Position Statements 2002 [Patient Safety]

Patient Safety

ICN Position:

Patient safety is fundamental to quality health and nursing care. ICN believes that the enhancement of patient safety involves a wide range of actions in the recruitment, training and retention of health care professionals, performance improvement, environmental safety and risk management, including infection control, safe use of medicines, equipment safety, safe clinical practice, safe environment of care, and accumulating an integrated body of scientific knowledge focused on patient safety and the infrastructure to support its development.

Nurses address patient safety in all aspects of care. This includes informing patients and others about risk and risk reduction, advocating for patient safety and reporting adverse events.

Early identification of risk is key to preventing patient injuries, and depends on maintaining a culture of trust, honesty, integrity, and open communication among patients and providers in the health care system. ICN strongly supports a system-wide approach, based on a philosophy of transparency and reporting - not on blaming and shaming the individual care provider – and incorporating measures that address human and system factors in adverse events.

ICN is deeply concerned about the serious threat to the safety of patients and quality of health care resulting from insufficient numbers of appropriately trained human resources. The current global nursing shortage represents such a threat.

ICN believes nurses and national nurses associations have a responsibility to:

Inform patients and families of potential risks.
Report adverse events to the appropriate authorities promptly.
Take an active role in assessing the safety and quality of care.
Improve communication with patients and other healthcare professionals.
Lobby for adequate staffing levels.
Support measures that improve patient safety.
Promote rigorous infection control programmes.
Lobby for standardised treatment policies and protocols that minimise errors.
Liase with the professional bodies representing pharmacists, physicians and others to improve packaging and labelling of medications.
Collaborate with national reporting systems to record, analyse and learn from adverse events.
Develop mechanisms, for example through accreditation, to recognize the characteristics of health care providers that offer a benchmark for excellence in patient safety.

Background

While health care interventions are intended to benefit the public, there is an element of risk that errors and adverse events will occur due to the complex combination of processes, technologies and human factors related to health care. An adverse event can be defined as harm or injury caused by the management of a patient’s disease or condition by health care professionals rather than by the underlying disease or condition itself.[1] Common threats to patient safety include medication errors, hospital acquired infections, exposure to high doses of radiation and use of counterfeit medicines.

Although human errors play a role in serious adverse events, there are usually inherent system factors, which if addressed properly would have prevented the errors.

There is a growing evidence that inadequate institutional staffing levels are correlated with increase in adverse events such as patient falls, bed sores, medication errors, nosocomial infections and readmission rates that can lead to longer hospital stays and increased hospital mortality rates. [2] Staff shortages and poor performance of personnel because of low motivation or insufficient technical skills are also important determinants of patient safety.

Poor quality health care causes substantial number of adverse events with serious financial impact on health care expenditures.

Adopted in 2002

Related ICN Position Statements:

Protection of the title “nurse”
Nursing regulation
Scope of nursing practice
Assistive or supportive nursing personnel.

ICN Publications:

Patient Safety, WHPA, Fact Sheet (2001).

[1] Thomas, E.J; & Brennan, BMJ, Incidence and types of preventable adverse events in elderly patients: population based review of medical records. 18 March 2000. p.9.

[2] Aiken, l.H. et al. Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. JAMA (2002); 288: 1987-1993.