2. INTRODUCTION
Patient safety is absence of preventable harm to patient during the process
of health care.
The discipline of patient safety is the co-ordinated efforts to prevent harm
to patients, caused by process of health itself.
It is generally agreed upon the meaning of patient safety is
“PLEASE DO NO HARM“
3. WHAT IS SAFETY . . . ?
S – SENSE THE ERROR.
A – ACT TO PREVENT IT.
F – FALLOW SAFETY GUIDELINES.
E – ENQUIRE INTO ACCIDENTS/DEATHS.
T – TAKE APPROPRIATE REMEDIAL MEASUES.
Y – YOUR RESPONSIBILTY.
4. WHY SAFETY IN THE HOSPITALS. . . ?
Hospitals is a peoples intensive place.
Provides services to sick people round the clock 24 hours daily 365 days a
year.
People have a free access to enter any part of the hospital for the purpose of
advice and treatment.
5. INTERNATIONAL PATIENT SAFETY GOALS (IPSG) HELP
ACCREDITED ORGANIZATIONS ADDRESS SPECIFIC
AREAS OF CONCERN IN SOME OF THE MOST
PROBLEMATIC AREAS OF PATIENT SAFETY.
Goal 1: Identify patients correctly
Goal 2: Improve effective communication
Goal 3: Improve the safety of high-alert medications
Goal 4: Ensure correct-site, correct-procedure, correct-patient surgery
Goal 5: Reduce the risk of health care-associated infections
Goal 6: Reduce the risk of patient harm resulting from falls
6. Goal 1
Improve the accuracy of patient identification.
Wrong-patient errors occur in virtually all stages of diagnosis and treatment. The intent for this goal is
two-fold: first, to reliably identify the individual as the person for whom the service or treatment is
intended; second, to match the service or treatment to that individual. Acceptable identifiers may be the
individual’s name, an assigned identification number, telephone number, or other person-specific
identifier.
ELEMENTS
Use at least two patient identifiers when administering medications, blood, or blood components; when
collecting blood samples and other specimens for clinical testing; and when providing treatments or
procedures. The patient's room number or physical location is not used as an identifier.
Label containers used for blood and other specimens in the presence of the patient.
7. Goal 2
Improve the effectiveness of communication among
caregivers.
Critical results of tests and diagnostic procedures fall significantly outside the normal range and may indicate a
life threatening situation. The objective is to provide the responsible licensed caregiver these results within an
established time frame so that the patient can be promptly treated.
ELEMENTS TO PERFORM.
Develop written procedures for managing the critical results of tests and diagnostic procedures that address the
following:
- The definition of critical results of tests and diagnostic procedures
- By whom and to whom critical results of tests and diagnostic procedures are reported
- The acceptable length of time between the availability and reporting of critical results of tests and diagnostic
procedures
Implement the procedures for managing the critical results of tests and diagnostic procedures.
Evaluate the timeliness of reporting the critical results of tests 3. and diagnostic procedures.
8. Goal 3
Improve the safety of using medications.
Label all medications, medication containers, and other solutions on and off the sterile field in perioperative and
other procedural settings.
Note: Medication containers include syringes, medicine cups, and basins.
ELEMENTS OF PERFORMANCE
Medications or other solutions in unlabelled containers are unidentifiable. Errors, sometimes tragic, have
resulted from medications and other solutions removed from their original containers and placed into unlabelled
containers. This unsafe practice neglects basic principles of safe medication management, yet it is routine in
many organizations.
The labelling of all medications, medication containers, and other solutions is a risk-reduction activity consistent
with safe medication management. This practice addresses a recognized risk point in the administration of
medications in perioperative and other procedural settings. Labels for medications and medication containers
are also addressed.
9. Goal 4:
Eliminate Wrong-site, Wrong-patient, Wrong-
procedure Surgery
Wrong-site, wrong-procedure, wrong-patient surgery is an alarmingly common occurrence in hospitals.
These errors are the result of ineffective or inadequate communication between members of the surgical
team, lack of patient involvement in site marking, and lack of procedures for verifying the operative site.
In this situations we has to use a checklist, including a “time-out” just before starting a surgical
procedure, to ensure the correct patient, procedure and body part.
The checklist also addresses the verification process that all documents and equipment needed for
surgery are on hand and correct and functioning properly before surgery begins.
In addition, we has to ensure that the precise site where the surgery will be performed is marked clearly
in advance and the patient is involved in doing this.
10. Goal 5:
Reduce the Risk of Health Care Acquired Infections
Infection prevention and control are challenging in most health care settings, and rising rates of health
care–associated infections are a major concern for patients and health care practitioners.
Infections common to all health care settings include catheter-associated urinary tract infections,
bloodstream infections, and pneumonia (often associated with mechanical ventilation).
Central to the elimination of these and other infections is proper hand hygiene, which is a central part of
everything we do.
Hence the proper hand washing before the procedures is a vital aspect.
12. Goal 6:
Reduce the Risk of Patient Harm Resulting
from fall
Many injuries in hospitals to both inpatients and outpatients are a result of falls.
The risk for falls is related to the patient, the situation, and/or the location.
Risks associated with patients might include patient history of falls, medications use, alcohol
consumption, gait or balance disturbances, visual impairments, altered mental status, and the like.
Patients who have been initially assessed to be at low risk for falls may suddenly become at high risk.
Reasons include, but are not limited to, surgery and/or anaesthesia, sudden changes in patient condition,
and adjustment in medications.
In this type of scenario, patients has to be assessed and periodically reassessed depending on each
patient’s risk for falling, including the potential risk associated with the patient’s medication regimen and
health status, and take action to decrease or eliminate any identified risks.
