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La gestion du risque iatrogène: une voie concrète d’amélioration continue de la qualité des soins en médecine néonatale

Iatrogenic risk monitoring: a concrete way of constant improvement of care quality in neonatal medicine

  • Revue Générale / General Review
  • Published:
Revue de médecine périnatale

Résumé

Les événements iatrogènes (EI) sont connus principalement lorsque leur gravité a été suffisante pour entraîner des conséquences sévères pour un ou plusieurs patients hospitalisés. En réalité, leur fréquence est généralement sous-estimée, alors que nombre d’entre eux entraînent des conséquences significatives pour les patients, prolongent les durées de séjour et compromettent en fin de compte la qualité des soins. Les nouveau-nés hospitalisés, patients parmi les plus vulnérables, sont particulièrement exposés à ce risque. Les différents types d’EI observables, leur incidence, leur gravité et leur évitabilité sont revus dans cet article. L’intérêt des différents systèmes de monitorage, en particulier des systèmes prospectifs, non punitifs, mis en place à l’échelle des structures de soins dans le cadre d’une démarche d’amélioration continue de la qualité, est souligné.

Abstract

Adverse events are recognized mainly when they are severe enough to be life-threatening or fatal for one or several hospitalized patients. In fact, the real incidence is usually underestimated despite their deleterious consequences as permanent injury to their vital organs including eyes, lungs, brain, and gastrointestinal tract, causing them to have lifelong disabilities. The risk is especially high for hospitalized neonates and the health and economic implications are important. The aim of this paper is to review the types of iatrogenic events, incidence rate, and severity and prevention policies. The effectiveness of different monitoring policies, in particular prospective and non-punitive, in order to improve quality of care, are reviewed.

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Authors and Affiliations

  1. Service de néonatologie, pôle Parents-Enfants, hôpital de La Conception, 147, boulevard Baille, F-13385, Marseille, France

    I. Ligi & U. Simeoni

  2. Cellule d’évaluation médicale, pôle de santé publique, EA 3279, Assistance publique-Hôpitaux de Marseille et faculté de médecine, université de la Méditerranée, 80, rue Brochier, F-13385, Marseille, France

    S. Tardieu

Authors
  1. I. Ligi
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  2. S. Tardieu
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  3. U. Simeoni
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Correspondence to I. Ligi.

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Ligi, I., Tardieu, S. & Simeoni, U. La gestion du risque iatrogène: une voie concrète d’amélioration continue de la qualité des soins en médecine néonatale. Rev. med. perinat. 2, 54–58 (2010). https://doi.org/10.1007/s12611-009-0042-3

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  • DOI: https://doi.org/10.1007/s12611-009-0042-3

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