backgrounders given to independent nurses during training: background in france, while the setup of...
TRANSCRIPT
Backgrounders given to independent nurses during training:
BackgroundIn France, while the setup of CF screening at birth in 2002, 49 specialized CF centres, called “CRCM” (CRCM : Resources and competencies center for CF) were also designed. The medical monitoring and the care for CF patients were organized. Many CF patients are treated with intravenous antibiotic at home by independent nurses. ObjectivesA french national coordinating nurses group of the French CF society was created in 2008. This group decided to investigate how every coordinating nurse had invested his/her mission on intravenous antibiotic homecare, with a special concern regarding the training and the support to the independent nurses who perform intravenous antibiotics at home.
MethodologyA questionnaire was developed by the CF national coordinating nurses group and mailed to the coordinating nurses of the 49 French CF centers. The results have been collected anonymously and analysed statistically. 67% of questionnaires were filled and analysed.
Conclusion Disparity of support for training and for accompanying independent nurses Disparity in resources for coordinating nurses Place of providers of medical equipment emerging in the training and support for independent nurses and for logistical support Improvement proposals:Achievement of a common basis and for training and technical sheets for independent nursesVisit the patient’s home with specifics targets so that the coordinating nurse meets at least once, the independent nurses
Assessment of the proposed training for independent nurses In the French CF Centers “CRCM”,
To carry out home based antibiotic treatmentM Kerbrat1,S Hauchecorne2,C Leguillon3,N Goriot-Raynaud4,H Fezaa5,B Recroix6,C Guinet7,H Joachim8, S Gonsseaume9 : CF coordinating
nurses 1North West network and Nantes, 2Bordeaux, 3Rouen, 4Giens, 5Paris-Necker, 6Nancy, 7Montpellier, 8Toulouse, 9Paris-Robert Debré
PerspectivesThat’s the First research work realized by the national coordinating nurses group of the French CF Society. The next step for the group is to evaluate the expected and experienced of the independent nurses. Then, by comparing the analysis of 2 questionnaires, the group wishes to produce good practice recommendations for independent nurses’ training and support in order to enable them to ensure optimal and safety home care during the intravenous antibiotic treatment, to improve homecare for patients.
ResultsThe main difficulties on recruitment of independent nurses to carry out a home based antibiotic treatment are: number of passes per day (3), non-availability, venous access, patient age, fear of the technical, bad environmental hygiene at home, apprehension of the CF disease and sometimes distance between the office nurse and patient, long intravenous perfusion time and having to stay near the patient during this time, with an already heavy workload for the independent nurses.Specific training is offered to the independent nurses (24/32 CRCM) and is free in most cases (4/24 is paying). It is mainly performed by the coordinating nurses (19/24 CRCM) and sometimes by the nurse of the providers of medical equipment (11/24 CRCM). The training is individual and/or collective. Its duration varies from 1 hour to 2 days. The demonstration equipment is donated by the providers of medical equipment. When training is not required, knowledge of care on intravenous central catheter is a necessary pre amount required training. In 24/32 CRCM there is a contact to respond in an emergency, round the clock. Apart from this hotline, the coordinating nurses communicate by phone with the independent nurses during the period of the intravenous antibiotic treatment: from « often » to « always »: 28/32 CRCM.Sometimes, the coordinating nurses go to the patient’s home to meet the independent nurses (16/32 CRCM). There are many disparities between CF centres concerning resources and permissions to go out of the hospital. The visit helps to reassure the patient and helps to support and to evaluate the independent nurses. 13/32 coordinating nurses feel satisfied with the independent nurses training and support, 16/32 would like to improve it.
Objectives of home visit: even if it is not always possible to do it (because of lack of time, not allowed to leave hospital to go to the patient's home) it allows the coordinating
nurses to:
On the 24 CRCM offering training to independent nurses, here is the content of the training : the main discussed topics are : drugs and equipment, presentation of the CF center,
CF disease, risk of antibiotics allergy and presentation of the patient:
17/24 CRCM propose a specific training which is strongly recommended for independent nurses:
Requirement level of the proposed training
4
13
7
0
2
4
6
8
10
12
14
required Stronglyrecommended
Not required
20
11
19
7 7
0
5
10
15
20
25
Reassure thepatient and his
family
Assess theindependent
nurse
Reassure theindependent
nurse
Meet thepatient infamiliar
surroundings
Other
8 8
11 11
14
0
2
4
6
8
10
12
14
16
Technical datasheets
File of care Backgrounderon the CF
Backgrounderon specific
careequipment fornursing home
Booklet of CFcentre
Never Sometimes Often Always
European Cystic Fibrosis Conference - Valencia 2010
21 21 2120
1918
16
11 11 119
8 8 8
5
0
5
10
15
20
25
Email: [email protected]
Acknowledgments to Dr G.Rault, Pr G.Bellon, L.Gueganton, J.Pengam and V.Bije for their assistance in this study