[The contribution of advanced practice nurses in the care of the frail and agitated elderly in emergencies: State of the art and qualitative study]/The contribution of advanced practice nurses in the care of the frail and agitated elderly in emergencies: State of the art and qualitative study.] / Contribution de l'infirmière de pratique avancée dans la prise en soins de la personne âgée de 75 ans et plus, fragile et agitée aux urgences : état des connaissances et étude qualitative.

INTRODUCTION: Emergency services are faced with people over the age of 75 whose frailty leads to states of agitation. OBJECTIVE: To improve the quality of the care of this situation through the invention of an advanced practice nurse. METHOD: A phenomenological and monocentric study from interviews with professionals intervening in emergencies about the difficulties they encountered. A thematic tree was constructed once the interviews were transcribed and coded. RESULTS: Five themes emerged from nine interviews, including: definition of agitation, its causes, and contributing factors. The consequences, the risks for the elderly, and the impact on care. The significance of this phenomenon. The link between agitation and frailty. Difficulties and possible measures to improve care. DISCUSSION: The data collected correspond to the data featuring in the literature and allow advanced practice nurses to pinpoint their actions. CONCLUSION: Advanced practice nurses can contribute to improving the care of the agitated elderly through primary and secondary prevention.

Benzodiazepine and Z drug cessation in elderly patients: A qualitative study on the perception of healthcare providers and the place of advanced practice nurses.

Sedative-use disorder can occur in elderly individuals, but remains a taboo subject. France is the second top-consuming country of benzodiazepines (BZDs) and Z drugs in Europe, with 38% of women >80 years old using these drugs. Despite the recommendations of the French National Authority for Health (HAS) to general practitioners, deprescription remains rare. The aim of this study was to understand the perception of healthcare providers towards BZD or Z drug withdrawal within a psychogeriatric unit and to provide insights from advanced practice nurses (APRNs) on this topic. Eight healthcare providers from different professions in a psychogeriatric unit were interviewed. The interviews were recorded and transcribed verbatim, and the data were analysed following the interpretive phenomenological approach. The COREQ statement was used as a guide in the reporting of the study. Four themes were identified in the interview transcripts: (i) problems specific to the elderly; (ii) problems specific to BZD or Z drug consumption; (iii) present care; and (iv) envisioned practice. While the healthcare providers interviewed appeared to have knowledge on the adverse effects of BZDs, it appears difficult to taper the use of BZDs outside crisis periods of behaviour disorders in elderly patients. Caregivers recommend an evolution of practices, such as introducing BDZ and Z drug withdrawal programs that could involve the emerging profession of APRNs in general practice in France. APRNs could be a valuable resource to screen for BZD-related disorders and to manage withdrawal strategies in complex cases.

[Development of research competence]. / Developpement de compétences par la recherche.

The implementation of the new reference system of training in nursing care requires from trainers to develop new educational skills. These allow to help students to transfer their experience in new situations of care. The study is based on the experience of two training institutes in nursing care which participated in programmes of European exchanges. In this presentation, we shall be interested in the one that participated in the Leonardo daVinci programme. The analysis shows that the confrontation with a new reference field, Europe, leads the trainers to modify their position by developing reflexive analysis and by using interactive educational methods. Therefore, they move from the "teaching" to the "training" process. The reference to concepts enhances the status of trainers who then become aware of their skills. Upstream to the project, it falls under IFSI head's responsibility to implement the conditions favourable to its success. This project integrated into that of the institution then becomes a training-action.

[Nursing education, the time of maturity]. / Formation infirmière, le temps de la maturité.

The change of the nursing training reference frame took around 10 years to be fully adopted by educational teams and their partners. Some pitfalls, coupled with progress in the nursing discipline, show that a development is now necessary. Advanced practice, university integration, experimentations: the scope of possibilities is vast.