPOE) systems contribute to securing intravenous potassium chloride (KCl) prescriptions with reference to the recommendations issued by French healthcare agencies. Methods: We sent a questionnaire to the members of the Association pour le Digital et l'Information en Pharmacie. Results: More than three quarters of the 84 responses received involving 23 CPOE systems indicate that it is possible to: prescribe an ampoule of concentrated potassium chloride 10% 10mL intravenously without any diluents (80%); prescribe 4g of KCl in a bag of 500mL of NaCl 0,9% (98%); prescribe a solution that contains 6 grams of KCl per liter (94%); prescribe the administration of an injectable ampoule orally by means of a free text comment (83%). Nearly half of the responses indicate that it is possible to prescribe: concentrated KCl ampoules as administration solvent (50%); an injectable vial to be administered by oral route (52%). Conclusion: At least 23 hospital CPOE systems are unable to secure the prescriptions of injectable KCl. This finding lifts the veil on an unthought, namely the role of CPOE systems in securing high-risk medications. In order to solve this problem, it should be mandatory that health information technology vendors pay particular attention to these drugs. With regard to injectable KCl, the utilisation of a dilution vehicle, maximum concentration and maximum infusion flow rate are the first four constraints to be satisfied.
MeSH term(s)	Humans ; Potassium ; Potassium Chloride ; Medical Order Entry Systems ; Medication Errors ; Hospitals
Chemical Substances	Potassium (RWP5GA015D) ; Potassium Chloride (660YQ98I10)
Language	French
Publishing date	2023-10-23
Publishing country	France
Document type	English Abstract ; Journal Article
ZDB-ID	307-4
ISSN	0003-4509
ISSN	0003-4509
DOI	10.1016/j.pharma.2023.06.007
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