title: [Security of hospital infusion practices: From an a priori risk analysis to an improvement action plan].
abstract: OBJECTIVE
  Infusion in care units, and all the more in intensive care units, is a complex process which can be the source of many risks for the patient. Under cover of an institutional approach for the improvement of the quality and safety of patient healthcare, a risk mapping infusion practices was performed.
  
  
  METHODS
  The analysis was focused on intravenous infusion situations in adults, the a priori risk assessment methodology was applied and a multidisciplinary work group established.
  
  
  RESULTS
  Forty-three risks were identified for the infusion process (prescription, preparation and administration). The risks' assessment and the existing means of control showed that 48% of them would have a highly critical patient security impact. Recommendations were developed for 20 risks considered to be most critical, to limit their occurrence and severity, and improve their control level. An institutional action plan was developed and validated in the Drug and Sterile Medical Devices Commission.
  
  
  CONCLUSIONS
  This mapping allowed the realization of an exhaustive inventory of potential risks associated with the infusion. At the end of this work, multidisciplinary groups were set up to work on different themes and regular quarterly meetings were established to follow the progress of various projects. Risk mapping will be performed in pediatric and oncology unit where the risks associated with the handling of toxic products is omnipresent.
authors: Pôle pharmacie, CHU de Clermont-Ferrand, rue Montalembert, 63003 Clermont-Ferrand, France. Electronic address: jpignard@chu-clermontferrand.fr.
authors: J
authors: J
authors: Pignard
authors: Service de réanimation médicale polyvalente, CHU de Clermont-Ferrand, rue Montalembert, 63003 Clermont-Ferrand, France.
authors: S
authors: S
authors: Cosserant
authors: Service d'hygiène, CHU de Clermont-Ferrand, rue Montalembert, 63003 Clermont-Ferrand, France; Direction qualité, gestion des risques et droits des usagers, CHU de Clermont-Ferrand, rue Montalembert, 63003 Clermont-Ferrand, France.
authors: O
authors: O
authors: Traore
authors: Service de réanimation médicale polyvalente, CHU de Clermont-Ferrand, rue Montalembert, 63003 Clermont-Ferrand, France.
authors: B
authors: B
authors: Souweine
authors: Pôle pharmacie, CHU de Clermont-Ferrand, rue Montalembert, 63003 Clermont-Ferrand, France; EA 4676 C-BIOSENSS, Clermont université, université d'Auvergne, BP 10448, 63000 Clermont-Ferrand, France.
authors: V
authors: V
authors: Sautou
mesh_terms: D006801:Humans; D007262:Infusions, Intravenous / Q000592:standards*; D007263:Infusions, Parenteral / Q000592:standards*; D007362:Intensive Care Units / Q000458:organization & administration; D061214:Patient Safety; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D011787:Quality of Health Care; D018570:Risk Assessment
keywords: Cartographie; Infusion; Injectable drug; Injectables; Intensive care unit; Mapping; Perfusion; Reassurance; Risks; Risques; Réanimation; Sécurisation