Iatrogénie médicamenteuse nosocomiale et gestion des risques d’erreur médicamenteuse: à propos de l’analyse des notifications du réseau REEM.

Records from REEM’s database of medication errors were studied. REEM is a voluntary medication error reporting program, specifically designed for French hospitals and health care systems and supported by AAQTE with the focus of collecting, analyzing, learning and ultimately reducing medication errors. REEM uses the NCC MERP index for categorizing medication errors. Records of medication errors submitted to REEM by participating health care institutions were analyzed for error category indexing (whether a medication error actually occurred, whether it affected the patient, and if so, the effect it had), node (the stage of the medication use process where the error occurred), type of error, causes, contributing factors and drugs involved. The article presents the results of analysis of 458 reports of medication errors. Errors that affected the patient were seen in 47,4% of the records, and 23,5% of them have contributed to or resulted in harm, and 1,1% in death. The contribution of the different causes of errors (drugs, order and human factors) and associated factors are discussed. This analysis of 458 medication errors reported by health professionnals to REEM produced detailed informations on the scope and nature of medication errors and the means to understand and learn about human factors and propose systemic management of medication error risk, to study and prevent actual medication errors and propose practical solutions that may be applicable to hospitals, and also to drive local quality improvement efforts and improve patient safety. [ABSTRACT FROM AUTHOR]