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This is a new job at the border between the nurse and the doctor. Scheduled by the Health Act of 2016 and already existing in the United Kingdom, the United States or Canada, it was the subject of more than a year of heated negotiations, doctors fearing to lose the hand in monitoring the patient. Expert, because trained in a field of specialty in particular, the nurse in advanced practice (IPA) may " participate in the overall care of patients " whose " followed " he will be " entrusted by a doctor ," says the decree published Thursday, July 19, 2018 in the Official Journal.
Shared domains
Three areas of intervention are planned, at the choice of the future IPA: " Stabilized chronic diseases, prevention and common polypathologies in primary care ", with a precise list of relevant pathologies such as diabetes or Alzheimer's disease," Oncology and Haematological Oncology "and finally " chronic kidney disease, dialysis, kidney transplantation ". Always " in respect of the course of care " and in a team coordinated by a doctor, the IPA will be able " to conduct an interview with the patient ", to trace its antecedents and " to carry out his clinical examination ". He will be authorized to perform " technical acts ", to prescribe certain drugs, medical devices " not subject to compulsory medical prescription ", and certain medical biology examinations.
may " renew, adapting them if necessary ", certain medical prescriptions. The advanced practice nurse will also have the possibility of " conducting any orientation, education, prevention or screening activity that he deems necessary ". He will perform " any act of evaluation ", of " conclusion " or clinical supervision, " consisting of adapting the follow-up of the patient according to the results " additional examinations " or the patient's global environment ". The IPA will participate finally in " the organization of the courses " between the primary care, the medical specialists and the health establishments or medico-social.
A " protocol of organization "shall be established between the physician and the IPA to clarify the rules of their" collaboration ". Finally, the IPA will be able, within his team, " to contribute to the badysis and evaluation of nursing professional practices, their improvement as well as the dissemination of evidence " and " to the production of knowledge by participating in the research work relating to the nursing practice ", which was a strong demand of the trade union organizations.
" Even if the texts could have gone more by giving greater autonomy to future IPAs, the creation of this new health professional is a real step forward for the profession on the one hand, but especially for the improvement of access to care ", reacted in a statement the president of the National Order of Nurses, Patrick Chamboredon. Faced with the " aging of the population ", " the explosion of chronic diseases " and " unequal distribution of health professionals on the territory ", the IPA will contribute" to fill a deficit in the supply of care "he said. According to him, the government " promised " to form 5,000 IPA before the end of the five-year period.
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