International Patient Safety Goals (IPSG) were developed in 2006 by Joint Commission International (JCI). It helps accredited organizations address specific areas of concern in some of the most problematic areas of patient safety.

1. INTERNATIONAL
PATIENT SAFETY
GOALS
PRESENTED BY:
MS. MONIKA KANWAR
ASSISTANT PROFESSOR
M.Sc. (N) MENTAL HEALTH NURSING

2. INTRODUCTION
• Patient safety Awareness week takes place this year from 12th – 18th
March, 2023.
• The aim of this weeks was to encourage everyone to learn more about
health care safety.
• The World Health Organization (WHO) define patient safety as “ the
absence of preventable harm to a patient during the process of health
care and reduction of risk of unnecessary harm associated with health
care to an acceptable minimum.

3. CONTD….
• According to World Health Organization (2019), each year, 134
million adverse events occur in hospitals in low and middle income
countries, due to unsafe care, resulting in 2.6 million deaths. They
also note that globally, as many as 4 in 10 patient are harmed in
primary and outpatient health care. Most detrimental errors are related
to diagnosis, prescription and the use of medicines.
• Ensuring patient safety is an ongoing concern for all healthcare
providers as it is a fundamental component to the delivery of safe
high-quality healthcare. However, even with the best of healthcare
and quality systems in place, adverse events can still occur.

4. CONTD….
• The International Patient Safety Goals (IPSGs) detailed in the Joint
Commission International (JCI) Accreditation standards for hospitals,
aim to encourage specific improvements inpatient safety by focusing
on the key problematic areas identified by the Joint Commission on
Accreditation of Healthcare Organizations (JCAHO).
• By focusing on key areas, engraining them in everyday practices and
getting these working more safely, healthcare providers can improve
patient safety and patient outcomes.

5. OBJECTIVES
• To promote specific improvements in patient safety
• Highlight problematic areas in healthcare
• Represent proactive strategies to reduce the risk of medical error.
• Provide clear priorities and solution for improving patient safety
• Describe evidence and expert based consensus solutions to these
problems.

6. VERSIONS
The Joint Commission has updated the IPSGs over time.
2006 Version:
• Identify patients correctly
• Improve effective communication
• Improves the safety of high-alert medications
• Eliminate wrong-site, wrong-patient, wrong-procedure surgery.
• Reduce the risk of health-acquired infections
• Reduce the risk of patient harm from falls.

7. CONTD….
2011 Version:
• IPSG.1 : Identify Patients correctly
• IPSG.2 : Improve Effective Communication
• IPSG.3 : Improve the Safety of High-Alert Medications
• IPSG.4 : Ensure correct-site, correct-procedure, correct-patient
surgery
• IPSG.5 : Reduce the risk of Healthcare-Associated Infections
• IPSG.6 : Reduce the risk of patient Harm resulting fron falls.

8. CONTD….
2017 Version:
• IPSG.1 : Identify Patients correctly
• IPSG.2 : Improve Effective Communication
• IPSG.3 : Improve the Safety of High-Alert Medications
• IPSG.4 : Ensure safe surgery
• IPSG.5 : Reduce the risk of Healthcare-Associated Infections
• IPSG.6 : Reduce the risk of patient Harm resulting from falls.

9. CONTD….
2021 Version:
• IPSG.1 : Improve the accuracy of patient identification
• IPSG.2 : Improve the effectiveness of communication among
caregivers
• IPSG.3 : Improve the Safety of medication administration
• IPSG.4 : Reduce patient harm associated with clinical alarm systems
• IPSG.5 : Reduce the risk of Healthcare-Associated Infections
• IPSG.6 : Better Identify the patient safety risk in the hospital
• IPSG.7 : Better prevent surgical mistakes.

10. IPSG:1
1. Improve the accuracy of patient Identification
• Wrong patient errors are common. It is important to correctly identify
patients throughout every stage of diagnosis and treatment.
• The Joint commission recommends using atleast two patient
identifiers when providing care to the patient.
• Good options are name, Date of birth, phone number or assigned
identification number. This will ensure each patient receives what
they need to get and stay healthy.

11. CONTD….
• Ensuring effective patient identification practices may seem a
cumbersome practice but in actual fact, patient identification errors
can happen in any aspect of patient’s journey and can result in
negative outcomes for patient.
• This is why it is crucial that effective patient identification practices
are part of everyday routine practices.
• “Time out” before starting all the surgical and invasive procedures
(preventing wrong site, wrong procedure, wrong patient surgery)
• In case of Unknown Patients:
- Unknown Male-1, Unknown Male-2, …….
- Unknown Female-1, Unknown Female-2, …….

12. CONTD….
• When to Identify the Patient:
- On Admission
- Before transferring to other unit
- Before administering
medications
- Before withdrawing blood
samples
- Before administering blood and
blood products
- Before doing any procedures
- Befire serving restricted diet.

13. IPSG:2
2. Improve the effectiveness of communication among caregivers
• This IPSG highlights the importance of effective communication
when verbally communicating patient care order, reporting critical
diagnostic results and during handovers of patient care.
• Ensuring the patient data is communicated accurately and understood
by the recipient is critical to reduce errors and improve patient safety.
• To support this, it is recommended that verbal and telephone orders
should be written down when received and read back to the individual
providing the information.

14. CONTD….
• The hospital should have a consistent and complete handover process
for transitions within the hospitals.
• Develop written procedures that specify who needs to communicate
what information and to whom; be sure to address the amount of time
allowed between the time a result is available and its reporting.
• Improve effective communication:
- Read back policy
- Repeat back policy
- Handover (ISBAR)

15. CONTD….
• Read back policy:
Emergency situations where the physician is not physically available at
that moment:
- Telephone orders
- Critical lab values (Panic values)
Write down
Read Back
Confirm

16. CONTD….
• Documentation:
- Telephone orders should be transcribed by the physician within 24
hours.
- Panic values: Document with date, time, critical value, Name of the
person who informed and name of the person who received the call.

17. CONTD….
• Repeat back policy:
- Emergency situations (cardiac arrest)
- Repeat back the orders
Administer Inj. Adrenaline 1 mg IV stat
Just repeat the order for confirmation before administer.

18. CONTD….
• ISBAR:
- I: Identification
- S: Situation
- B: Background
- A: Assessment
- R: Recommendation

19. IPSG:3
3. Improve the Safety of medication administration:
• The objective of this IPSG is to improve patient safety whilst
administering High Alert Medications (HAMs).
• All medications are dangerous when used inappropriately, but High
alert medications have the potential to cause harm that is likely to be
more serious when they are given in error.
• The hospital also needs to have a process in place to minimize
confusion around look-alike/sound-alike (LASA) medications.

20. CONTD….
• Always label all medications, medication containers, and other
solutions. This prevent any mix-ups from occurring which may
ultimately harm the patient.
• Take special care when treating a patient who is using anticoagulation
therapy. Additionally, maintain and communicate accurate patient
information regarding their medications to other staff member, the
patient, and any other caregivers.
• Be sure to compare any new prescriptions with the medications they
are already taking and provide written information about medications
when possible.

21. CONTD….
• High Alert Medications:
Drugs that bear a heightened risk of causing significant patient harm
when they are used in Error.
- A: Adrenaline, Atropine, Adenosine
- P: Potassium and other concentrated electrolytes (calcium gluconate,
magnesium sulphate, sodium bicarbonates)
- I: Insulin
- N: Narcotics and other sedatives
- C: Chemotherapeutic agents
- H: Heparin and other coagulants

22. CONTD….
• LOOK ALIKE SOUND ALIKE (LASA):
LOOK ALIKE:
These are represented in yellow Colour. These are the drugs which
looks similar but have different functions.
- Tablet Avil and Tablet Lasix
- NS 100 ml and Inj. Mannitol

23. CONTD….
SOUND ALIKE:
These are represented in green Colour. These are the drugs which
sounds similar but have different functions.
- Inj. Meropenem and Inj. Imipenem
- Inj. Atropine and Inj. Actrapid
- Tab. Amlodipine and Tab. Nifedipine

24. CONTD….
Improve the safety of high alert medications:
1. Storage:
2. Administration:
3. Documentation:

25. CONTD….
1. Storage:
• High Alert Medicines:
- Keep under lock
- Label with High Alert Sticker (Red colour)
- Auxiliary label indicating the phrase “High Alert, Double Check” and
a caution symbol
- Label the concentrated electrolytes with concentrated electrolyte
sticker.

26. CONTD….
• Look Alike Sound Alike:
- Label with LASA sticker (Look alike drugs are labeled with yellow
colour and sound alike drugs are labeled with green colour)
- Segregate and keep separately (Apart from each other in the same
rack or different rack or shelves marked as LASA).

27. CONTD….
2. Adminitration of High Alert Medications:
- Double checking (Independent double check)
- Infusion pump should be set properly
- Proper dilution
- Proper labelling
- Close monitoring
Documentation.

28. CONTD….
• Things to remember while administering High Alert Medications:
- Written order (Date, Time, Drug name, Dosage, Route, Dilution,
frequency, duration, Name of the doctor who prescribed the drug and
his/her signature)
- Verbal orders are strictly prohibited (Until it’s an emergency situation)
- Indent correctly
- Dispense correctly
- Double independent cross check before administer and document.

29. IPSG:4
4. Reduce patient harm associated with clinical alarm systems:
• What with various alarms used for different patients and different
wards, there are numerous problems that can arise in a given setting.
• In some cases, alarms are too quiet and are easily missed, in other
cases, alarms are so noisy or constant that they are turned out or even
shut off.
• Make whatever improvements necessary to make sure alarms are
heard and responded to.

30. IPSG:5
5. Reduce the risk of Healthcare-Associated Infections:
• Effective infection prevention and control practices are critical to
reducing the spread of health care- associated infections.
• The focus of this IPSG is on hand hygiene and requires the hospital to
adopt and implement an evidence-based hand-hygiene guideline
throughout the hospital to reduce risk of health care-associated
infections (HAIs).
• According to TJC, “One of the most important ways to address HAIs
is by improving the hand hygiene of healthcare staff.

31. CONTD….
• Just washing your hands can make enormous difference in patients
outcomes and in reducing the risk of HAIs.
• Points to remember:
- Hand Hygiene
(Hand rub, Medical Hand wash and Surgical Hand wash)
- Biomedical waste management
- Standard Precautions

32. CONTD….
• Hand Hygiene:
Moments of Hand Hygiene:
1. Before touching a patient
2. Before clean/aseptic
procedures
3. After body fluid exposure
risk
4. After touching a patient
5. After touching patient
surroundings

33. CONTD….
• Hand Hygiene comprises of:
1. Hand rub (20-30 seconds)
2. Medical Hand wash (40-60 seconds)
3. Surgical Hand wash (3-5 minutes)

34. CONTD….
• Steps of Hand rub:

35. CONTD….
• Steps of Hand wash:

36. CONTD….
• Surgical Hand wash:

37. CONTD….
• Biomedical waste management:
1. Black: General waste
2. Red: Infected waste (plastic and rubber)
3. Yellow: Infected waste (Incinerable)
4. Blue: Unbroken glass items
5. Sharp container: Sharps

38. CONTD….

39. CONTD….
• Standard Precautions:
1. Hand Hygiene
2. Use of proper PPE (Cap, Gown, Mask, Goggles, and Gloves)
3. Droplet precautions
4. Airborne precautions
5. Contact precautions
6. Reverse isolation precaution

40. IPSG:6
6. Identify patient safety risk:
• When caring for a patient under any circumstances, mental health
should never be neglected.
• The risk of suicide is one that cannot be taken lightly.
• Always follow policies and procedures addressing the care of patients
identified as a risk for suicide and ensure follow-up care is procured
upon discharge.

41. IPSG:7
7. Prevent mistakes in surgery:
• A mistake in surgery can be catastrophic, leading to lifelong issues for
patients.
• Reduce the risk of surgery by verifying repeatedly that the correct
surgery is being performed on the correct patient’s body.
• TJCs recommends pausing before any surgery to ensure that a mistake
is not made.

42. CONTD….
• Significant patient injury and adverse events can result from wrong-
site, wrong-procedure, and wrong-patient surgery.
• These events can occur from ineffective communication, lack of
processes and lack of patient involvement in the site marking.
• This is an ongoing concern for hospitals. To help minimize these
adverse events from occurring, hospitals should use multiple
strategies when identifying the correct patient, correct procedure and
correct site.