[Developing ISP skills: the challenge facing the Sdis medical training department]

Teaching can be taught! In order to develop and maintain the skills of its caregivers, the Departemental Fire and Rescue Service 77 Health Sub-Directorate is engaged in an innovative pedagogical dynamic, combining a real engineering of its training programs in compliance with the principles of active pedagogy, full and regular training of its teaching teams.

[Nursing at the heart of advanced practice]

The posture of the advanced practice nurse (APN) is based on clinical leadership. Their missions contribute to improving the quality of care provided to patients and their families, as well as to deploying the skills of health professionals. It bases its clinical approach on nursing sciences. The RPN can be a lever for the development of the nursing discipline by conducting research or studies based on an epistemological approach.

[The advanced practice nurse as a health care influencer]

The skills that advanced practice nurses use with patients, health care professionals and within the health care system enable them to exercise real leadership. The use of conceptual models and theories in nursing, tools for tracking and valuing clinical judgment, and nursing diagnoses and other concepts are essential to guaranteeing their disciplinary identity and ensuring interprofessional collaboration.

[Reflexivity, a meaningful posture]

In France, periodic certification of nurses will come into effect in 2023. In Canada, self-assessment, which corresponds to the evaluation of one's own competencies, is one of the means used to evaluate these professionals. This capacity is based on the principle of reflexivity, which is implemented at various levels: initial training, continuing professional development, and analysis of professional practices in the field. Advanced practice nurses are now among the players in this process.

Jarman index related to post-perinatal mortality

Post-perinatal infant deaths in North and Southern Derbyshire District Health Authorities were calculated by electoral ward over a period of two years and related to Jarman scores of deprivation. The deaths were categorised into clinical-pathological groupings after full confidential enquiry. The post-perinatal death rates were significantly related to Jarman score of deprivation.

Differences in postperinatal infant deaths between north and southern Derbyshire

In depth confidential inquiries on all post-perinatal infant deaths were carried out for two years in North and Southern Derbyshire District Health Authorities in order to explore why the postperinatal death rates and cot death rates have been consistently higher in Southern than in North Derbyshire. It was found that the death rates for probably inevitable deaths and for 'idiopathic' cot deaths were the same in both districts. The differences in the death rates lay in the group of partly explained cot deaths. Adverse social factors associated with each death were recorded and an estimate made of their relevance to the individual deaths. The group of deaths most amenable to intervention was those of category B (partly explained cot deaths). As judged by the Jarman index there are more areas of deprivation in Southern than in North Derbyshire.