International Patient Safety Goals

1. International Patient
Safety Goals
Dr. Ankit Singh

3. International Patient Safety Goals
• GOAL 1: Identify patients correctly
• GOAL 2: Improve staff communication
• GOAL 3: Use medicines safely
• GOAL 4: Use alarms safely
• GOAL 5: Prevent infection
• GOAL 6: Identify patient safety risks
• GOAL 7: Prevent mistakes in surgery

4. Purpose
• The purpose of the National Patient Safety Goals is to
improve patient safety.
• The goals focus on problems in health care safety and how
to solve them.

5. Goal 1: Identify Patients Correctly
• Use two patient identifiers
• UHID – Unique hospital identification number
• (P202203100923) and patient Name ( Ms. / Mr. xxx )
• Other patient identifications
• IP number – IP20220310182
• Wrist band
• Normal In- patient – Blue with white
• Newborn - Pink with white

6. Wrist band
Wrist Band name Color
Allergy Red
Fall risk Yellow
Latex Allergy Green
Restricted extremity Pink
Vulnerable patient Orange
DNR Purple

7. Triage band – Australasian triage
scale
Priority Category Color
0 Deceased Black
1 Immediate Red
2 Delayed Yellow
3 Minimal Green

8. Importance of patient identification
• To prevent error and patient harm
• Patient identification to be checked in all aspects like
 Admission and Discharge
 Handover
 Shifting and receiving the patient
 All invasive and non – invasive procedure
 Invasive procedure – Any surgery
 Non invasive procedure - NST
 All investigations – Blood investigations, CT, MRI, X-ray

9. Goal 2: Improve staff
communication
• Staff to staff communication – use SBAR method
• S - Situation
• B - Background
• A - Assessment
• R - Recommendation
• This method is used to give handovers and it will give
complete data of patient

10. Critical value intimation
• Use read back policy- Eg: Sodium: 135 mEq/L it should be
repeated by the staff like Sodium : 135 mEq/L with Name and
UHID
• Verbal medication orders and other information received through
phone calls should use a read-back policy for better confirmation
and to prevent error.

11. • Verbal orders should be documented in the case sheet with date,
time and Physician name
• Documentation should be legible and should not overwrite
• Only standard abbreviation should be used – HB (Haemoglobin)
• Do not use any symbols and shortcuts

12. Goal 3: Use medication safely
• Every medications should be labeled
• Use capital letter while writing medications
• Dual check for high- alert medications
• Document drug allergy, ADR and follow up
• Crash cart checklist to be updated and regular check at each shift.

13. • Separate Adult and pediatric crash cart to be maintained
• Use the Tallman method for identifying LASA drugs – Look alike and Sound
alike
• Eg: DOPAmine – DOBUTAmine
• Color coding
• High alert – RED
• Look alike - GREEN
• Sound alike – BLUE
• Emergency drugs - RED

14. • Do not use open medication
• Staff should be aware of medication uses and side effects
• Nursing officer should not prescribe any medications
• Proper documentation for all medications with date, time, and
signature
• Do not use any sample medications

15. • While receiving medication from pharmacy staff should cross check with
prescription order.
• Loaded medication should not store for long time, use as earlier as
possible
• Date of opening and valid date should be mentioned for all multi-load
drug vial
• Multi-load drug vial – maximum 10 pricks and valid for 28 days
• Medication errors to be documented

16. Goal 4: Use alarms safely
• Monitor alarms to be checked regularly about the sound
quality
• Aware of Normal and abnormal sounds
• Maintain a checklist for all monitors

17. Goal 5: Prevent infection
Protocols for prevention of infection

18. HIC : Forms
• Catheter related blood stream infection form
• VAP – Ventilator Associated pneumonia
• UTI – Urinary tract infection form
• Surveillance of surgical site infection

19. • HIC bundles ( VAP, SSI, UTI, CRBSI )
• Quality indicators
• Visiting guidelines for critical care
• Disinfection protocols
• Personal protection equipments
• Proper Biomedical waste segregation

20. Goal 6: Identify patient safety risk
Safety measures
• Grab bars for steps and washrooms
• Side rails for all beds
• Anti skid floor, tiles and mats
• Bed height in low position
• Proper lightening
• Use caution board while mopping
• Remove unwanted equipment from patient area
• Fall risk alert band - Yellow

21. Reduce the risk of fall
• Fall history
• Initial fall risk assessment – Morse fall scale
• Complete observation
• Not leaving patient alone
• Medication history
• Patient using walking aids need complete observation
• Incident form to be documented

22. Goal 7: Prevent mistakes in surgery
• Use WHO surgery safety checklist to prevent error
Sign in – before induction of anesthesia
Time out – Before skin incision
Sign out – before any member of the team leaves the
operating room and before patient leaves the operating room

23. Sign in – before induction of
anesthesia
 Patient identification
 Procedure name
• Informed consent
• NPO status
• Surgical site marking
• Test dose
• Type of Anaesthesia
• Multi Para monitor functioning status
• Drug allergy
• Pre-medication confirmation

24. • Risk of blood loss
• Aspiration risk
• Resuscitation equipment
• Pre – assessment and diagnosis
• Parts preparation
• Use of anticoagulants
• Availability of blood product
• Any specific concern

25. Time out – Before skin incision
• Patient identification
• Procedure name
• Sterilization indicators
• Additional concern
• Counts of sponge and instruments
• Antibiotic prophylaxis
• Introduction of team members by themselves by name and role.
• Confirmation of side of incision

26. • Relevant investigation reports and images
• Equipment and implants checking
• Any specific equipment requirement
• Critical and unexpected steps
• Case duration
• Anticipated blood loss
• Surgical site infection bundle to be undertaken

27. Sign out – before any member of the team
leaves the operating room and before patient
leaves the operating room
• Completion of instruments, sponge, needle, sharps and any
other counts
• Name of procedure done
• Key concern for recovery and management
• Specimen obtained from the patient

28. • Specific post procedure instruction
• Note: The checklist to be completely filled and
signed before patient leaving the OT

29. Thank you