{"id":9410,"date":"2025-09-25T09:06:49","date_gmt":"2025-09-25T07:06:49","guid":{"rendered":"https:\/\/www.easistent.ro\/?p=9410"},"modified":"2025-10-23T09:24:48","modified_gmt":"2025-10-23T07:24:48","slug":"siguranta-pacientului-o-fila-de-istorie","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=9410","title":{"rendered":"Siguran\u021ba pacientului \u2013 o fil\u0103 de istorie"},"content":{"rendered":"\n<h3><strong>Timp aproximativ de lectur\u0103: 6 minute<\/strong><\/h3>\n\n\n\n<p class=\"has-drop-cap\">\u00cen 2018, au fost publicate trei rapoarte importante privind defectele de calitate \u00een asisten\u021ba medical\u0103 global\u0103:<\/p>\n\n\n\n<ul><li>&#8222;Dep\u0103\u0219irea decalajului global \u00een privin\u021ba calit\u0103\u021bii \u00eengrijirilor medicale&#8221; &#8211; din partea Academiilor Na\u021bionale de \u0218tiin\u021be, Inginerie \u0219i Medicin\u0103 din SUA<\/li><li>\u201dSistemele de s\u0103n\u0103tate de \u00eenalt\u0103 calitate \u00een era Obiectivelor de Dezvoltare Durabil\u0103\u201d \u00a0&#8211; din partea Comisiei The Lancet<\/li><li>\u201dFurnizarea serviciilor de s\u0103n\u0103tate de calitate \u2013 Un imperativ global pentru accesul universal la serviciile de s\u0103n\u0103tate &#8221; &#8211; din partea Organiza\u021biei Mondiale a S\u0103n\u0103t\u0103\u021bii (OMS), OCDE \u0219i B\u0103ncii Mondiale.<\/li><\/ul>\n\n\n\n<p>De\u0219i au fost realizate separat, <strong>fiecare dintre aceste rapoarte a estimat c\u0103 peste cinci milioane de decese pe an \u00een lume pot fi atribuite defectelor de calitate ale asisten\u021bei medicale, printre aceste cauze num\u0103r\u00e2ndu-se problemele legate de siguran\u021ba pacien\u021bilor<\/strong>.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><a href=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2025\/09\/sigurantapacientului.jpg\"><img width=\"1024\" height=\"513\" src=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2025\/09\/sigurantapacientului-1024x513.jpg\" alt=\"\" class=\"wp-image-9395\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2025\/09\/sigurantapacientului-1024x513.jpg 1024w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2025\/09\/sigurantapacientului-300x150.jpg 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2025\/09\/sigurantapacientului-768x385.jpg 768w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2025\/09\/sigurantapacientului.jpg 1373w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/a><\/figure><\/div>\n\n\n\n<h2><strong>Dar ce este, mai exact, siguran\u021ba pacien\u021bilor?<\/strong><\/h2>\n\n\n\n<p>Potrivit OMS, siguran\u021ba pacien\u021bilor este definit\u0103 ca &#8222;<em>absen\u021ba v\u0103t\u0103m\u0103rilor care pot fi prevenite la un pacient \u0219i reducerea riscului de v\u0103t\u0103mare inutil\u0103 asociat\u0103 asisten\u021bei medicale la un minim acceptabil<\/em>&#8222;.<\/p>\n\n\n\n<p>\u00cen contextul mai larg al sistemului de s\u0103n\u0103tate, siguran\u021ba pacien\u021bilor este &#8222;<em>un cadru de activit\u0103\u021bi organizate care creeaz\u0103 culturi, procese, proceduri, comportamente, tehnologii \u0219i medii \u00een domeniul asisten\u021bei medicale care reduc \u00een mod constant \u0219i durabil riscurile, reduc apari\u021bia daunelor evitabile, reduc probabilitatea erorilor \u0219i reduc impactul daunelor atunci c\u00e2nd acestea apar<\/em>&#8222;.<\/p>\n\n\n\n<p>Momentul de na\u0219tere al domeniului siguran\u021bei pacien\u021bilor este considerat decizia Institutului de Medicin\u0103 din SUA de a \u00eenfiin\u021ba un Comitet privind calitatea \u00eengrijirii \u00een America, al c\u0103rui prim raport, <strong>&#8222;To Err Is Human&#8221;,<\/strong> <strong>din 1999<\/strong>, a constatat c\u0103 erorile medicale au provocat \u00eentre 44.000 \u0219i 98.000 de decese pe an \u00een Statele Unite, echivalentul pr\u0103bu\u0219irii unui avion jumbo \u00een fiecare zi, raport care a stimulat intensificarea activit\u0103\u021bii de siguran\u021b\u0103 a pacien\u021bilor \u00een medicin\u0103.&nbsp; \u00cen acel raport, Dr. Leape \u0219i coautorii s\u0103i au eviden\u021biat faptul c\u0103 majoritatea erorilor medicale care au condus la 100.000 de decese pe an \u00een SUA au fost cauzate de sisteme disfunc\u021bionale, nu de indivizi care au comis gre\u0219eli, a\u0219a cum au crezut mult timp profesia medical\u0103 \u0219i publicul.<\/p>\n\n\n\n<p>Dar chiar \u00eenainte de acest &#8222;moment de na\u0219tere&#8221; al domeniului siguran\u021bei pacien\u021bilor, \u00een diferite p\u0103r\u021bi ale lumii \u0219i \u00een diferite perioade s-au depus eforturi pentru a dezvolta \u0219i \u00eembun\u0103t\u0103\u021bi sistemele \u0219i protocoalele aplicate \u00een asisten\u021ba medical\u0103. \u00cen acest sens, c\u00e2teva nume ies \u00een eviden\u021b\u0103 &#8211; <strong>pacientul Ernest Amory Codman, Florence Nightingale, Ellison C. (&#8222;Jeep&#8221;) Pierce, David Gaba \u0219i Richard Cook,<\/strong> de exemplu, sunt doar c\u00e2\u021biva dintre pionierii medicali ai secolelor XIX \u0219i XX care, cu curaj, au \u00eenceput s\u0103 trag\u0103 semnale de alarm\u0103 cu privire la r\u0103ul pe care \u00eel pot face \u00eengrijirile medicale bine inten\u021bionate de altfel \u0219i, la fel de important, s\u0103 ofere idei cu privire la modul \u00een care transparen\u021ba, \u0219tiin\u021ba sistemelor, standardele \u0219i buna conducere pot salva vie\u021bi, f\u0103c\u00e2nd ca furnizarea \u00eengrijirilor s\u0103 fie mai sigur\u0103, la fel cum \u00eengrijirile \u00een sine pot salva vie\u021bi prin utilizarea descoperirilor biomedicale.<\/p>\n\n\n\n<p>\u0218tiin\u021bele moderne ale siguran\u021bei \u0219i primele lor rude apropiate, \u0219tiin\u021bele erorii umane, au ap\u0103rut pentru prima dat\u0103 \u00een anii 1960 \u0219i 1970. Semin\u021bele au fost prezente \u00een studiile de psihologie cognitiv\u0103, psihologie social\u0103 \u0219i teoria general\u0103 a sistemelor din secolul precedent.<\/p>\n\n\n\n<p>Cu toate acestea, domeniul \u0219tiin\u021bei siguran\u021bei nu s-a conturat p\u00e2n\u0103 c\u00e2nd un grup de ingineri \u0219i psihologi nu au \u00eenceput s\u0103 numeasc\u0103 problemele erorilor umane \u0219i ale siguran\u021bei sistemelor \u00eencep\u00e2nd cu anii 1960. Printre fondatori s-a num\u0103rat <strong>profesorul James Reason<\/strong>, de la Universitatea din Manchester, a c\u0103rui carte din 1990, &#8222;Human Error&#8221;, a fost \u0219i r\u0103m\u00e2ne cea mai important\u0103 monografie pe aceast\u0103 tem\u0103.<\/p>\n\n\n\n<p><strong>Lucian L. Leape<\/strong>, care a murit anul acesta, a devenit un student al acestor \u0219tiin\u021be emergente ale siguran\u021bei la scurt timp dup\u0103 apari\u021bia c\u0103r\u021bii lui Reason \u0219i, mai t\u00e2rziu, a fost creditat cu na\u0219terea domeniului siguran\u021bei pacien\u021bilor \u00een medicin\u0103 prin lucrarea din 1994 intitulat\u0103 &#8222;Error in Medicine&#8221;, care a fost primul articol important pe tema siguran\u021bei pacien\u021bilor \u00een literatura medical\u0103 general\u0103.<\/p>\n\n\n\n<p>Dup\u0103 ce a ob\u021binut diploma de licen\u021b\u0103 \u00een chimie la Universitatea Cornell \u00een 1952, Lucian Leape a servit ca locotenent \u00een Marina SUA, iar \u00een 1955 a intrat la Harvard Medical School. Dup\u0103 ob\u021binerea diplomei de medic \u00een 1959, Dr. Leape s-a preg\u0103tit ca chirurg pediatru la Massachusetts General Hospital \u0219i Children&#8217;s Hospital din Boston. \u00cen 1973, a devenit profesor de chirurgie la Facultatea de Medicin\u0103 a Universit\u0103\u021bii Tufts \u0219i \u0219ef al sec\u021biei de chirurgie pediatric\u0103 la Centrul Medical Tufts-New England (\u00een prezent Centrul Medical Tufts).<\/p>\n\n\n\n<p><strong>Raportul din 1999 intitulat &#8222;To Err is Human&#8221;, publicat de Committee on the Quality of Care in America <\/strong>(Comitetul pentru calitatea \u00eengrijirii medicale \u00een America), \u00een cadrul c\u0103ruia Dr. Lucian L. Leape a fost un membru-cheie, <strong>este considerat<\/strong> <strong>momentul de na\u0219tere al domeniului siguran\u021bei pacien\u021bilor<\/strong>.<\/p>\n\n\n\n<p>Ca urmare a reglement\u0103rilor \u0219i a presiunii publice, sistemele de s\u0103n\u0103tate din \u00eentreaga \u021bar\u0103 au \u00eenceput s\u0103 abordeze gre\u0219elile medicale ca pe o problem\u0103 la nivel de sistem, lans\u00e2nd departamente pentru siguran\u021ba pacien\u021bilor \u0219i angaj\u00e2nd responsabili pentru siguran\u021ba pacien\u021bilor.<\/p>\n\n\n\n<p>O alt\u0103 piatr\u0103 de hotar \u00een dezvoltarea domeniului siguran\u021bei pacien\u021bilor a fost publicarea \u00een 2021 a c\u0103r\u021bii Dr. Leape intitulat\u0103 &#8222;Making Healthcare Safe&#8221;. Acoperind dezvoltarea domeniului de la sf\u00e2r\u0219itul anilor 1980 p\u00e2n\u0103 \u00een 2015, Dr. Leape detaliaz\u0103 evolu\u021biile, actorii, organiza\u021biile, cercetarea \u0219i activit\u0103\u021bile de elaborare a politicilor care au marcat evolu\u021bia \u0219i progresele majore ale siguran\u021bei pacien\u021bilor \u00een acest interval de timp.<\/p>\n\n\n\n<p>\u00cen plus, \u0219i poate cel mai important, aceast\u0103 carte nu numai c\u0103 detaliaz\u0103 \u00een mod cuprinz\u0103tor cum \u0219i de ce apar prea des erori umane \u0219i de sistem \u00een procesul de furnizare a asisten\u021bei medicale, dar promoveaz\u0103 \u0219i o \u00een\u021belegere aprofundat\u0103 a principiilor \u0219i practicilor siguran\u021bei pacien\u021bilor, inclusiv modul \u00een care acestea au fost influen\u021bate de \u0219tiin\u021bele moderne ale siguran\u021bei \u0219i de teoria \u0219i proiectarea sistemelor de ast\u0103zi.<\/p>\n\n\n\n<p>Programele de siguran\u021b\u0103 a pacien\u021bilor care au ap\u0103rut \u00een anii care au urmat public\u0103rii lucr\u0103rilor, rapoartelor \u0219i c\u0103r\u021bii de referin\u021b\u0103 a Dr. Leape sunt \u00een vigoare ast\u0103zi \u00een \u00eentreaga lume \u0219i au salvat nenum\u0103rate vie\u021bi, cum arat\u0103 rapoartele men\u021bionate mai sus. Cele mai eficiente dintre aceste programe sprijin\u0103 sistemele de testare \u0219i r\u0103sp\u00e2ndire a interven\u021biilor \u0219i strategiilor tangibile de siguran\u021b\u0103, de \u00eenv\u0103\u021bare din excelen\u021b\u0103 \u0219i de \u00eembun\u0103t\u0103\u021bire continu\u0103, prin implementarea unor elemente importante, la diferite niveluri.<\/p>\n\n\n\n<p>Dar despre aceste elemente \u0219i cum s-au rafinat ele vom discuta pe larg \u00een num\u0103rul viitor al revistei.<\/p>\n\n\n\n<p><em>Mirela Musta\u021b\u0103, redactor executiv<\/em><\/p>\n\n\n\n<p><em>Surse de documentare:<\/em><\/p>\n\n\n\n<ol><li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK216084\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK216084\/<\/a><\/li><li><a href=\"https:\/\/www.nytimes.com\/2025\/07\/01\/health\/lucian-leape-dead.html?searchResultPosition=14\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.nytimes.com\/2025\/07\/01\/health\/lucian-leape-dead.html?searchResultPosition=14<\/a><\/li><li><a href=\"https:\/\/www.researchgate.net\/publication\/351953688_Making_Healthcare_Safe_The_Story_of_the_Patient_Safety_Movement\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.researchgate.net\/publication\/351953688_Making_Healthcare_Safe_The_Story_of_the_Patient_Safety_Movement<\/a><\/li><li><a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/patient-safety\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/patient-safety<\/a><\/li><li><a href=\"https:\/\/www.england.nhs.uk\/patient-safety\/patient-safety-improvement-programmes\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.england.nhs.uk\/patient-safety\/patient-safety-improvement-programmes\/<\/a><\/li><li><a href=\"https:\/\/vitalacy.ai\/6-qualities-of-an-effective-patient-safety-program\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/vitalacy.ai\/6-qualities-of-an-effective-patient-safety-program\/<\/a><\/li><li>Sursa foto: <a href=\"https:\/\/www.holidayscalendar.com\/event\/world-patient-safety-day\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.holidayscalendar.com\/event\/world-patient-safety-day\/<\/a><\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Timp aproximativ de lectur\u0103: 6 minute \u00cen 2018, au fost publicate trei rapoarte importante privind defectele de calitate \u00een asisten\u021ba medical\u0103 global\u0103: &#8222;Dep\u0103\u0219irea decalajului global \u00een privin\u021ba calit\u0103\u021bii \u00eengrijirilor medicale&#8221; &#8211; din partea Academiilor Na\u021bionale de \u0218tiin\u021be, Inginerie \u0219i Medicin\u0103 din SUA \u201dSistemele de s\u0103n\u0103tate de \u00eenalt\u0103 calitate \u00een era Obiectivelor de Dezvoltare Durabil\u0103\u201d \u00a0&#8211; [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":9396,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,13],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/9410"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9410"}],"version-history":[{"count":1,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/9410\/revisions"}],"predecessor-version":[{"id":9411,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/9410\/revisions\/9411"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/9396"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9410"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9410"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9410"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}