The new programs of therapeutic education of patient (ETP), wished by the Haute Autorité de Sante (HAS), must permit to better deal with patients presenting a heavy disease, requiring a multidisciplinary approach. Both medical and paramedical team of the vascular surgery departement emphasized the need for a more specific evaluation of chronic wounds, difficult to treat and prolonging the hospitalizations. Knowledge of increasingly complex wound dressings requires a specific formation. Together wih the Antipain Committee (CLUD) of our unit, we wished to build a team to educate the patient, to deal with his wounds, and to improve its quality of life. This program explains the various administrative and structural steps to create such a network of care and to obtain accrediatation by HAS. Who to contact? Is it necessary to be surrounded ? Who will coordinate this program? To who is it addressed? How is it financed? So many questions which make it possible to work out a solid file. In 2012, 32 patients were selected, 27 were included. Mean age was 73.8 years. Eleven programs were finished, There were 7 abandons, 2 deaths, and 7 programs are still running. Average duration of a finished program was 9.3 weeks. It is very important for an ETP program to lay down a therapeutic objective (here cicatrization) and several educational objectives (resumption of walk, daily activities, etc…) as of the entry in the program. Annual evaluation is required by the HAS to improve the quality of the program. A four-year evaluation will determine if the program works well as a whole to decide its continuation, if necessary its reorientation, or its stop. The development of a therapeutic program of education makes it possible to better coordinate the assumption of responsibility of the patients presenting of the chronic wounds. The follow-up of the dressings is improved by a specific consultation by a graduate nurse. We noted the importance of the educational objectives for the patients so that they better live their vascular disease. References
HAS-Inpes. 2007. Guide méthodologique. Structuration d’un programme d’éducation thérapeutique du patient dans le champ de la maladie chronique HAS. 2012. Auto-évaluation annuelle d’un programme d’éducation thérapeutique du patient. Guide pour les coordonnateurs et les équipes.
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Saturday January 25
L eg arteries Why and how educate patients with chronic wound of the leg Armand Bourriez, Jean Sabatier, Magalie Julien Clinique de l’Europe, Rouen, France