New ICN position statement highlights safe staffing and health workforce safety as priority areas for patient safety

24 August 2023
Position statement

Highlighting that ”Patient harm from unsafe care is one of the leading causes of death and disability globally and a growing public health challenge”, a new position statement released by the International Council of Nurses (ICN) calls on governments to substantially increase investment and recruitment, development and training and retention of the health workforce, particularly in low- and middle-income countries, as a critical action to reduce patient harm and advance patient safety.

The position statement recognises that it is imperative that patient safety is genuinely at the centre of all our healthcare organisations and systems, which is reflected by a transparent workplace culture that encourages the reporting of concerns about practices and mistakes.

The position statement also “calls on governments to be accountable for delivering needs-based safe nurse staffing by ensuring sufficient funding and establishing legislation and effective human resource planning to ensure an adequate supply of health workers to meet patient and population needs” and urges “governments to sign the Health Worker Safety Charter and take urgent and sustainable action through its key measures.”

Speaking at the World Economic Forum’s Growth Summit: Jobs and Opportunity for All 2023 in May this year, ICN Chief Executive Howard Catton said:

“When we do not have enough educated nurses available, we know that the risks to patients increase. We know that the number of nurses in different countries and different regions is related to mortality. You can see this across all regions. So this is clearly a patient safety issue! But we still seem to have this brick wall that when it comes to talking about investment in our health care systems, we struggle to make investment in the health care workforce.”

A recent article in The Lancet, co-authored by Mr Catton, addressed the impact of the COVID-19 pandemic as a catalyst for accelerating global action on patient safety, and concluded that, “The COVID-19 pandemic has shown the urgency of preventing harm to patients and health workers and ensuring the delivery of safe health care. Global efforts to improve patient safety now need to be strengthened and accelerated.”

ICN has created module on patient safety as part of its new global online learning platform designed to build professional practice knowledge through competency-based education to facilitate advancing the Global Patient Safety Action Plan 2021-2030 and the Global Strategic Directions of Nursing and Midwifery 2021-2025.

ICN’s new position statement on patient safety asserts that “health care worker safety and patient safety are inextricably linked. Violence and abuse, burnout, stress, moral injury, physical illness and stigma experienced by nurses are associated with worsening safety and quality of care. , Creating safe working environments and protecting the mental health of nurses and health workers have extensive positive outcomes, including preventing patient harm, and are essential to delivering quality care. ”

As well as calling for governments to take action to ensure patient safety, the position statement provides action points for national nursing associations and individual nurses, including:

  • contribute to the development of patient safety legislation and ensure its delivery and maintenance;
  • advocate for nurses to be key members of clinical leadership groups that plan, develop and implement national patient safety improvement priorities;
  • advocate for the use of incident reporting systems at all health facilities and for policies and processes that support nurses to report patient safety without detriment or fear of retribution;
  • ensure that standards for undergraduate and postgraduate nursing education curricula include patient safety with an interprofessional team-based approach;
  • collaborate with national patient safety organizations; • support patient and family engagement and empowerment in patient safety;
  • support nurses to participate in establishing, synergizing, and scaling-up patient safety surveillance systems;
  • ensure that patient safety core competencies are part of nursing regulatory standards;
  • advocate for national policies that promote functional multidisciplinary teams, investment in interprofessional learning and governance and funding models that support team-based care; and
  • leverage the policy priorities of the World Health Organization Global Strategic Directions for Nursing and Midwifery to advance patient safety.

Patient Safety Day is celebrated each year on 17 September. This year the theme is “Engaging patients for patient safety", in recognition of the crucial role patients, families and caregivers play in the safety of health care.

ICN’s position statements address a variety of areas related to health, well-being and nursing professional advancement. All position statements can be found here.

International Council of Nurses. ICN Position Statement: Prevention and management of workplace violence [Internet]. Geneva: International Council of Nurses; 2017 [cited 2023 Jun 1]. Available here

World Health Organization. Charter: Health worker safety: A priority for patient safety [Internet]. Geneva: World Health Organization; 2020 Sep 17 [cited 2023 Jun 1].

International Council of Nurses. ICN Position Statement: Occupational health and safety [Internet]. Geneva: International Council of Nurses; 2017 [cited 2023 Jun 1]. Available here