{"id":1907,"date":"2010-10-01T01:00:00","date_gmt":"2010-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/astreinte-infirmiere-ide-en-endoscopie-durgence-experience-du-centre-hospitalier-davignon-cha\/"},"modified":"2018-10-20T18:39:58","modified_gmt":"2018-10-20T16:39:58","slug":"astreinte-infirmiere-ide-en-endoscopie-durgence-experience-du-centre-hospitalier-davignon-cha","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/astreinte-infirmiere-ide-en-endoscopie-durgence-experience-du-centre-hospitalier-davignon-cha\/","title":{"rendered":"Astreinte Infirmi\u00e8re (IDE) en endoscopie d\u2019urgence : exp\u00e9rience du Centre Hospitalier d\u2019Avignon (CHA)"},"content":{"rendered":"

2010<\/strong><\/p>\n

D Imbert, A Lichere, O Barthelemy, D Bozec, M Molina, E Meloni
\nS Bellon, S Bramli, B Coulibaly, JP Arpurt. CH Avignon.<\/em><\/p>\n

Endoscopie <\/strong>– \u00a02010-09-14 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Une endoscopie digestive d\u2019urgence est une endoscopie r\u00e9alis\u00e9e en dehors des heures ouvrables, le week-end ou les jours f\u00e9ri\u00e9s, mais dans un d\u00e9lai de moins de 12 heures. C\u2019est un acte m\u00e9dical fr\u00e9quent requ\u00e9rant ma\u00eetrise du geste, parfaites conditions de r\u00e9alisation et ad\u00e9quation du mat\u00e9riel. Dans ces conditions, l\u2019endoscopiste ne peut \u00eatre aid\u00e9 que par une infirmi\u00e8re form\u00e9e aux techniques endoscopiques th\u00e9rapeutiques.
\n80 % des endoscopies d\u2019urgence sont r\u00e9alis\u00e9es pour h\u00e9morragie digestive (HD) haute ou basse. Les autres indications sont certains corps \u00e9trangers, les ingestions de caustiques, les occlusions par cancer depuis la partie gauche du transverse jusqu\u2019au rectum, les syndromes d\u2019Ogilvie, les volvulus sigmo\u00efdiens, les colites graves et, exceptionnellement, une angiocholite grave ou une exploration bronchique.
\nNous rapportons l\u2019exp\u00e9rience de la mise en place d\u2019une astreinte IDE d\u2019endoscopie digestive d\u2019urgence au CHA depuis le 1er juillet 2007.
\nMat\u00e9riels et M\u00e9thodes
\nL\u2019astreinte n\u2019est actuellement assur\u00e9e que les week-end et les jours f\u00e9ri\u00e9s. Elle d\u00e9bute le vendredi ou la veille d\u2019un f\u00e9ri\u00e9 \u00e0 16h30 et se termine le lundi ou le lendemain d\u2019un f\u00e9ri\u00e9 \u00e0 7h30. Sur la base du volontariat, 6 IDE y participent ( 3 du secteur endoscopie digestive, 3 du secteur endoscopie bronchique). Un tableau annuel d\u2019astreinte est mis en place et envoy\u00e9 \u00e0 la direction des soins infirmiers (1 week-end toutes les 6 semaines et 2 f\u00e9ri\u00e9s par an)
\nAfin d\u2019assurer la tra\u00e7abilit\u00e9 de l\u2019 appel, l\u2019endoscopiste appelle l\u2019IDE par l\u2019interm\u00e9diaire du standard de l\u2019h\u00f4pital.
\nL\u2019examen est r\u00e9alis\u00e9 au bloc op\u00e9ratoire dans la salle d\u00e9di\u00e9e aux endoscopies digestives, le plus souvent sous anesth\u00e9sie g\u00e9n\u00e9rale. Il faut 30 mn pour installer la salle et le mat\u00e9riel d\u00e9di\u00e9e aux urgences en prenant compte du temps de d\u00e9sinfection de l\u2019endoscope. En fin de proc\u00e9dure, la remise \u00e0 niveau de la salle et du mat\u00e9riel est de minimum 1 heure, comprenant la d\u00e9sinfection du mat\u00e9riel utilis\u00e9. Parfois, l\u2019examen est r\u00e9alis\u00e9 hors bloc (R\u00e9animation, Soins Intensifs Cardiologiques, N\u00e9onatalogie) et n\u00e9cessite le transport du mat\u00e9riel sur le site.
\nL\u2019indemnisation de l\u2019 astreinte IDE se compose en 2 parties :
\n–\tforfaitaire : 39h pour 1 jour f\u00e9ri\u00e9, 63h pour un week-end, 87 h pour 3 jours, r\u00e9mun\u00e9r\u00e9e sur la base du 1\/3 du tarif des heures suppl\u00e9mentaires
\n–\tau temps de d\u00e9placement fix\u00e9 en heures suppl\u00e9mentaires pleines (comprenant le temps du trajet). Le tarif est fonction de l\u2019horaire et de l\u2019\u00e9chelon de l\u2019IDE.
\nLa d\u00e9claration du temps de d\u00e9placement se fait par l\u2019infirmi\u00e8re, co-sign\u00e9e par le cadre infirmier et envoy\u00e9e \u00e0 l\u2019administration tous les mois.
\nR\u00e9sultats
\nPour la demi-ann\u00e9e 2007, 60 examens ont \u00e9t\u00e9 r\u00e9alis\u00e9s, 132 en 2008 et 156 en 2009. Pour l\u2019ann\u00e9e 2009, la r\u00e9partition des examens est la suivante : 110 endoscopies digestives hautes (80 HD, 23 corps \u00e9trangers, 7 caustiques), 41 endoscopies digestives basses ( 20 HD, 10 Ogilvie et volvulus, 11 proth\u00e8ses) et 5 ERCP (angiocholites).
\nLe co\u00fbt global annuel de cette astreinte IDE week-end et jours f\u00e9ri\u00e9s pour le CHA est d\u2019environ 35 000 euros (charges patronales comprises)
\nEn moyenne, une IDE est r\u00e9mun\u00e9r\u00e9e de 300 \u00e0 500 euros brut par astreinte de week-end.
\nEn conclusion, l\u2019installation de cette astreinte IDE a permis d\u2019am\u00e9liorer la qualit\u00e9 de r\u00e9alisation des endoscopies en urgence tant sur le plan du geste technique que de la maintenance, la d\u00e9sinfection et la tra\u00e7abilit\u00e9 du mat\u00e9riel. La place de l\u2019IDE d\u2019endoscopie est indispensable et incontournable. Elle doit \u00eatre bien comprise par nos directions en soins infirmiers et administratives, avec le soutien du GIFE (Groupement Infirmier pour la Formation en Endoscopie).
\nL\u2019avenir au CHA sera l\u2019obtention d\u2019une astreinte \u00e9largie \u00e0 la semaine et l\u2019installation d\u2019armoire de stockage des endoscopes qui permettra de ne pas avoir \u00e0 r\u00e9aliser la d\u00e9sinfection initiale de l\u2019endoscope jusqu \u2018\u00e0 72h de stockage.<\/p>\n","protected":false},"excerpt":{"rendered":"

2010 D Imbert, A Lichere, O Barthelemy, D Bozec, M Molina, E Meloni S Bellon, S Bramli, B Coulibaly, JP Arpurt. CH Avignon. Endoscopie – \u00a02010-09-14 –\u00a0CO – ________________________________ Une endoscopie digestive d\u2019urgence est une endoscopie r\u00e9alis\u00e9e en dehors des heures ouvrables, le week-end ou les jours f\u00e9ri\u00e9s, mais dans un d\u00e9lai de moins de […]<\/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":[6],"tags":[21],"class_list":["post-1907","post","type-post","status-publish","format-standard","hentry","category-endoscopie","tag-21"],"yoast_head":"\nAstreinte Infirmi\u00e8re (IDE) en endoscopie d\u2019urgence : exp\u00e9rience du Centre Hospitalier d\u2019Avignon (CHA) - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/astreinte-infirmiere-ide-en-endoscopie-durgence-experience-du-centre-hospitalier-davignon-cha\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Astreinte Infirmi\u00e8re (IDE) en endoscopie d\u2019urgence : exp\u00e9rience du Centre Hospitalier d\u2019Avignon (CHA) - 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