{"id":8089,"date":"2024-08-19T10:00:04","date_gmt":"2024-08-19T08:00:04","guid":{"rendered":"https:\/\/eu.bd.com\/iv-news\/?p=8089"},"modified":"2024-07-26T09:37:48","modified_gmt":"2024-07-26T07:37:48","slug":"preserver-la-securite-du-patient-et-reduire-les-erreurs-de-connexion","status":"publish","type":"post","link":"https:\/\/eu.bd.com\/iv-news\/fr\/actualites-et-innovation\/preserver-la-securite-du-patient-et-reduire-les-erreurs-de-connexion\/","title":{"rendered":"Pr\u00e9server la s\u00e9curit\u00e9 du patient et r\u00e9duire les erreurs de connexion"},"content":{"rendered":"<p>Les erreurs d&#8217;administration de m\u00e9dicaments de type \u00ab\u00a0mauvaise voie\u00a0\u00bb peuvent avoir des cons\u00e9quences catastrophiques, y compris la parapar\u00e9sie, la parapl\u00e9gie ou le d\u00e9c\u00e8s.<sup>1,2<\/sup><\/p>\n<p>Ces types d&#8217;erreurs surviennent g\u00e9n\u00e9ralement \u00e0 la suite d&#8217;erreurs de connexion, lorsque le m\u00e9dicament est administr\u00e9 par une mauvaise voie, comme l&#8217;administration d&#8217;une p\u00e9ridurale par voie intraveineuse, l&#8217;administration d&#8217;un m\u00e9dicament intraveineux par voie p\u00e9ridurale ou l&#8217;administration d&#8217;un m\u00e9dicament destin\u00e9 \u00e0 une administration intraveineuse par voie intrath\u00e9cale \u00e0 la place.<sup>1,3,4,5<\/sup><\/p>\n<h2>Le r\u00f4le des connecteurs Luer dans les erreurs de type \u00ab\u00a0mauvaise voie\u00a0\u00bb<\/h2>\n<p>Les syst\u00e8mes de connexion Luer standardis\u00e9s utilis\u00e9s aujourd&#8217;hui ont \u00e9t\u00e9 con\u00e7us pour assurer des connexions hautement fiables et exemptes de fuites entre les tubes, les seringues et les autres accessoires.<sup>3,4,5<\/sup> Ils pr\u00e9sentent une configuration m\u00e2le-femelle universelle qui peut \u00eatre utilis\u00e9e sur diff\u00e9rents types d&#8217;\u00e9quipements m\u00e9dicaux.<sup>3 <\/sup>Cette utilisation universelle a toutefois \u00e9t\u00e9 identifi\u00e9e comme une cause principale d&#8217;erreurs d&#8217;administration de m\u00e9dicaments de type mauvaise voie.<sup>4,6,7 <\/sup><\/p>\n<p><strong>Plus d\u2019informations \u00e0 ce sujet : <\/strong><a href=\"https:\/\/eu.bd.com\/iv-news\/fr\/actualites-et-innovation\/pratiques-danesthesie-regionale-perspective-dune-enquete-europeenne\/\">Pratiques d\u2019anesth\u00e9sie r\u00e9gionale \u2013 Perspective d\u2019une enqu\u00eate europ\u00e9enne<\/a><\/p>\n<h3>Erreurs de connexion neuraxiale<\/h3>\n<p>La conception simple et fonctionnelle des connecteurs Luer contribue \u00e0 leur facilit\u00e9 d&#8217;utilisation.<sup>3,5,8<\/sup> Cependant, ces caract\u00e9ristiques de conception rendent \u00e9galement possibles les connexions erron\u00e9es entre voies d&#8217;administration des m\u00e9dicaments.<sup>3,5,8<\/sup><\/p>\n<p>Une analyse de 133 \u00e9tudes de cas portant sur une p\u00e9riode de 20 ans, de 1999 \u00e0 2019, a montr\u00e9 que l&#8217;\u00e9v\u00e9nement le plus fr\u00e9quemment rapport\u00e9 impliquait l&#8217;administration d&#8217;une anesth\u00e9sie p\u00e9ridurale par voie intraveineuse (29,2\u00a0% des \u00e9v\u00e9nements)\u00a0; 27,7\u00a0% des \u00e9v\u00e9nements impliquaient l&#8217;administration d&#8217;un m\u00e9dicament intraveineux par voie p\u00e9ridurale\u00a0; et 25,4\u00a0% des \u00e9v\u00e9nements r\u00e9sultaient d&#8217;un m\u00e9dicament destin\u00e9 \u00e0 l&#8217;administration intraveineuse, mais administr\u00e9 par voie intrath\u00e9cale.<sup>1<\/sup><\/p>\n<h3>Quelle est l&#8217;ampleur de ces impacts\u00a0? Voici quelques exemples\u00a0:<\/h3>\n<ul>\n<li>Dans une enqu\u00eate men\u00e9e aupr\u00e8s d&#8217;unit\u00e9s d&#8217;anesth\u00e9sistes obst\u00e9triques au Royaume-Uni, 20\u00a0% des unit\u00e9s ont signal\u00e9 une connexion accidentelle de solutions d&#8217;anesth\u00e9siques locaux aux syst\u00e8mes intraveineux (IV) et 7\u00a0% ont signal\u00e9 l&#8217;administration par voie p\u00e9ridurale de m\u00e9dicaments destin\u00e9s \u00e0 l&#8217;administration IV.<sup>9<\/sup><\/li>\n<li>Sur 2 ans (2006-2008), 6,6\u00a0% (n = 40) de tous les incidents critiques d&#8217;anesth\u00e9sie p\u00e9diatrique au Royaume-Uni ont \u00e9t\u00e9 class\u00e9s comme \u00ab\u00a0mauvais m\u00e9dicament\u00a0\u00bb, \u00ab\u00a0mauvaise voie d&#8217;administration\u00a0\u00bb ou \u00ab\u00a0mauvaise dose\u00a0\u00bb <sup>10<\/sup><\/li>\n<\/ul>\n<h2>Le NHS remplace les connecteurs Luer par une option plus s\u00fbre<\/h2>\n<p>Reconnaissant ces risques pour la s\u00e9curit\u00e9 des patients et des m\u00e9dicaments, l\u2019\u00e9quipe nationale de s\u00e9curit\u00e9 des patients du National Health Service (NHS) anglais a \u00e9mis une <a href=\"https:\/\/www.england.nhs.uk\/publication\/national-patient-safety-alert-transition-to-nrfit-connectors-for-intrathecal-and-epidural-procedures-and-delivery-of-regional-blocks\/\">alerte nationale de s\u00e9curit\u00e9 des patients<\/a> demandant \u00e0 tous les prestataires concern\u00e9s financ\u00e9s par le NHS de passer aux connecteurs NRFit\u2122 pour toutes les proc\u00e9dures intrath\u00e9cales et p\u00e9ridurales, ainsi que pour l\u2019administration de blocs r\u00e9gionaux, d\u2019ici le 31 janvier 2025.<sup>11<\/sup><\/p>\n<p><strong><em>NRFit\u2122 <\/em><\/strong>est le nom des connecteurs neuraxiaux qui ont \u00e9t\u00e9 d\u00e9velopp\u00e9s pour s&#8217;aligner sur la directive ISO 80369-6, faisant partie de la s\u00e9rie de normes 80369 pour les connecteurs de petite taille publi\u00e9e en 2016.<sup>7,12<\/sup> Ils sont environ 20\u00a0% plus petits qu&#8217;un connecteur Luer, et en plus du changement de taille, ils comportent \u00e9galement d&#8217;autres \u00e9l\u00e9ments de conception pour \u00e9viter les erreurs de connexion, comme par exemple un collier sur les connexions m\u00e2les coulissantes.<sup>7,13<\/sup><\/p>\n<p>Les modifications illustrent le concept de design \u00ab\u00a0\u00e0 fonction forc\u00e9e\u00a0\u00bb, qui est essentiel dans la pr\u00e9vention des erreurs d&#8217;administration de m\u00e9dicaments \u2013 en raison de la conception du produit, il est presque impossible de commettre une erreur de connexion.<sup>14<\/sup><\/p>\n<p><strong><em>Tendance \u00e0 utiliser<\/em> le code <em>couleur jaune pour les connecteurs neuraxiaux\u00a0:<\/em><\/strong> Outre les modifications de conception des connecteurs NRFit\u2122, il existe \u00e9galement une tendance dans certaines parties du monde \u00e0 utiliser la couleur jaune pour indiquer les voies neuraxiales.<sup>3,7<\/sup><\/p>\n<p><strong>Plus d\u2019informations \u00e0 ce sujet : <\/strong><a href=\"https:\/\/eu.bd.com\/iv-news\/fr\/publications-scientifiques\/que-pouvons-nous-retenir-de-la-nouvelle-enquete-sur-lanesthesie-loco-regionale\/\">Que pouvons-nous retenir de la nouvelle enqu\u00eate sur l\u2019anesth\u00e9sie loco-r\u00e9gionale\u202f?<\/a><\/p>\n<h2>Mise en \u0153uvre des normes et du NRFit\u2122\u00a0:<\/h2>\n<p>Le Royaume-Uni est l\u2019un des premiers pays europ\u00e9ens \u00e0 \u00e9mettre une alerte nationale sur la s\u00e9curit\u00e9 des patients demandant \u00e0 tous les prestataires financ\u00e9s par le NHS de passer aux connecteurs NRFit\u2122.<sup>11 <\/sup>Partout dans le monde, les taux d\u2019adoption varient, mais la plupart des pays et r\u00e9gions travaillent \u00e0 l\u2019\u00e9laboration de plans de mise en \u0153uvre des normes pour les connecteurs.<sup>3,7<\/sup><\/p>\n<div class=\"su-button-center\"><a href=\"https:\/\/lp.bd.com\/202406-MDS24-UKI_EN-EE-LeadGen-Safety_switch_Discovery-LP_LP-EN-01-MainLP.html\" class=\"su-button su-button-style-default\" style=\"color:#FFFFFF;background-color:#2D89EF;border-color:#246ec0;border-radius:6px\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"color:#FFFFFF;padding:0px 18px;font-size:14px;line-height:28px;border-color:#6cadf4;border-radius:6px;text-shadow:none\"> EN SAVOIR PLUS<\/span><\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Les erreurs d&#8217;administration de m\u00e9dicaments de type \u00ab\u00a0mauvaise voie\u00a0\u00bb peuvent avoir des cons\u00e9quences catastrophiques, y compris la parapar\u00e9sie, la parapl\u00e9gie&#8230;<\/p>\n","protected":false},"author":8,"featured_media":8091,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[748],"tags":[],"class_list":["post-8089","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-actualites-et-innovation","speciality-abord-vasculaire","speciality-anesthesie","speciality-securite-du-patient","contenttype-article-fr","target-directeur-responsable-dhopital","target-medecin","target-soins-infirmiers"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pr\u00e9server la s\u00e9curit\u00e9 du patient et r\u00e9duire les erreurs de connexion - BD IV News<\/title>\n<meta name=\"description\" content=\"D\u00e9couvrez comment le National Health Service (NHS) am\u00e9liore la s\u00e9curit\u00e9 du patient 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