Dans le Code de la santé publique (article L. 4311-1), il est indiqué que l’adaptation des posologies par un infirmier est possible sur la base de résultats d’analyses de biologie médicale, sauf en cas d’indication contraire du médecin, et sous réserve d’une information du médecin traitant désigné par le patient. Cette adaptation doit également s’inscrire dans un protocole dans le cadre d’un exercice coordonné et moyennant certaines conditions à déterminer par décret.
Le décret vient de paraître. Il précise que le protocole doit respecter plusieurs points, notamment détailler les activités réalisées par les infirmiers qui participent à sa mise en œuvre, prévoir les critères d’éligibilité et de retrait des patients concernés ainsi que les modalités de leur information sur le protocole et encore déterminer les conditions d’organisation permettant d’assurer, en cas de besoin, l’accès au médecin traitant du patient ou, à défaut, à un médecin exerçant dans le cadre du même dispositif d’exercice coordonné.
Pour rappel : le dispositif d’exercice coordonné concerne le travail au sein d’équipes de soins primaires, de CPTS (communautés professionnelles territoriales de santé), de centres de santé ou encore de maisons de santé. Le protocole doit également être porté à la connaissance de l’Agence régionale de santé, qui le transmet au comité national des coopérations interprofessionnelles.
Reste à déterminer la liste des pathologies et traitements concernés, pour le moment non connue, mais qui devrait être fixée prochainement par arrêté du ministre chargé de la Santé, après avis de la Haute Autorité de santé.
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