title: [Security of the medicinal therapy: Cartography of risks a priori within service of orthopaedic surgery].
abstract: BACKGROUND
  Security and quality of the Medicinal Therapy are one of the most important objectives of the April 6th, 2011 order. The objective is to realize this study of the risks incurred by patients related to management and security of medicinal therapy in order to establish a plan to reduce the risks of drug's dispensation.
  
  
  METHODS
  The method of the Preliminary Risk Analysis (PRA) has been implemented by a multidisciplinary group in a hospital service of orthopaedic surgery. The study focused on the dispensation phase of medicinal circuit.
  
  
  RESULTS
  This analysis revealed 148 scenarii, 35 were criticality unacceptable. Fifty-four initial risk control actions were proposed and their stress levels to put them in place were evaluated.
  
  
  CONCLUSIONS
  The main measures of risk management are: training, information, communication, computerization, automation, dual control, updating the documentation system, drug reconciliation and respect for Best Practices Hospitallers (BPH).
  
  
  CONCLUSIONS
  Risk management requires a significant human and financial investment as well as, material resources and multidisciplinary expertise in order to offer the best solutions.
authors.affiliation: Pharmacie, Ambroise-Paré AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France. Electronic address: anais.razurel@lrb.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Razurel
authors.affiliation: Qualité et gestion des risques, Ambroise-Paré AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France.
authors.forename: É
authors.initials: É
authors.lastname: Bertrand
authors.affiliation: Chirurgie orthopédique, Ambroise-Paré AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Deranlot
authors.affiliation: Chirurgie orthopédique, Ambroise-Paré AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Benhamou
authors.affiliation: Pharmacie, Ambroise-Paré AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France.
authors.forename: T
authors.initials: T
authors.lastname: Tritz
authors.affiliation: Pharmacie, Ambroise-Paré AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Le Mercier
authors.affiliation: Chirurgie orthopédique, Ambroise-Paré AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Hardy
mesh_terms: D003199:Computer Systems; D004358:Drug Therapy / Q000592:standards*; D006761:Hospitals / Q000592:standards; D006801:Humans; D019637:Orthopedic Procedures / Q000592:standards*; D009985:Orthopedics / Q000458:organization & administration / Q000592:standards*; D012308:Risk Management / Q000379:methods*
keywords: Analyse de système; April 6th 2011 order; Arrêté 6 avril 2011; Gestion des risques; Management and security of medicinal therapy; Prise en charge médicamenteuse; Risk analysis study; Risk management; Security; Sécurité