Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.

1. Patient and staff safety
management
DR.ANJALATCHI MUTHUKUMARAN
VICE PRINCIPAL
ERA COLLEGE OF NURSING , LUCKNOW-
226003

2. Introduction
• To develop and implement an integrated
system of helping employees in ensuring the
quality of services by:
Identifying
Managing
Reducing hazards and risks of undesirable or
adverse events associated with service
delivery throughout the organization

4. PATIENT SAFETY GOAL

6. PATIENT SAFETY AREAS

7. Safety of female patient
• Male and female patients should not be kept in same ward/
room except ICU.
• Female patients are supposed to be informed the procedure
of the treatment well before the actual treatment takes place.
• During treatment: – Preferably should be treated by female
physician – If, female physician is not there, she should be
accompanied by Female (attendant/ nurse/ patient)
throughout the procedure.
• In female ward, no male staff should be allowed to work
(Nurses, housekeeping).
• During the routine examination by a male Physician, he
should be accompanied by the female nurse, on his round.

8. DAMA
• DAMA, is a very important from patients’ point of view.
• This occurs, if:
– Patient is not satisfied by the presently provided services by the hospital.
– Unwillingness to get admitted and stay in the hospital, even if consulted by
the physician.
– He does not want to get hospitalized.
– He is financially not sound to afford the services.
– His disease might be incurable.
• DAMA, is given under certain protocols designed by the hospital
management; which are as follows:
– He is counseled about the risk factor about his health and mental status.
– He is informed about the potential risk during the transportation from one
end to another.
– A consent form is given to his relatives to take the responsibility of the
patient and risk associated with his transportation and thus health status.

9. Code pink system
• Swapping/theft or missing/ absconding of
patient
• In case a patient goes missing, code pink is
activated in the hospital.
• Psychiatric patients may attempt to run away
from the hospital premises if the security is not
up to the mark.
• In case of theft of any patient, code pink is
activated.

10. Safety of patients’ belongings
• If a patient comes to ‘Casualty,/ Accident and
emergency department, it is the duty of the nurse
attending the patient, to keep the jewellery and his
other personal belongings in a safe place.
• There should be a clear documented policy,
regarding safety of patients’ personal belongings,
hence if unconscious, the sister in charge of the
patient looks after his belongings and keeps them
safe with the security officer.
• Such safety Policy should be conveyed to the
patients and their relatives through notice boards

11. Safety of dead bodies
• • Safety of dead bodies is a very crucial job.
• • They should properly name the dead body and it
should be kept in the mortuary.
• • The mortuary should have a distinct register of the
inward and outward of the dead bodies. It should be
guarded 24*7 by a security personnel.
• • If, the hospital, does not possess a mortuary, it
cannot hold the body for more than 2 hours in its
premises.
• • If the mortuary facility is not provided to the dead
body, Ice bed should be arranged, where the dead
body can be temporarily preserved.

12. Risk management process

13. Five steps of risk management process

14. Risk Identification
• Know the hazards or potential risks.
• Risks when triggered, cause problems.
• Can be internal or external (SOURCE
ANALYSIS).
• Events leading to a problem are investigated
(PROBLEM ANALYSIS)

15. Risk Assessment
• • To assess the potential severity of damage,
loss and recurrence

16. Review and Follow-up
• Incident Reporting System
• Hazards Surveillance Rounds
• Infection Control Surveillance
• Hospital Safety Committee
• Infection Prevention & Control Committee
• Medication Safety
• Audits, focused studies

17. MEASURES TO BE TAKEN BY THE
HOSPITAL AUTHORITY

18. Prevention of accidents
• Prevention of accidents: slip, trip, and fall
• Slipping: slipping on the floor is caused by minor
deficiencies ,fractures or head injury
• Preventive measures:-
• • Non skid flooring, especially in the bath rooms / toilets,
ramps, stairs.
• • Adequate warning sign to warning sign when the floor is
being washed or mopped, to warn the public passing over
the wet surface.
• • Provision of double railing on both sides of the ramps and
stairs.
• • Provision of grab bar on both sides of walls

19. • Preventive measures for tripping and falling
Timely, repairs of all walking surface to make
them smooth.
• Adequate lighting Providing steps without any
‘nosing’ in the stairs.
• Sharp elevation of the floor level outside the
bath room (to prevent bath water overflowing
into the room) can be cause tripping.

20. Safe flooring
• Different areas of hospital require different
types of flooring.
• Infection Preventive Smooth Non Absorbent
Easily Cleanable Scratch Resistant Accident
Preventive
• • Easy To Walk,
• • Non Skid Variety

21. Patient friendly stairs Features
• Stairs- flooring should be hard, level and non
skid type even when wet.
• Nosings- Non protruding type to prevent
tripping of patients due to toes getting caught
while climbing up the stairs.
• Handrails should be extending Beyond first
and last step.

22. Safe , patient friendly stairs
• • Stairs in hospital should have following
features.
• • Risers : 0.15m
• • Treads: 0.32m
• • Flooring: Hard level and nonskid type.
• • Nosing : Non-protruding type, so as to prevent
tripping of the patient.
• • Handrails : At two different level (upper one at
0.9m and lower one at 0.5m) .It should be
extending beyond the first and last steps.

23. PATIENT FRIENDLY RAMPS
• Gradient: Not more than 8.3%
• Landing: 6m
• Flooring: Hard nonskid type minimum 1.6m
wide.
• Hand rails: Two hand rails on each side.
• One at height of 0.9m and other at height of
0.5m for those on wheel chairs

24. Prevention of other accident and falls
• Difficult to keep a track of all people
• Unpredictable tendencies
• Therefore, permanent elimination of such risk: High
railings around terrace Restricted entries to • Terrace
• Water tank areas (Lid to be kept closed) Provision of
fixed grills
• At windows
• Balconies
• stairs All manholes/ opening to sewers and such places
should be closed

25. SAFE PATIENT FRIENDLY TOILETS /
WASHROOMS
• Wash hand basins :
• Working height : 96 cm
• Water source: 106 cm
• Height of the rim: 91 cm
• WASH ROOM: Floor: non skid surface
• Grab bar : At a suitable height for patient sitting on the stool or chair.
• Water temperature : 43.5 for patient’s wash rooms.
• Wash room/ toilet door should be opening outside.
• Disabled friendly facilities
• • Stairs and ramps at the entrance should have rails for convenience of the
handicapped.
• • Wash hand basins : – Height - 80cm – Depth 69 cm
• • Grab bar : on the both side
• • Wash room
• • Chair/stool for the patient
• • Grab bar available
• • Height of mirror for the wheelchair patient :0.9m above the floor

26. Conclusion
• The ultimate goal of patient safety program is
that the medical centre has a safety level that is
sufficient to protect patients from harm and
preventable complication, disability and
mortality during medical management.

27. My Role as an Administrator
• Patient Centered Care Measuring harm
Understanding cause Identifying solutions
Evaluating Impact Translating evidence into
safer care Training Security Staff

29. References
• http://www.nursingworld.org/ojin/Hospital-
Culture-of-Patient-Safety
• Safety in Hospitals, by S.K.Joshi.

30. National patient safety day
• National safety Day 4th March