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Four years after the launch of Article 51, more than 1,000 projects have been submitted. Among them, 118 experiments have been authorized, enabling the treatment of one million patients throughout France. These experiments are very diverse and cover many of the issues facing our healthcare system. Nurses play a central role, combining care, coordination, specialized care and access to new missions.

In order to meet the health needs of the population, the joint management of three establishments in the Yvelines Nord territorial hospital group has chosen to deploy advanced nursing practice. To facilitate the implementation of these professionals, an innovative organization has been designed, resulting in the creation of a specific department. The advanced practice nurse is part of a coordinated care pathway where his or her pivotal role in patient care leads him or her to develop numerous partnerships.

Therapeutic patient education (TPE) is part of the nurse's role, but a minimum of 40hours of training is required to practice in a national or regional program. Offering TPE requires a good command of the pathologies concerned, finding the time to proceed in a way that is comfortable for everyone, identifying the health professionals who intervene in the home. But also showing adaptability to accompany the patient towards autonomy.

Dental care, which has long been neglected by health policies, is now an integral part of a multi-professional health system. The nurse, an essential sentinel in hospital structures, plays a key role in the patient's dental care. At the dawn of an increasingly personalized medicine, initiatives are being implemented to decompartmentalize the skills of each specialty.

Background : The integration of nurse practitioners into primary healthcare settings is highly complex, yet it has not been extensively studied with regard to broader socioprofessional changes occurring in health care.Objective : This study sought to examine the integration and negotiation of the role of nurse practitioners in interprofessional primary healthcare settings.Method : A critical ethnography framed by actor-network theory and Foucault's concepts of discourse and power was conducted in three different primary healthcare models in which semi-structured interviews (n=23 nurse practitioners), direct observation, and document analysis were performed.Results : Organizational aims, practice standards, nurse practitioners' right to self-determination, collaborative dynamics with physicians, and patient management were identified as integration factors that produced greater instability, needs for negotiation, and professional, identity, and moral difficulties for nurse practitioners.Discussion : The findings from this study challenge the widespread perception that the role of nurse practitioners lacks clarity and enable a renewed understanding of their integration process in primary healthcare settings.

Abroad, advanced practice in emergency medicine has had positive effects on populations. In France, following the reform of emergency departments, advanced practice nurses in emergency medicine will become a reality. This new profession raises certain fears. Their contribution must be alongside the patients and in the organisations. For this, patient pathways need to be identified and cooperation between the advanced practice nurses and emergency room doctors must be established.

Numerous studies show the risk of a breakdown in the continuity of care when a patient leaves hospital. A study was carried out of hospital-based nurses, to find out their representations with regard to their role in the hospital-home transition. The results enable areas of improvement to be identified.

While being integrated into a public health policy which is extending their role, advanced practice nurses should operate within a discipline-specific approach, which takes account of their professional identity and ensures their added value for the health care system. Conceptual models of nursing care and other nursing theories are there to guide their practice and enable them to stay focused on their specific discipline.

The presence of nurses within occupational health care teams is now mandatory. Their role, centred on prevention, health protection and employees' safety, is practised under the authority and in close collaboration with the occupational health doctor, within a multidisciplinary team. Over recent years, their scope of practice has been expanded to include the individual monitoring of employees' health. It could be further expanded in future.

Advanced practice is an opportunity for nurses wishing to develop their career while keeping their hand in clinical practice, in direct contact with the patient. This new role is in its infancy. Its implantation in the hospital setting must be thought through and assessed by the whole team in order to demonstrate the benefit it can offer.

Over the last fifteen years, official texts regulating nursing practice have expanded the scope of nurses' functions. The prescribing of medical devices for dressings and the monitoring of oral chemotherapy at home illustrate this evolution for private practice nurses. However, while these technical skills are recognised, the private practice nurse's coordination role still needs to be acknowledged.

In support of caregivers in the field, the regional pediatric palliative care resource teams travel to health, medico-social and liberal structures, as well as to homes to accompany children and their families affected by serious illness. Nurses play an important role in this sensitive care. Research and teaching enable them to disseminate the palliative culture and advance knowledge.

The role of the nurse in the emergency reception service has become more complex in recent years in view of the evolution of these services. The particularity of this position lies in its autonomy, adaptation, adjustment, capacity for anticipation and participation in the diagnosis. Illustration of the central role of the nurse in the multidisciplinary care chain of a patient with limb trauma.

The occurrence of severe limb trauma is a brutal event for all patients in any context. Many questions quickly arise, with a very broad scope - from the course of the intervention to family and social reintegration. The nurse has an essential role in listening, educating and supporting the patient before and after the operation. In addition to reassurance, she plays a central role in organising the return home and helping the patient to resume socio-professional activities.

At the "Maison de Solenn", the role of the nurse is complex and plural. One of our main missions is to receive healthcare demands, to evaluate their pertinence and to direct them, if necessary, towards more adapted structures or professionals. This reception can be done by telephone or directly on site. The nurse must also point out the institutional framework for any follow-up undertaken in the structure. She is also responsible for accompanying the patient and the family to the various care providers. This welcome and support nursing role exists in more specifically transcultural situations.

Hormone deprivation therapies play a key role in the treatment of prostate cancer. These treatments require standardized care and regular monitoring. The objective of this work was to review the different hormonal therapies available, their side effects and the role of a coordinating nurse in the management of these therapies. First generation hormone therapy is the standard treatment for metastatic prostate cancer. In the past years, second generation hormone therapies have been indicated in combination with first-generation hormone therapies at different stages of the disease. These molecules are responsible for several side effects that should be monitored and prevented. Thus, after an initial assessment, clinical and paraclinical follow-up are essential. Our center has set up monitoring by a coordinating nurse (IDEC) to optimize the education and follow-up of the patient, but also to provide psychosocial support adapted throughout the patient's care path under hormone therapy. This monitoring and information function by IDEC can be facilitated by new digital solutions.

International audience; Introduction: The management of patients in functional urology is complex and requires the expertise of the medical team but also of the nurse team. The aim of this article is to detail the roles of the nurses in functional urology.Methods: Exchanges with the nurses of our unit, analysis of the literature using the terms "nurse", "urology", "urodynamics" in the PubMed search engine, and a search for regulatory texts relating to the practice of nurses in urology units were conducted.Results: Since the creation of the Inter-University Diploma of Nurse Expert in Urology in 2002 and the inter-professional cooperation protocols in 2009, the urologist can rely on the specific skills of nurses to optimise the patient's management: from endoscopic or urodynamic explorations, to stomatherapy or sexology, from therapeutic education to specialised treatments such as posterior tibial nerve stimulation, sacral neuromodulation or botulinum toxin injections. Their expertise is an undeniable asset in the patient support and for the quality of care. The cooperation protocols respond to the current problems of the healthcare system: attractiveness for paramedical professionals, medical demographics and ambulatory care. The increasingly frequent practice of multidisciplinary consultation meetings also gives them a coordinating role.Conclusion: Nurses in functional urology plays a major role in diagnostic and therapeutic management as the patient's privileged contact and collaborator with the referring urologist.

The purpose of this article is to explain the role of urology nurse in prehabilitation and same-day discharge programs for robotic radical prostatectomy.This article is based on the analysis of the literature and the experience of our center.In order to prepare patients for outpatient surgery, urology nurse plays a key role during prehabilitation journeys. Two weeks before the operation, the healthcare teams (nurses, anesthetists, physiotherapists, etc.) organize workshops to explain to patients the operation course and post-operative care in order to allay any anxieties. Individual and group interviews, in specific workshops (compression stockings, urinary catheter, sexology) are organized in particular with urology nurse to answer all patients' questions. In association with enhanced recovery after surgery pathway, these programs improve the patient experience and satisfaction as well as peri-operative outcomes, and allows the development of an outpatient surgery program which currently represents approximately one third of surgeries.The implementation of perioperative protocols including prehabilitation improves the early results of robotic total prostatectomy, but also the patient experience. The urology nurse has a key role to play during these patient education days and in the preparation, information, support and follow-up of the patient, since the prehabilitation journey until the patient leaves the outpatient clinic.

Advanced nursing practice is now established in French law. Master's degree courses in nursing exist in several universities and the first advanced practice nurses are entering the field of care with greater autonomy and competence. Nurses working in mobile palliative care teams (MPCT) have carried out research to clarify the nursing position in MPCT. Although little is known, support for healthcare teams is considered to be the backbone of the nursing role in MPCT.

Background : In France, home parenteral nutrition (HPN) is managed by two parallel healthcare systems : in approved specialist centers (HPN12 weeks), and outside of these approved specialist centers (HPN12 weeks). Objective : To prospectively evaluate infectious and vascular complications in adult cancer patients undergoing HPN administered via a central venous line, outside of approved specialist HPN centers. Methods : Our observational prospective study included adult patients with cancer, hospitalized for 48 hours or more, and under HPN. They had a WHO performance status of ≤ 2 and had had a nutritional consultation before discharge. Results : 25 patients were included in the study, with a median age of 63 years [19–74]. Weight loss of ≥ 5% was reported in 79% of patients. The Ingesta score was7 in 96% of cases. 87% of patients presented chill or body temperature variation episodes, with a median of 2 episodes [1–6] per patient. The median delay between end of hospitalization and the first chill episode was 11 days [1–85]. A vascular complication (obstruction without thrombosis) was reported in one patient. Discussion : This high number of infectious episodes requires improvement of patient care when it comes to strictly adhering to the recommendations. Getting the approved specialist HPN centers to work together and share care protocols could be the first important step.

Postnatal depression is a priority public health problem. Its prevalence and its impact on women and their children justify the implementation of specific nursing interventions to prevent the disease from settling in and becoming chronic. This problem was the focus of a study by the Haute École de la santé de Lausanne in Lausanne, Switzerland.

Nurses can help improve access to health services and the quality of the care, provided that they fully engage in their field of practice. Conducted in Quebec in a remote region far from any major urban centers, this study aims to 1) measure the actual scope of nursing practice (ASCOP) in community health services and 2) determine the individual and work-based characteristics that influence it. This study uses a transversal description of work.Forty-four (44) nurses practicing in different types of community health services were invited to answer an online questionnaire. The results indicate a suboptimal ASCOP. Activities related to improving the quality and safety of care obtained the lowest scores. Activities with the highest scores were the assessment and planning of care, the education of individuals and their families, and updating and using knowledge. While no characteristics influenced the overall ASCOP, significant differences were found for gender, weekly working time, and sub-regions for certain dimensions of the ASCOP. The findings offer some insight into nursing practices in community health services in remote areas. This portrait helps to formulate recommendations adapted to these contexts.

The number of hematopoietic stem cell transplantation is in constant rise. This increase has put in spotlight the lack of physician availability. Some healthcare centers have already organised a nurse's consultation under the supervision of an expert physician. We conducted a survey among nurses and physicians from the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) centers who confirmed the need to create a special transplantation-skilled population of nurses. During this ninth annual workshop of the SFGM-TC, we have defined the required conditions for a transplant nurse consultation until day 100 post-transplant with the responsibility of the transplant expert physician. To help the centers in this dynamic, we provided practical tools to support this consultation. The current heath policy is in favor of an increased autonomy of the expert nurse. The implementation of the status of nurse in advanced practice is the first step in this professional development.