Peste 40% dintre unitățile sanitare nu au raportat nicio eroare medicală în 2020

villy
June 10, 2021
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Peste 40% dintre unitățile sanitare nu au raportat nicio eroare medicală în 2020

  • Jumătate dintre erori au fost cauzate de nerespectarea măsurilor de prevenire și combatere a infecțiilor asociate asistenței medicale
  • Doar 4,3 % din sesizările înregistrate la nivelul Comisiilor de malpraxis în perioada 2015 – 2019 au fost confirmate ca fiind malpraxis
  • Cifrele au fost relevate de un studiu realizat de Observatorul Român de Sănătate la inițiativa Asociației Ayan

11 iunie 2021 – 217 unități sanitare (42%) din cele 513 înregistrate la Autoritatea Națională de Management al Calității în Sănătate (ANMCS) nu au raportat anul trecut niciun eveniment advers asociat actului medical, relevă studiul Siguranța pacientului în actul medical, realizat de Observatorul Român de Sănătate la inițiativa Asociației Ayan. Acest lucru semnalează faptul că în România nu există încă o cultură a raportării erorilor bine înrădăcinată în practicile sistemului medical, cu efecte negative inclusiv la nivelul procesului de învățare din greșeli. Dintre erorile raportate, jumătate au fost cauzate de nerespectarea măsurilor de prevenire și combatere a infecțiilor asociate asistenței medicale.

“Studiul a fost realizat în contextul în care pandemia de Covid-19 a evidențiat vulnerabilitățile sistemelor de sănătate din întreaga lume, inclusiv din România. Astfel, am analizat siguranța pacientului concentrându-ne pe erorile care apar în actul medical, cu scopul final de a contribui la îmbunătățirea practicilor de siguranță a pacientului. Acest lucru este imperios necesar pentru creșterea calității asistenței medicale și a încrederii populației în actul medical. Prin acest studiu ne propunem și să creăm o platformă de dialog între autorități, medici și pacienți, astfel încât să poată fi găsite soluţii concrete în beneficiul tuturor părţilor implicate.”, a declarat Constantin Radu, Medic și Director Executiv Observatorului Român de Sănătate.

În legislația din România lipsește o definiție clară a conceptului de “eroare medicală” în concordanță cu terminologia recomandată de Organizația Mondială a Sănătății și Uniunea Europeană. Sistemul actual de raportare vizează evenimentele adverse asociate asistenței medicale, care prin definiție includ doar erorile medicale cu consecințe asupra pacientului. Dar erorile medicale se referă și la acele greșeli ce apar în asistența medicală care nu au consecințe asupra pacientului, iar omiterea raportării acestora constituie o barieră în procesul de învățare din greșeli.

Încă din anul 2009 Consiliul European a sugerat statelor membre UE implementarea unui set de măsuri pentru siguranța pacientului, precum sisteme de raportare și învățare, emanciparea pacientului, politici naționale și locale de siguranța pacientului și diseminarea informațiilor despre siguranța pacientului către părțile implicate în asistența medicală. O evaluare cu privire la procesul de implementare a acestor măsuri recomandate, publicată într-un raport al Comisiei Europene din 2014, arată că România se clasa pe ultimul loc, alături de Slovenia, cu doar 3 sub-măsuri implementate dintr-un număr de 13 recomandări.

Mai mult, în prezent, România are un sistem de raportare a evenimentelor adverse asociate asistenței medicale doar în unitățile sanitare cu paturi, față de alte țări în care raportarea cuprinde și alte unități precum ambulatorii, cabinete de medicină de familie și centre rezidențiale pentru bătrâni.

În ce privește evenimentele adverse raportate, cele mai frecvente sunt infecțiile nosocomiale, de medicație și căderile. La nivel general, în anii 2019 și 2020, în România au fost raportate peste 5.800 cazuri de infecții asociate asistenței medicale, peste 1.300 de erori medicale care au rezultat în traumatismul pacientului și 128 de cazuri de deces din cauza unor erori medicale.

Printre cei mai expuși erorilor medicale sunt pacienții pediatrici, potrivit datelor prezentate în studiu.

O altă situație evidențiată de Observatorul Român de Sănătate privește Comisia de monitorizare și competență profesională pentru cazurile de malpraxis din cadrul DSP. Din datele adunate de la 31 de DSP-uri din țară, peste jumătate dintre sesizările adresate Comisiilor de malpraxis sunt respinse pe motiv de lipsă a documentelor sau neplată a taxei pentru experții care ar trebui să analizeze cazul. Doar 4,3 % din sesizările înregistrate la nivelul Comisiilor de malpraxis în perioada 2015 – 2019 au fost confirmate ca fiind malpraxis.

Printre recomandările Observatorului Român de Sănătate în vederea îmbunătățirii calității actului medical se numără:

  • îmbunătățirea actualei metodologii de raportare
  • comunicarea transparentă a datelor generate de sistemul de raportare al ANMCS
  • obligativitatea raportării sau introducerea unei forme de recompensă pentru unitățile sanitare care raportează
  • transmiterea către fiecare unitate sanitară care raportează erori medicale a unor rapoarte periodice care să cuprindă și recomandări specifice pentru reducerea frecvenței acestora
  • crearea unei culturi organizaționale non-represive, care să încurajeze raportarea și învățarea din greșeli
  • alinierea eforturilor țării noastre în aria siguranței pacientului cu cele de la nivelul UE

# # #

Despre Observatorul Român de Sănătate

Observatorul Român de Sănătate esteun think-tank non-profit a cărei misiune este aceea de a contribui la îmbunătățirea serviciilor de sănătate din România și estul Europei. Observatorul desfășoară studii de cercetare privind activitatea acestor servicii, integrând evidențele disponibile privind teme de interes pentru a informa elaborarea unor politici de sănătate coerente și eficiente.

Despre Asociația Ayan

Asociația Ayan a luat naștere în anul 2019, ca urmare a unei erori medicale în care Ayan, un copil de numai un an, şi-a pierdut viaţa. Sesizând educaţia precară în rândul publicului cu privire la drepturile pacienţilor, în general, şi a erorilor medicale, în special, părinţii lui Ayan au decis înfiinţarea Asociaţiei, prin care îşi propun să facă o schimbare în sistemul medical românesc, astfel încât cazuri precum cel al lui Ayan să nu se mai poată întâmpla. Astfel, Asociaţia îşi propune educarea publicului în legătură cu drepturile pacientului, stimularea sa de a reacționa atunci când există disfuncționalități în interacțiunea cu sistemul medical, precum şi inițierea unui dialog între părțile implicate cu privire la problematica erorilor medicale. Asociația Ayan doreşte să aducă la aceeaşi masă pacienții, medicii și autoritățile, pentru ca erorile medicale să nu mai fie un subiect tabu şi să poată fi găsite soluţii în beneficiul tuturor părţilor implicate.

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