Drug error: laws and experience in France

Abstract

Drug error is the omission or the non-intentional realization of an act during the drug process that may harm the patient. The error may be confirmed, potential or latent. Drug errors are the most frequent among medical errors. Age (older and younger patients) and co-morbidities are the commonly reported risk factors for drug errors. Two recent French laws regarding the management of drug errors in the hospital are presented. The hospital, patient, health, territory (HPST) law (July 2009) assigns the management of quality and safety of health care to hospitals. The law focusing on the quality of drug management in hospitals (April 2011) recommends to set up a quality management system in each hospital to ensure the quality and security of drug use. In addition, a national evaluation of drug errors has been organized, allowing a direct intervention of national health authorities to modify drug presentation and labeling, if required. Two examples of drug error management processes, one in a university hospital and the other in an intensive care unit, are presented. Multidisciplinary management, absence of informant sanction, and collection of anonymous data are the reasons for the success of those systems. If a drug error is related to practices, then analysis and improvement of practices by local management are mandatory. Participation of all health professionals involved in the drug process as well as a strong commitment of hospital staff are the two essential conditions to make the drug error management process successful.