Le centre hospitalier Le Vinatier \u2013 Psychiatrie Universitaire Lyon M\u00e9tropole (PULM) poursuit le d\u00e9ploiement de protocoles de coop\u00e9ration en psychiatrie en ouvrant un nouveau dispositif \u00e0 l\u2019interface avec la m\u00e9decine g\u00e9n\u00e9rale. Un protocole local intitul\u00e9 \u00ab Renouvellement des prescriptions somatiques des patients \u00e9quilibr\u00e9s suivis en ambulatoire en psychiatrie \u00bb est mis en \u0153uvre \u00e0 l\u2019H\u00f4pital de Jour M\u00e9decine (HDJ) \u2013 CoR\u00e9So.<\/p>\n
Ce protocole, fond\u00e9 sur le cadre l\u00e9gal des protocoles de coop\u00e9ration cr\u00e9\u00e9s par la loi HPST du 21 juillet 2009, organise une d\u00e9l\u00e9gation d\u2019actes entre m\u00e9decins et infirmi\u00e8res. Des infirmi\u00e8res sp\u00e9cifiquement form\u00e9es peuvent, dans un cadre d\u00e9fini, renouveler certains traitements somatiques et prescrire des examens de surveillance pour des patients adultes suivis en psychiatrie et pr\u00e9sentant une pathologie somatique chronique stabilis\u00e9e (hypertension art\u00e9rielle, diab\u00e8te de type 2, dysthyro\u00efdie, asthme ou BPCO, dyslipid\u00e9mie), \u00e0 condition qu\u2019une \u00e9valuation m\u00e9dicale r\u00e9cente ait eu lieu.<\/p>\n
Lors de la consultation, l\u2019infirmi\u00e8re \u00e9value l\u2019\u00e9tat de sant\u00e9 r\u00e9cent du patient \u00e0 partir de l\u2019entretien, des param\u00e8tres cliniques, des traitements en cours et des derniers r\u00e9sultats d\u2019examens. Cette \u00e9valuation est structur\u00e9e par un arbre d\u00e9cisionnel int\u00e9grant la recherche de \u00ab drapeaux rouges \u00bb ou signes d\u2019alerte imposant un recours m\u00e9dical. En l\u2019absence de signes d\u2019alerte, l\u2019infirmi\u00e8re est autoris\u00e9e \u00e0 renouveler \u00e0 l\u2019identique les traitements somatiques pr\u00e9vus par le protocole et \u00e0 prescrire, si n\u00e9cessaire, un bilan biologique ou un ECG. D\u00e8s qu\u2019une anomalie est identifi\u00e9e ou que la situation sort du cadre protocolaire, le m\u00e9decin d\u00e9l\u00e9gant est sollicit\u00e9 pour d\u00e9cider de la conduite \u00e0 tenir.<\/p>\n
Le suivi des patients est organis\u00e9 en alternance entre consultations infirmi\u00e8res et consultations m\u00e9dicales afin d\u2019assurer une surveillance somatique r\u00e9guli\u00e8re et de limiter les ruptures de parcours de soins. Le protocole pr\u00e9voit une gradation de l\u2019activit\u00e9 de consultation et de prescription en fonction de l\u2019intensit\u00e9 et de la stabilit\u00e9 de la situation clinique, les patients les plus l\u00e9gers ou les plus stabilis\u00e9s relevant en priorit\u00e9 d\u2019un suivi infirmier. Les premi\u00e8res consultations dans ce cadre ont d\u00e9but\u00e9 en septembre 2026, avec des retours qualifi\u00e9s de positifs par les infirmi\u00e8res et les patients. Ce dispositif illustre une r\u00e9organisation des t\u00e2ches entre professionnels de sant\u00e9 en psychiatrie, avec des enjeux de continuit\u00e9 des soins somatiques pour des patients suivis en ambulatoire.\u00a0(contenu r\u00e9sum\u00e9 par l’IA)\u200bLire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" Le centre hospitalier Le Vinatier \u2013 Psychiatrie Universitaire Lyon M\u00e9tropole (PULM) poursuit le d\u00e9ploiement de protocoles de coop\u00e9ration en psychiatrie en ouvrant un nouveau dispositif \u00e0 l\u2019interface avec la m\u00e9decine […]<\/p>\n","protected":false},"author":1,"featured_media":4388,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center 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