Definition :

in 2008, the national council of nurses (CII) brought its definition of the advanced practice nurse.

”The nurse who exercises in advanced practice is a graduate nurse who has acquired theoretical knowledge, the know-how to make complex decisions, as well as the clinical skills essential to the advanced practice of his profession. The characteristics of this advanced practice are determined by the context in which the nurse will be authorized to practice”.

Framework of professional practice :

Advanced practice nurses (APNs) can practice:
on an outpatient basis:
– within a primary care team coordinated by the doctor (for example in a house or health center) or the care team of a medical center of the army health service coordinated by an army doctor
– in the assistance of a medical specialist, excluding primary care

in a health establishment, a medico-social establishment or an army hospital, within a care team coordinated by a doctor.

The IPA participates in the overall care of patients and in the organization of pathways.
Advanced practice aims to:
• develop skills to promote career development
• improve the quality of care and healthcare pathways
• strengthen equity and access to care for population
• focus the care on the person, his entourage and the health needs of the populations

Areas of intervention

– stabilized chronic pathologies; prevention and common polypathologies in primary care

– oncology and hemato-oncology

– chronic kidney disease, dialysis and kidney transplantation

– psychiatry and mental health

– Emergency


• Evaluate the state of health of patients in relay of medical consultations for identified pathologies

• Define and implement the patient’s care plan based on the overall assessment of his state of health

• Design and implement prevention and therapeutic education actions
• Organize the care and health pathways of patients in collaboration with all the actors concerned
• Set up and conduct actions to assess and improve professional practices by exercising clinical leadership
• Research, analyze and produce professional and scientific data

Training :

The IPA diploma is accessible in initial and continuing training to holders of the State nursing diploma or a European equivalence. Nurses who so wish can enter training directly after obtaining the DE in nursing.

The training is organized around a 1st year of common core to lay the foundations of nursing practice in advanced practice and a 2nd year focused on lessons related to the chosen option.

To practice as an advanced practice nurse, you must :

• hold the DEIPA (diploma at baccalaureate level + 5)
• have 3 years of experience as a nurse in the basic profession
• be registered as an IPA with the National Order of Nurses

Aids :

Amendment 10 provides financial support for self-employed nurses following IPA training.
This financial assistance of €15,000 helps mitigate the loss of income linked to the drop in your activity during your training.

This aid is contractualized between IDEL and the CPAM of Dordogne.

Demography :

Currently, the department has 4 IPAs distributed as follows:
• 1 liberal IPA
• 3 salaried IPAs (2 at the CH of PGX, 1 at the CH of Sarlat)

to know more :

Infirmiers en pratique avancée (IPA) en Nouvelle-Aquitaine | Agence régionale de santé Nouvelle-Aquitaine (