La Haute Autorit\u00e9 de sant\u00e9 (HAS) compl\u00e8te son dernier rapport sur les \u00e9v\u00e9nements ind\u00e9sirables graves associ\u00e9s aux soins (EIGS) par une analyse sp\u00e9cifique des EIGS survenant chez des patients en fin de vie, \u00e0 partir des d\u00e9clarations recueillies dans le cadre du dispositif national mis en place depuis 2017. Cette analyse porte sur des situations de prise en charge complexes, concernant 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.<\/p>\n
La HAS constate que ces situations de fin de vie se caract\u00e9risent par des trajectoires cliniques vari\u00e9es, parfois prolong\u00e9es, marqu\u00e9es par une d\u00e9gradation progressive de l\u2019\u00e9tat de sant\u00e9, des besoins croissants en soins et en accompagnement, et par des d\u00e9cisions m\u00e9dicales complexes (objectifs de soins, soulagement des sympt\u00f4mes, proportionnalit\u00e9 des traitements, respect des volont\u00e9s du patient). Les patients, tr\u00e8s vuln\u00e9rables, sont expos\u00e9s \u00e0 des risques sp\u00e9cifiques li\u00e9s \u00e0 leur \u00e9tat clinique, \u00e0 leur d\u00e9pendance aux soins, \u00e0 l\u2019usage de traitements \u00e0 risque et \u00e0 la complexit\u00e9 des prises en charge. Toute d\u00e9faillance dans un des \u00e9l\u00e9ments de cette prise en charge peut entra\u00eener des cons\u00e9quences graves.<\/p>\n
L\u2019analyse des d\u00e9clarations met en \u00e9vidence une pr\u00e9dominance de causes organisationnelles \u00e9vitables dans la survenue des EIGS en fin de vie. La HAS rappelle que l\u2019erreur humaine est fr\u00e9quente et inh\u00e9rente \u00e0 l\u2019activit\u00e9 de soins, en particulier dans un contexte complexe et en \u00e9volution constante, et qu\u2019elle ne peut \u00eatre totalement supprim\u00e9e. La s\u00e9curit\u00e9 des soins repose sur la r\u00e9duction maximale de ces erreurs et sur leur gestion appropri\u00e9e lorsqu\u2019elles surviennent.<\/p>\n
Dans ce contexte, marqu\u00e9 aussi par l\u2019\u00e9volution des attentes soci\u00e9tales, le renforcement des droits des patients, la strat\u00e9gie d\u00e9cennale des soins d\u2019accompagnement 2024\u20112034 et le d\u00e9veloppement des prises en charge hors h\u00f4pital, la HAS souligne la n\u00e9cessit\u00e9 de mieux objectiver les risques associ\u00e9s aux soins en fin de vie. Sur la base des d\u00e9clarations des professionnels et des \u00e9tablissements sanitaires et m\u00e9dico-sociaux, elle pr\u00e9conise en particulier de mieux formaliser le plan personnalis\u00e9 de soins et d\u2019accompagnement et de garantir la continuit\u00e9 des prises en charge. Les recommandations formul\u00e9es ciblent exclusivement les causes profondes identifi\u00e9es dans les EIGS analys\u00e9s et n\u2019annulent ni ne remplacent les recommandations d\u00e9j\u00e0 publi\u00e9es ant\u00e9rieurement par la HAS ou d\u2019autres organismes, qui restent pleinement valides.\u00a0(contenu r\u00e9sum\u00e9 par l’IA)\u200bLire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" La Haute Autorit\u00e9 de sant\u00e9 (HAS) compl\u00e8te son dernier rapport sur les \u00e9v\u00e9nements ind\u00e9sirables graves associ\u00e9s aux soins (EIGS) par une analyse sp\u00e9cifique des EIGS survenant chez des patients en 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