{"id":1775,"date":"2004-10-01T01:00:00","date_gmt":"2004-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/linfirmiere-referente-en-hepatologie-cest-possible-pour-certaines-pathologies-experience-de-lhopital-de-st-brieuc\/"},"modified":"2018-10-20T18:39:34","modified_gmt":"2018-10-20T16:39:34","slug":"linfirmiere-referente-en-hepatologie-cest-possible-pour-certaines-pathologies-experience-de-lhopital-de-st-brieuc","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/linfirmiere-referente-en-hepatologie-cest-possible-pour-certaines-pathologies-experience-de-lhopital-de-st-brieuc\/","title":{"rendered":"L\u2019INFIRMI\u00e8RE R\u00e9F\u00e9RENTE EN H\u00c9PATOLOGIE. C\u2019EST POSSIBLE POUR CERTAINES PATHOLOGIES. EXP\u00e9RIENCE DE L\u2019H\u00f4PITAL DE ST BRIEUC"},"content":{"rendered":"

2004<\/strong><\/p>\n

O. NOUEL ; C. TREGUIER ; M. GAUTHERET ; M.N. GRIN ; M. DARTOIS-HOGUIN ;
\nM. LE BRIS ; S. MANFREDI<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a02004-09-14 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Il existe une certaine inqui\u00e9tude parmi les gastro-ent\u00e9rologues concernant la d\u00e9mographie future de la profession o\u00f9 une diminution importante des praticiens est attendue \u00e0 partir de 2008. Une r\u00e9ponse partielle \u00e0 ce probl\u00e8me pourrait \u00eatre la d\u00e9l\u00e9gation de t\u00e2che telle qu\u2019elle est sugg\u00e9r\u00e9e dans le rapport BERLAND.
\nL\u2019h\u00f4pital de jour d\u2019HGE de l\u2019h\u00f4pital de St BRIEUC comprend 4 places et accueille par an 3600 venues. Parmi ces venues, une bonne moiti\u00e9 est repr\u00e9sent\u00e9e par le suivi et le traitement de l\u2019h\u00e9patite chronique C (270 malades dans la file active), le suivi et le traitement de l\u2019h\u00e9mochromatose Homozygote (198 malades ). Ces 2 affections sont simples et st\u00e9r\u00e9otyp\u00e9es. L\u2019une et l\u2019autre sont par contre fortement consommatrices d\u2019un temps indispensable \u00e0 permettre une bonne adh\u00e9sion aux traitements et au suivi.
\nL\u2019organisation de notre HdJ repose sur une IDE (C.T.). Cette IDE a re\u00e7u une formation sp\u00e9cifique sur l\u2019h\u00e9patite C (formation interne et externe), et une formation interne sur l\u2019H\u00e9mochromatose .
\nUn protocole de suivi des traitements de l\u2019h\u00e9patite C par Bi-th\u00e9rapie a \u00e9t\u00e9 mis au point reposant sur l\u2019\u00e9ducation, la surveillance h\u00e9matologique et virologique en HdJ. Dans ce protocole, l\u2019IDE assurait 5 consultations (4 le premier mois, une au 3\u00b0 mois). 32 malades ont \u00e9t\u00e9 trait\u00e9s suivant ce protocole avec une tr\u00e8s bonne adh\u00e9sion aux traitements et une tol\u00e9rance qui subjectivement nous a sembl\u00e9 meilleure. Les r\u00e9ductions de dose d\u2019IFN ou de RIBA nous ont sembl\u00e9 moindre que ce qui est publi\u00e9. Le nombre des consultations m\u00e9dicales \u00e9vit\u00e9es serait de 160. L\u2019\u00e9tude des RVP chez ces malades sera int\u00e9ressante.
\nPour les surcharges en Fer, le travail de L\u2019IDE r\u00e9f\u00e9rente a consist\u00e9 en la r\u00e9alisation des saign\u00e9es, \u00e0 s\u2019assurer de leur tol\u00e9rance clinique et biologique, \u00e0 v\u00e9rifier que la surveillance \u00e9tait bien conforme aux prescriptions initiales (surveillance des malades ayant une fibrose importante), \u00e0 v\u00e9rifier que l\u2019enqu\u00eate g\u00e9n\u00e9tique \u00e9tait bien compl\u00e8te et \u00e0 la rappeler aux patients, donner toutes les informations n\u00e9cessaires sur la maladie et poser l\u2019indication d\u2019une consultation de Gastro-ent\u00e9rologie, certains malades n\u2019\u00e9tant pas vus durant plusieurs ann\u00e9es. Il est impossible de chiffrer le nombre de consultations \u00e9vit\u00e9es.
\nCette exp\u00e9rience (sauvage) serait \u00e0 confronter \u00e0 celles en cours de fa\u00e7on plus officielle.
\nElle est actuellement \u00ab hors la loi \u00bb par rapport au d\u00e9cret sur les comp\u00e9tences des IDE.<\/p>\n","protected":false},"excerpt":{"rendered":"

2004 O. NOUEL ; C. TREGUIER ; M. GAUTHERET ; M.N. GRIN ; M. DARTOIS-HOGUIN ; M. LE BRIS ; S. MANFREDI H\u00e9patologie – \u00a02004-09-14 –\u00a0CO – ________________________________ Il existe une certaine inqui\u00e9tude parmi les gastro-ent\u00e9rologues concernant la d\u00e9mographie future de la profession o\u00f9 une diminution importante des praticiens est attendue \u00e0 partir de 2008. […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[15],"class_list":["post-1775","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-15"],"yoast_head":"\nL\u2019INFIRMI\u00e8RE R\u00e9F\u00e9RENTE EN H\u00c9PATOLOGIE. C\u2019EST POSSIBLE POUR CERTAINES PATHOLOGIES. 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