World Patient Safety Day 2015

World Alliance Patient Safety Day is observed every year on 9^th of December. The purpose of patient safety day is to create awareness on the importance of the safety of the patient in all developing and developed countries around the world. The patient safety day was first initiated by the World Health Organization (WHO) in 2004. From then it has conducted several awareness campaigns to promote the effects of unsafe healthcare practices and the importance of ensuring proper safety to the patient in hospitals.

Patient safety can be defined as the process of eliminating any preventable harm to the patient during the process of healthcare. Patient safety has emerged as a global threat and WHO considers this to be the main cause of increased mortality rates in the world.

According to the WHO estimates, 1 in 10 people dies due to preventable deaths globally. Therefore, this day focuses on creating awareness regarding the factors that contribute to preventable deaths and how to ensure proper patient safety.

Threats to Patient Safety

The main factors that contribute to preventable deaths and impose threat to the safety of patients are the following:

Healthcare-associated Infections (HCAIs): HCAI is considered to be the most harmful cause of deaths around the world. Both the developing and the developed countries have fallen prey to this. It is estimated that in every 100 hospitalized patients, about 7 in developed and 10 in developing countries will acquire health care-associated infections (HCAIs). WHO has launched “Clean Care is Safe Care” and “ Save Lives: Clean Your Hands” in 2005 to emphasize the importance of giving clean treatment and washing hands regularly before and after contact with a patient.

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Medication Errors: Medication errors contribute to a higher mortality and morbidity rates in the world. The main drawback in ensuring proper drug administration is due to the confusion between "look-alike and sound-alike” medications. Doctors and nurses tend to make errors while prescribing medications which can cause harm to the patient’s life.

Surgical Errors: Surgery is the most common and preferred technique for eliminating disabilities and critical injuries. It is estimated that surgeries are done mainly for cardiovascular diseases, cancer and orthopedic injuries. Unsafe surgical practices can lead to fatal errors and significant complications. WHO reports that the crude mortality rate after major surgery is 0.5-5%; it has started the “Safe Surgery Saves Lives” campaign in 2009 to improve the safety of surgical care around the world.

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Diagnostic Errors: The important factor contributing to the interpretation of a disease is diagnosis. Millions of medical devices are available and the chances of committing errors are high. Errors can occur due to faulty devices, misinterpretation, exchange of samples, improper doses, etc.

Unsafe Injection Practices: Reusing syringes and needles contribute to millions of deaths annually. They act as a powerful medium of transmission for diseases like Hepatitis B and Hepatitis C infection and HIV. These indirectly increase the mortality rates.

Unsafe Maternal and Childbirth Care: WHO reports that about 2.6 million in stillbirth, and another 2.7 million in a newborn death occur annually. The majority of these deaths are preventable. Lack of timely care, continuous monitoring and simple errors committed during diagnosis and delivery period contribute to the increased maternal and infant mortality rates.

Unsafe Blood Transfusions: Majority of healthcare providers use central venous catheters (CVC) for giving medicines and fluids to the patients, but the complications associated with it remain unaware. They cause several bloodstream infections resulting in prolonged hospital stay and increased costs of care. About 25 % of patients who acquire CVC die globally.

Lack of Proper Hospital Infrastructure & Manpower: Hospital infrastructure also plays an important role in patient safety. It is must to ensure that hospitals are well equipped with adequate beds, medicines, diagnostic devices, intensive care units, neonatal and maternal care, well-trained healthcare personnel. Lack of any of these factors can increase the rate of preventable deaths.

Improper Communication and Co-Ordination: Ineffective communication and coordination between doctors, nurses and hospital staffs can cause risk to the patient safety. Work stress, longer working hours, lack of holidays can also add stress to their communication resulting in miscommunications, misdiagnosis, prescribing wrong medicines and tests, etc.

Patient Safety Solutions

In 2005, the World Health Organization (WHO) summoned a Center for Patient Safety Solutions. Experts conducted several surveys and established key criteria for reducing healthcare errors to ensure proper patient safety.These include:

Look-Alike, Sound-Alike Medication Names: Confusion regarding drugs with similar generic and brand names can be eliminated by proper labeling. It is must to label drug storage boxes with correct label for easy handling and prescription.

Patient Identification: Ensure correct patient identity by providing identity cards to eliminate testing, medication and discharge errors.

Correct Procedure at Correct Body Site: Surgical procedures must be performed at the correct injured site to eliminate unwanted post-operative complications. Increased foot traffic, ineffective communication inside the operation theaters must be avoided.

Avoiding Catheter and Tubing Mis-Connections: Eliminate use of catheters for blood transfusions to reduce the risk of bloodstream infections. Misplacing catheter and tubing and delivering medications through the wrong route can cause harm to the patient.

Single Use of Injection Devices: Ensure syringes are used for a single shot and immediately thrown off. It is estimated that the reuse rate of injection devices has reduced to 5.5% and the number of injections per person by 2.88% in 2010.

Improved Hand Hygiene to Prevent Health Care-Associated Infections: Infection prevention and control (IPC) has been set up to prevent the harm caused by infection to patients and health workers. Simple and low-cost infection prevention and control measures, such as appropriate hand hygiene can reduce the frequency of health care-associated infections (HAIs) by more than 50%.

WHO reports that prolonged hospitalization, litigation costs, hospital acquired infections, disability and medical expenses cost some countries as much as US$ 19 billion annually. Therefore, the economic benefits of improving patient safety are compelling.

WHO’s Current Plans for Ensuring Patient Safety:

WHO has identified the following as the key technical areas of work for the 2015-2017 period:

• Proper hand hygiene
• Prevention of surgical site infections
• Control of antimicrobial resistance
• Safe injection procedures
• Burden of health care-associated infections
• IPC country capacity-building
• Prevention of catheter-associated bloodstream infections and urinary tract infections

What Must a Patient Do?

• Make sure you know about the standards of care and treatment of the hospitals in your locality. Every hospital will be given a safety score based on the quality of care provided.
• Give proper personal data to the hospital staffs. Ensure you get a personal identity card.
• Inform doctors about your medical history, previous surgeries undergone, allergies, prescribed medications and tests and also about the current medications.
• Ensure the medications and tests provided to you are appropriate. Ask questions if you have any doubt or if you are not sure of any detail about the diagnosis.
• Seek a second opinion on a medical condition without fear.
• Ask the doctor about the pros and cons of any medical procedure and be clear about its side effects.
• Inform hospital staffs if you are pregnant or breastfeeding.
• Ask reasons in case of prolonged hospital stay and also about dietary patterns.
• Inform doctors if you have difficulty breathing, pain, fever, dizziness, vomiting or unexpected reactions
• Ask when you should come back for a check-up

Reference:

http://www.who.int/

Source-Medindia