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Success of routine check-ups with the MESI mTABLET ABI. A case study by advanced practice nurse Aurélie Rouffy, France

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Aurélie Rouffy is an advanced practice nurse (Fr. infirmière en pratique avancée, IPA) in Adriers, West France. After a decade as a private nurse (Fr. cabinet infirmier), she has qualified as an advanced practice nurse in stabilised chronic pathologies. Thus, she now mainly works with chronic patients for education, prescription renewal, screening and follow-up of associated pathologies.

Preventive check-ups represent an important part of her work – also by means of the MESI ABI TABLET ABI. She uses it at her office as well as at patients’ homes (e.g. upon prescription renewal, when she suspects the presence PAD). The following case study highlights the importance of routine check-ups of risk groups.

Case study

The patient was a 70-year-old Englishman living in France. He was overweight and hypertensive, with a rather sedentary lifestyle. His health status seemed normal, however, and he experienced no difficulty walking in terms of lameness or pain. Due to the presence of several risk factors, an ABI check-up was performed.

The ABI result was very bad – between 0.6 and 0.8. Ms Rouffy made an urgent call to the angiology practice she usually works with and where they are aware that she is equipped with the MESI mTABLET ABI. After sharing the ABI result, she obtained an emergency appointment for her patient. The diagnosis of advanced PAD was confirmed and the patient underwent a revascularisation surgery. On this occasion, the vascular specialists also discovered an abdominal aortic aneurysm, which also required an emergency operation.

Example of the MESI mTABLET ABI result screen

Ms Rouffy states: I recommend the MESI mTABLET because it truly enables effective arterial assessment in risk groups like the elderly, especially since they can ignore the symptoms and attribute them to age.

A nurse as a professional and a volunteer. An interview with Aurélie Rouffy

Aurélie Rouffy graduated in nursing in 2007. After working briefly in a hospital, she worked as a visiting nurse (Fr. infirmière libérale) for 10 years. She then obtained her master’s degree in advanced practice nursing with specialisation in stabilised chronic pathology, prevention and common pathologies in primary care. She is now part of multi-professional healthcare structure covering the French countryside. For more than 15 years, she has also been active as a volunteer firefighter nurse.

What was your motivation to become a nurse and later an advanced practice nurse?

I wanted to be a nurse for as long as I can remember, so going to a nurse training institute (IFSI) for a state diploma was a no-brainer. After nearly 15 years of practice, however, I wanted to acquire new skills and develop further, so I decided on advanced practice nurse studies.

What does your daily work consist of? What are its greatest challenges and triumphs?

I receive patients for consultation to renew their treatments, monitor their pathologies, and carry out clinical examinations as well as further examinations if necessary. The advanced practice nurse is a new profession, so the biggest challenge is to make one’s way in the healthcare system; it is a struggle to bring a new profession to life. The biggest challenge is getting it accepted. The triumph, however, is the quality of care it offers. Indeed, the positive feedback from patients, and the impact of screening and prevention on improving their health can not be denied.

One of the most important tasks of primary care is early detection of pathologies. In this, cardiovascular diseases are among the most deadly. In France, Peripheral Arterial Disease (PAD) affects more than 2 million people and is particularly dangerous because 70% of patients show no symptoms. How does the use of technology contribute to early detection and what role do you play?

I routinely check up patients at risk (diabetics, patients with heart disease, post-stroke patients, etc.) as well as those who report pain or difficulty walking. A partnership with an angiology practice enables me to get quick appointments when I refer patients to them, and it is agreed that they undergo a Doppler ultrasound of the lower extremities and the supra-aortic arteries at the same time so as not to waste time. In fact, 15% of the screenings carried out over the first 6 months of activity showed anomalies with sometimes catastrophic ABIs. These screenings were all later confirmed by a PAD diagnosis, with surgery in 50% of cases.

In general, also thanks to the MESI mTABLET ABI, we can discover problematic cases before surgery is needed. We can then start with a drug treatment and/or lifestyle changes (for example, encouraging the patients to walk and exercise more).

Could you describe where your work, check-ups and the diagnostic measures that you carry out fit into doctor-nurse coordination?

I monitor the care pathways, make appointments with the angiologist, prepare referrals for the Doppler ultrasound of the lower extremities and the supra-aortic arteries, and give appropriate therapy advice. There is always a communication exchange with the primary care physician; if a treatment needs to be modified, the patient is checked again by the doctor or by myself – our collaboration is based on trust. I also receive the angiologist’s report, just like the general practitioner.

What would you say to people considering becoming an advanced practice nurse?

I would tell them that although the path is long, it is a fulfilling career.

Aurélie Rouffy is an advanced practice nurse with a specialisation in stabilised chronic pathology, prevention and common pathologies in primary care. She owns her own office in Adriers (86, France), within a multi-professional healthcare structure in a rural area.