References of "GHUYSEN, Alexandre"
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See detailFatigue-related risk perception among emergency physicians working extended shifts.
Berastegui, Pierre ULiege; Jaspar, Mathieu ULiege; Ghuysen, Alexandre ULiege et al

E-print/Working paper (in press)

There is a growing body of studies indicating that extended shift duration has an adverse effect on fatigue, consequently leading to reduced work performance and higher risk of accident. Following modern ... [more ▼]

There is a growing body of studies indicating that extended shift duration has an adverse effect on fatigue, consequently leading to reduced work performance and higher risk of accident. Following modern fatigue risk management systems (FRMS), acceptable performance could be maintained by the mobilization of appropriate mitigation strategies. However, the effective deployment of such strategies assume that workers are able to assess their own level of fatigue-related impairments. In this study, we sought to determine whether emergency physicians’ subjective feelings of sleepiness could provide accurate knowledge of actual fatigue-related impairments while working extended shifts. We conducted a prospective observational study with a within-subjects repeated measures component. We collected sleep logs, sleepiness ratings and reaction times on a Psychomotor Vigilance Task (PVT) at different time points during shifts. Our results show that the PVT is sensitive to sleep loss and fatigue, with a 10% increase in mean reaction time across the shift. Subjective sleepiness, however, showed no significant association with time since awakening and was not a significant predictor of PVT performance. Our results are consistent with experimental studies showing that individuals tend to underestimate fatigue-related impairments when sleep deprived or functioning under adverse circadian phase. The discrepancy between subjective sleepiness and actual fatigue-related impairments may give workers the illusion of being in control and hinder the deployment of mitigation strategies. Further research is needed to determine the relative weight of circadian phase shifting and cumulative sleep deprivation in the decline of self-knowledge in extended shifts. [less ▲]

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See detailInformal fatigue-related risk management in the emergency department: a trade-off between doing well and feeling well?
Berastegui, Pierre ULiege; Jaspar, Mathieu ULiege; Ghuysen, Alexandre ULiege et al

E-print/Working paper (in press)

The effect of shift work on health and safety has long been a concern of public authorities, and increasingly stringent directives have been issued over the past decades. However, there are evidences that ... [more ▼]

The effect of shift work on health and safety has long been a concern of public authorities, and increasingly stringent directives have been issued over the past decades. However, there are evidences that current directives still represent a hazard in some work settings by disturbing the sleep/wake regulation processes. Emergency physicians are known to be particularly vulnerable to sleep deprivation due to inconsistent shift rotation, extended duty periods and overnight calls. However, naturalistic studies have actually failed to systematically demonstrate that sleep deprivation is associated with poorer work performance in emergency physicians. The inconsistency of these results could reside in physicians’ ability to compensate for fatigue-related impairments. Our aim is to identify informal fatigue management strategies used by emergency physicians and to assess the efficiency in terms of fatigue, work performance and associated risks for physician burnout. We conducted a prospective longitudinal study with 28 emergency physicians for a total of 182 shifts. At enrolment, participants answered the Maslach Burnout Inventory and the Fatigue Management Survey. During shifts, we measured fatigue using the Psychomotor Vigilance Task and work performance using an adapted version of the Physician Achievement Review. Our results show that emergency physicians working at this public sector hospital use different types of compensatory strategies to manage fatigue-related risk, and that some of these strategies might result in a trade-off between work performance and occupational burnout. We propose further considerations for the implementation and follow-up of a fatigue risk management system in the emergency department. [less ▲]

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See detailEvaluation of Surgical Simulation in Temporal Bone Surgical Radio-Anatomy Learning
ROGISTER, Florence ULiege; SALMON, Caroline ULiege; GHUYSEN, Alexandre ULiege et al

Conference (2019, March 28)

Background Lack of data regarding efficiency of simulation-based teaching, in particular high-fidelity virtual reality, constitutes a major drawback for its implementation in the medical training. However ... [more ▼]

Background Lack of data regarding efficiency of simulation-based teaching, in particular high-fidelity virtual reality, constitutes a major drawback for its implementation in the medical training. However, it provides a structured, safe and supportive environment to familiarize with complex anatomy and practice surgical skills. We aimed to evaluate high-fidelity virtual reality simulation in learning of temporal bone radio-anatomy during ENT residency. Materials and Methods 15 Belgian otorhinolaryngology residents completed 5 sessions of simulation in antro-mastoidectomy using VOXEL-MAN Tempo® surgical simulator. Technical mistakes and surgical parameters were recorded. Before and after training period, residents completed a temporal bone radiological anatomy test available online (http://www.radioanatomie.com). Pre- and post-simulation scores were compared as primary endpoint by non-parametric Wilcoxon test using RCmdr (https://www.r-project.org). As secondary endpoint, residents’ surgical skills following simulation training were blindly assessed on cadaveric human temporal bones using a reproducible scale by seniors otologist surgeons of our department. Correlation between radiological testing and dissection scale were evaluated by Spearman regression. Finally, trainees completed a survey on the device itself. Results Performance on radiological testing significantly increased with a mean improvement of 28 ± 12.12 (Wilcoxon p = 0.0011). Surgical results on cadaveric specimens were not correlated to surgical simulation parameters. Higher results on radiological testing were associated with higher scores on dissection scale, suggesting that subjects who succeeded better at dissection were those who knew best anatomy. Among residents, 80% felt this tool suitable for early surgical education, and 84.6% queried further information on simulation techniques. 100% of trainees would integrate this tool within their learning of temporal bone's radiological and surgical anatomy. Conclusions High-fidelity virtual reality simulator improved temporal bone anatomy teaching and specifically increased knowledge of temporal bone radiological anatomy. Acknowledgement No conflict of interest. [less ▲]

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See detailSurgical Simulation in Temporal Bone Surgical Radio-Anatomy Learning
ROGISTER, Florence ULiege; SALMON, Caroline ULiege; GHUYSEN, Alexandre ULiege et al

in B-ENT (2019, February 23)

Introduction and Aim: We aimed to evaluate high-fidelity virtual reality simulation in learning of temporal bone radio-anatomy during ENT residency. Methods: Fifteen ENT residents completed a radiological ... [more ▼]

Introduction and Aim: We aimed to evaluate high-fidelity virtual reality simulation in learning of temporal bone radio-anatomy during ENT residency. Methods: Fifteen ENT residents completed a radiological temporal bone anatomical testing before and after five training sessions on the VOXEL-MAN Tempo® surgical simulator. Secondary investigation: residents also completed a personal subjective assessment after these training session and residents’ technical skills were assessed on cadaveric temporal bones. Results: Primary outcome: Residents significantly improved their performance on the temporal bone radiological anatomy test after completing virtual training on the simulator. Secondary outcomes: The personal assessment survey indicated that 100% of the residents would integrate this virtual tool within the learning methods. No significant correlation was found between virtual simulator performances and surgical performances on cadaveric model, but a significant correlation was shown between the anatomical testing result and the performances on cadaveric model. Conclusions: This study suggested that a high-fidelity virtual reality simulator, the VOXEL-MAN Tempo® device, improved teaching of temporal bone anatomy and specifically increased trainees’ practical knowledge regarding radiological anatomy of temporal bone. [less ▲]

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See detailImpact of a prehospital discrimination between trauma patients with or without early acute coagulopathy of trauma and the need for damage control resuscitation: rationale and design of a multicenter randomized phase II trial.
TONGLET, Martin ULiege; D'ORIO, Vincenzo ULiege; MOENS, Didier ULiege et al

in Acta Chirurgica Belgica (2018)

BACKGROUND: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be ... [more ▼]

BACKGROUND: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be evaluated. The primary objective of this study is to evaluate the impact on mortality of a prehospital discrimination between trauma patients with or without a potential need for damage control resuscitation. METHODS: The trial will be designed as randomized phase II clinical trial with comparison of the experimental protocol against the standard of care. The TICCS will be calculated on the site of injury for the patients of the intervention group and treatment will be guided by the TICCS value. Seven days mortality, 30 days mortality, global use of blood products and global hospital length-of-stay will be compared. DISCUSSION: Many data suggest that a very early flagging of trauma patients in need for DCR would be beneficial but this need to be proved. Do we improve our quality of care by an earlier diagnosis? Does a prehospital discrimination between trauma patients with or without a potential need for DCR has a positive impact? [less ▲]

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See detailFatigue‐related risk management in the emergency department: a focus‐group study
Berastegui, Pierre ULiege; Jaspar, Mathieu ULiege; GHUYSEN, Alexandre ULiege et al

in Internal and Emergency Medicine (2018)

Fatigue has major implications on both patient safety and healthcare practitioner’s well-being. Traditionally, two approaches can be used to reduce fatigue-related risk: reducing the likelihood of a ... [more ▼]

Fatigue has major implications on both patient safety and healthcare practitioner’s well-being. Traditionally, two approaches can be used to reduce fatigue-related risk: reducing the likelihood of a fatigued operator working (i.e. fatigue reduction), or reducing the likelihood that a fatigued operator will make an error (i.e. fatigue proofing). Recent progress mainly focussed on fatigue reduction strategies such as reducing work hours. Yet it has to be recognized that such approach has not wholly overcome the experience of fatigue. Our purpose is to investigate individual proofing and reduction strategies used by emergency physicians to manage fatigue-related risk. 25 emergency physicians were recruited for the study. Four focus groups were formed which consisted of an average of six individuals. Qualitative data were collected using a semi-structured discussion guide unfolding in two parts. First, the participants were asked to describe how on-the-job fatigue a ected their e ciency at work. A mind map was progressively drawn based upon the participants’ perceived effects of fatigue. Second, participants were asked to describe any strategies they personally used to cope with these effects. We used inductive qualitative content analysis to reveal content themes for both fatigue effects and strategies. Emergency physicians reported 28 fatigue effects, 12 reduction strategies and 21 proofing strategies. Content analysis yielded a further classification of proofing strategies into self-regulation, task re-allocation and error monitoring strategies. There is significant potential for the development of more formal processes based on physicians’ informal strategies. [less ▲]

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See detailPlace de la simulation et de la réalité virtuelle dans la formation : développement d’un environnement de réalité virtuelle en médecine de catastrophe
Servotte, Jean-Christophe ULiege; Ghuysen, Alexandre ULiege; Goosse, Manon ULiege et al

Conference (2018, March 17)

cette communication vise à présenter la place de la réalité virtuelle en simulation ainsi que le développement d'un environnement en médecine de catastrophe

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See detailImpact d’une formation par simulation à la réanimation néonatale: une étude randomisée contrôlée
Servotte, Jean-Christophe ULiege; Ghuysen, Alexandre ULiege; Simonet, Bénédicte et al

Poster (2018, January 20)

Introduction : La naissance reste un évènement à risque (Mileder et al., 2014). Les évènements hypoxiques survenant en post-partum immédiat chez des nourrissons à terme sont responsables d’une mortalité ... [more ▼]

Introduction : La naissance reste un évènement à risque (Mileder et al., 2014). Les évènements hypoxiques survenant en post-partum immédiat chez des nourrissons à terme sont responsables d’une mortalité estimée à 0,6% (Gold, Blond & Lionnet 2009). En 2014, 64 accouchements inopinés sont survenus en Wallonie, dont 20% concernaient des enfants prématurés. De plus, une réanimation néonatale a été nécessaire pour 5,3% des naissances (CEpiP 2014). Or, de nombreux professionnels de l’urgence souffrent d’une expertise limitée dans ce domaine (Nadel et al. 2000). En effet, la réanimation néonatale nécessite des compétences cognitives, techniques et comportementales spécifiques, difficiles à acquérir et maintenir dans le temps (Halamek et al., 2016). A ce titre, nous nous sommes interrogés sur la pertinence d’un enseignement par simulation. Objectif : Comparer l’impact relatif d’une formation utilisant la simulation clinique versus un enseignement clinique traditionnel sur l’évolution des connaissances et des compétences techniques en réanimation néonatale. Matériel & Méthodes : Des infirmiers se spécialisant en soins intensifs et aide médicale urgente (SIAMU) ont été assignés, après randomisation, à un groupe expérimental (GE) ou à un groupe contrôle (GC). Le GE a bénéficié d’un cours théorique et d’une formation à la réanimation néonatale par simulation (2h), suivis de 4 semaines de stage. Le GC a reçu un cours théorique suivi de 4 semaines de stage. La population a été évaluée à 2 reprises au moyen d’une simulation de réanimation néonatale et de questionnaires : avant la formation et 4 semaines plus tard. Deux experts ont évalué leurs compétences techniques sur base d’une grille critériée. Résultats : Trente-six participants ont été inclus dans l’étude. Les connaissances ont progressé significativement pour le GC (p < 0,001) et pour le GE (p < 0,001). Toutefois, le GE a amélioré davantage le niveau de ses connaissances globales (p < 0,001) et spécifiques (p < 0,001). La formation a permis une amélioration significative des compétences techniques, évaluée à 83,3% pour le GC et 175% pour le GE, qui est resté plus performant (p=0,003). Conclusions : Si deux méthodes pédagogiques ont amélioré les connaissances et les compétences techniques des infirmiers SIAMU en matière de réanimation néonatale, l’impact s’est révélé significativement supérieur grâce à l’enseignement par simulation. [less ▲]

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See detailSécurité d’administration des médicaments : comparaison de l’impact d’une formation par simulation et des stages cliniques
Servotte, Jean-Christophe ULiege; Bragard, Isabelle ULiege; Galerin, Catherine et al

Poster (2018, January 20)

Introduction : La probabilité de subir au moins une erreur médicamenteuse est un problème quotidien pour le patient hospitalisé (Donaldson et al., 2017 ; IOM, 2006), qui touche, dans deux tiers des cas ... [more ▼]

Introduction : La probabilité de subir au moins une erreur médicamenteuse est un problème quotidien pour le patient hospitalisé (Donaldson et al., 2017 ; IOM, 2006), qui touche, dans deux tiers des cas, l’administration intra-veineuse (Ross et al., 2000 ; Gissinger, 2010, Ross et al., 2000). Pareilles erreurs entrainent une surmortalité et un accroissement considérable des coûts des soins de santé (Goodstone & Goodstone, 2013). Les infirmiers récemment diplômés étant particulièrement exposés au risque de commettre ce type erreur (Cloete, 2015), nous nous sommes dès lors interrogés sur l’impact potentiel d’une formation à la sécurité d’administration des médicaments intraveineux utilisant les modalités de la simulation, en comparaison avec le stage seul. Matériels et méthodes : L’ensemble des étudiants infirmiers de deuxième année (n=99), de la Haute Ecole Namur-Liège-Luxembourg, ont été répartis de manière aléatoire en deux groupes : formé (GF, n = 49) ou non (GC, n = 50). Les deux groupes ont été évalués à deux reprises, au début et à la fin d’un stage de quatre semaines. La formation incluait un carnet de préparation (bases théoriques et calculs de débit) et une séance de simulation de trois heures utilisant des patients standardisés dans 5 scénarii. L’évaluation comportait un exercice structuré ayant pour thème la modification des débits de perfusions et de pousses-seringues. Des questionnaires ont collecté des données sociodémographiques et évalué les connaissances ainsi que le sentiment d’auto-efficacité des participants. Résultats : Le sentiment d’auto-efficacité s’est amélioré uniquement dans le GF (gain : 19% ; p < 0,001). Les connaissances se sont améliorées dans le GC (+ 45%) et le GF (+150%), et la différence d’amélioration est significative (p<0,001). Les compétences se sont améliorées également davantage pour le GF (+128,5%) que pour le GC (+47,2%) avec une différence significative (p < 0,001). Discussion et Conclusions : La formation utilisant la simulation offre des perspectives intéressantes en matière de sécurité d’administration des médicaments intraveineux. Elle semble être plus efficace que la formation traditionnelle des étudiants en soins infirmiers. Des études complémentaires sont actuellement en cours afin de vérifier son impact réel sur le terrain. [less ▲]

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See detailReliability of the computerized version of the ELISA scale at the University Hospital of Liège.
JOBE, Jérôme ULiege; Dewalque, Amélie; GHUYSEN, Alexandre ULiege

Conference (2018, January 20)

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