Le texte pr\u00e9sente le dispositif de d\u00e9claration et d\u2019analyse des \u00e9v\u00e9nements ind\u00e9sirables graves associ\u00e9s aux soins (EIGS) et le r\u00f4le de la Haute Autorit\u00e9 de sant\u00e9 (HAS), en particulier dans le contexte de la fin de vie. Un EIGS est d\u00e9fini par le code de la sant\u00e9 publique (art. R.1413-67) comme un \u00e9v\u00e9nement inattendu au regard de l\u2019\u00e9tat de sant\u00e9 et de la pathologie de la personne, entra\u00eenant le d\u00e9c\u00e8s, la mise en jeu du pronostic vital, ou un d\u00e9ficit fonctionnel permanent probable, y compris une anomalie ou malformation cong\u00e9nitale.<\/p>\n
Depuis 2017, la HAS re\u00e7oit, au niveau national, les d\u00e9clarations d\u2019EIGS r\u00e9alis\u00e9es par les professionnels de sant\u00e9, apr\u00e8s pseudonymisation par les agences r\u00e9gionales de sant\u00e9 (ARS). Sa mission est d\u2019analyser ces \u00e9v\u00e9nements et de produire un bilan annuel assorti de pr\u00e9conisations pour am\u00e9liorer la s\u00e9curit\u00e9 des patients. La HAS souligne l\u2019existence d\u2019une sous-d\u00e9claration importante des EIGS en France, ce qui limite la valeur \u00e9pid\u00e9miologique ou statistique de ces donn\u00e9es et ne permet pas de les g\u00e9n\u00e9raliser \u00e0 l\u2019ensemble de la population ou des secteurs de soins. Ces donn\u00e9es sont toutefois jug\u00e9es utiles pour d\u00e9crire les circonstances des accidents d\u00e9clar\u00e9s et orienter les actions de s\u00e9curit\u00e9 des soins.<\/p>\n
La HAS rappelle que l\u2019erreur humaine est fr\u00e9quente et inh\u00e9rente \u00e0 toute activit\u00e9, en particulier dans un secteur complexe et \u00e9volutif comme la sant\u00e9. L\u2019objectif de s\u00e9curit\u00e9 ne consiste pas \u00e0 supprimer toutes les erreurs, jug\u00e9 impossible, mais \u00e0 les r\u00e9duire autant que possible et \u00e0 g\u00e9rer de mani\u00e8re adapt\u00e9e celles qui surviennent.<\/p>\n
Le texte met l\u2019accent sur les situations de fin de vie, qui concernent des personnes atteintes de maladies graves, \u00e9volutives, en phase avanc\u00e9e, potentiellement mortelles ou avec un pronostic vital engag\u00e9 \u00e0 court ou moyen terme. Cette p\u00e9riode se caract\u00e9rise par des trajectoires cliniques vari\u00e9es, parfois prolong\u00e9es, une d\u00e9gradation progressive de l\u2019\u00e9tat de sant\u00e9, une augmentation des besoins de soins et d\u2019accompagnement, et des d\u00e9cisions complexes concernant les objectifs de soins, le soulagement des sympt\u00f4mes, la proportionnalit\u00e9 des traitements et le respect des volont\u00e9s de la personne. Les patients en fin de vie, particuli\u00e8rement vuln\u00e9rables, sont expos\u00e9s \u00e0 des risques sp\u00e9cifiques li\u00e9s \u00e0 leur \u00e9tat clinique, \u00e0 leur d\u00e9pendance aux soins, \u00e0 l\u2019emploi de traitements \u00e0 risque et \u00e0 la complexit\u00e9 des prises en charge, toute d\u00e9faillance pouvant avoir des cons\u00e9quences graves.<\/p>\n
Dans un contexte d\u2019\u00e9volution des attentes soci\u00e9tales, de renforcement des droits des patients, de mise en \u0153uvre d\u2019une strat\u00e9gie d\u00e9cennale des soins d\u2019accompagnement 2024\u20112034 et de d\u00e9veloppement des prises en charge hors h\u00f4pital, le texte souligne la n\u00e9cessit\u00e9 de mieux objectiver les risques associ\u00e9s aux soins en fin de vie. C\u2019est dans cette perspective que la HAS a entrepris l\u2019analyse des d\u00e9clarations d\u2019EIGS survenus chez des patients en fin de vie, afin d\u2019alimenter la r\u00e9flexion sur les risques et les actions d\u2019am\u00e9lioration de la s\u00e9curit\u00e9 des soins dans ce champ.\u00a0(contenu r\u00e9sum\u00e9 par l’IA)\u200bLire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" Le texte pr\u00e9sente le dispositif de d\u00e9claration et d\u2019analyse des \u00e9v\u00e9nements ind\u00e9sirables graves associ\u00e9s aux soins (EIGS) et le r\u00f4le de la Haute Autorit\u00e9 de sant\u00e9 (HAS), en particulier dans […]<\/p>\n","protected":false},"author":1,"featured_media":4149,"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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