[Feasibility and accuracy of day surgery: Review of 396 operated breast cancer patients]. / La chirurgie du cancer du sein en ambulatoire est faisable et fiable de nos jours : étude portant sur 396 patientes.

INTRODUCTION: Breast cancer surgery is suitable for outpatient practice. Indeed, this is a planned surgery with short operative time. Objective was to evaluate the recognized success indicators in day surgery: rate of conversion into conventional hospitalization, rate of complications and re-hospitalizations the month following surgery. METHODS: Consecutive cases of breast cancer patients operated in day surgery were prospectively entered into the Day Surgery database between 25 November 2012 and 31 December 2013. Patient characteristics and tumor pathology, preoperative procedures and type of surgery were collected. Statistical analysis was performed. RESULTS: Three hundred and ninety-six consecutive patients were included. The mean age was 54 years [25-84], we performed 382 conservative breast surgery (98.2%), 238 sentinel node (60.1%) and 40 axillary lymphadenectomy (10.1%). Thirty-nine scheduled for outpatient surgery were hospitalized in conventional surgery being a conversion rate of 9.8%, 95% CI [6.9-12.7] with 24 patients because of a drainage (61.5%). We have observed 15 complications in the month after the surgery (3.7%, 95% CI [1.8-5.6]), and 5 rehospitalization in the month following surgery (1.2%, IC 95% [0.1-2.3]). CONCLUSION: Postoperative complication and readmissions are very low (<5%) after breast ambulatory surgery. This confirms its feasibility and safety in a breast cancer center. Adaptating anaesthetic methods to ambulatory care and preparing patient going home with an axillary drain are necessary to reduce rate of conversion to hospitalisation.

[Long-term intravenous devices, continuity of care from the specialist doctor to the nurse]. / Gestion des risques des dispositifs intraveineux de longue durée.

Long-term intravenous devices have become an essential tool in the treatment of patients requiring the administration of medication over more than one month. The choice of device must be established through consultation between the nursing team and the patient. Several types of complications can be observed immediately after the insertion of the device and during treatment. Protocols in the community and at hospital are therefore necessary in order that doctors, nurses, specialists and experts work together. Clinical and translational research should enable the incidence of certain complications, notably infections and thrombosis, to be further reduced.

[Nursing care in reconstructive surgery in cases of head and neck cancer]. / Les soins infirmiers dans la chirurgie de reconstruction lors d'un cancer ORL.

The treatment of cancers of the upper aerodigestive tract favours an organ- and function- preserving surgical approach. The nursing care draws on multiple skills, on both a technical and educational level, in order to assure global patient management.

[Interactive information tools for women facing a mastectomy]. / Des outils interactifs pour l'information des femmes confrontées a une mastectomie.

Around 20 to 30% of women treated for breast cancer undergo a mastectomy in France. Of these patients, 70% do not have reconstructive surgery. It would seem that information surrounding reconstructive procedures is insufficient. Tools created in partnership with caregivers and patients are necessary to help women understand the choices they have.

[Hemophilia patient education: teaching and assessment of 10 programs]. / Éducation thérapeutique des patients hémophiles : évaluation pédagogique et formative de 10 programmes.

A group of health professionals and patients conducted a pedagogical assessment of Therapeutic Patient Education (TPE) in haemophilia in France, focused on 2 main subjects: "the objectives and aims of TPE programs" and "the health professionals' ability to lead and contribute to TPE programs" (3). The use of a research laboratory and a participatory methodology allowed for identifying the assessment's challenges and contributed to its smooth running. TPE is starting to be integrated with medical care for patients, and a multidisciplinary approach better meets patients' educational needs. Two prerequisites for improving the pedagogical quality of these programs are self-reported patient needs and coordination of the TPE activities. The parties involved in this study are now better prepared to meet the ARS (4) TPE program specifications in haemophilia, and, importantly, are better prepared to undergo the assessment that takes place every 4 years.