Background and importance In France, since 1994, the responsibility for the health of prisoners has been transferred to the public hospital service.1 The supply of drugs and stock management are thus organised by the hospital, under the responsibility of a pharmacist. Angoulême prison is attached to the Angoulême hospital centre. The last state of play of medication circuit in prison was carried out in 2006. Twenty-five percent of prisons did not have a pharmacist.2 In 2018, Angoulême prison was inspected by the regional health agency. Several dysfunctions concerning drug management were highlighted. No pharmacist and pharmacy technician (PT) were identified to manage the medication circuit, despite the obligation by law.
Aim and objectives The aim of this study was to realise a risk mapping of drug management at the prison in order to implement corrective actions to improve this circuit and meet regulatory requirements.
Material and methods A preliminary risk analysis was chosen to carry out the risk mapping. The working group included a doctor, a pharmacist, a nurse, a PT, a health framework and a manager responsible for risk management.
Results The risk mapping concerned the stages of preparation and delivery of drugs. The initial criticalities of the scenarios were distributed as follows: 46.5% unacceptable (C1), 37.2% tolerable under control (C2) and 16.3% unacceptable (C3). After the implementation of corrective actions, the residual criticalities were distributed as follows: 97.7% C1 criticality and 2.3% C2 criticality. Ten corrective actions were identified by the working group, for example, the computerisation of prescriptions and the over-labelling of non-unit drug blisters.
Conclusion and relevance The preparation step is considered more risky. For the preparation stage 76% of the scenarios were classified as very vulnerable versus 58% for the delivery stage. The realisation of the risk mapping of drug management at prison made it possible to identify the potential dangers. The weekly nominative automated preparation of drugs by the pharmacy represents a major challenge.
References and/or acknowledgements 1. Loi no. 94–43 du 18 janvier 1994 relative à la santé publique et à la protection sociale.
2. Cabelguenne D, et al. Le circuit du médicament en milieu carcéral français: état des lieux et principales recommandations en vue de son optimisation.
Conflict of interest No conflict of interest
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