[Antiepileptic drugs administration by nasogastric tube in comatose patients]

AIM

To evaluate the modalities of administration of antiepileptic drugs (AED) with nasogastric tube (NGT) by nurses and to draw up recommendations.

METHODS

Our study consisted on investigating the modalities of administration of AED's with NGT by nurses during four months. We prepared 10 questions including demographic information. Participation was voluntary and anonymous. The questionnaire was distributed in seven intensive care departments after authorization of each head of the department. Thus, 45 nurses were included.

RESULTS

Nurses sex ratio was 1.5 and mean age was 31 years (25 to 37 years). Among the nurses, 60% mentioned that the NGT were silicone made and 4% that they were PVC made. The mean duration before replacing the NGT was thought to be 5±3 days. Among the nurses, 91% affirmed to clear the NGT after each use. All the nurses had agreed that the solid form is the most commonly used pharmaceutical form in the NGT. AED were associated with the enteral feeding solution in 56%. The AED should be crushed before administration for 98% of the nurses even in case of polymedication. Among them, 62% recommended to crush all of the associated drugs together. Before introducing the AED into the NGT, 93% of the nurses reported mixing with tap water. We have noticed that 62% of nurses felt the need to improve their knowledge AED administration with NGT.

CONCLUSION

To optimize AED therapy, modalities of administration by NGT in epileptic comatose patients should be enhanced.

[Place of coordination of complex pathways in oncology by coordinating private nurses]

BACKGROUND

The complexity of the hospital-city care pathway is a real challenge because of the lack of coordination and communication between many stakeholders. As part of a call for projects from the General Directorate of Healthcare Provision, an experiment involving private oncology coordinating nurses was developed to address this issue. To our knowledge, there is no evaluation so far of such a protocol .

METHODS

This single-center retrospective study focused on data from the ONC'IDEC program between 2015 and 2018, where 28 private nurses provided a 24/7 hotline. The objective was to qualitatively assess the coordination of this system. The nature and number of calls, patient satisfaction and medico-economic parameters were assessed.

RESULTS

More than a hundred patients (n=114) were included in this device (mean age: 72 ± 12 years). The most frequent reasons for calls concerned the patient's general condition (35 %) and home treatment follow-ups (13 %) but also referrals to the primary doctor (4 %), which helped avoiding hospitalizations. The patients were satisfied with the experiment (overall score of 8.4/10).

DISCUSSION

Thanks to the ONC'IDEC program, patients were able to benefit from more appropriate care through a privileged interlocutor by making their care pathway more fluid and avoiding hospitalizations. It would be interesting to confirm these results by means of a study with a higher level of evidence, by comparing this protocol to conventional hospital coordination.

[The mental health of allied professionals in interventional electrophysiology]

The mental health of allied professionals in interventional electrophysiology is an increasingly concerning topic given the emotional and physical demands inherent in their role, which deserves particular attention. This article examines the impact of stress, anxiety, and burnout on these healthcare professionals. To this end, an anonymous survey of allied professionals in interventional electrophysiology was conducted using a questionnaire via a dedicated survey platform over a period from October 17 to December 10, 2024. The data extracted and analyzed with the help of the platform revealed the following difficulties: lack of recognition, unsatisfactory working conditions, high workload, relational difficulties, and a lack of organization. This has resulted in an impact on the feelings of the allied professionals and especially on their work. In conclusion, this study reveals a generalized feeling of malaise among all allied professionals in interventional electrophysiology on a psychological, emotional, and physical level, as well as the importance of investing in the mental health of allied professionals for the improvement of the entire healthcare system.