The Institute of Medicine (IOM) defined safety as “freedom from accidental injury.” Patient safety has multiple definitions:
- Agency for Healthcare Research and Quality (AHRQ) – A discipline in the health care sector that applies safety science methods toward the goal of achieving a trustworthy system of health care delivery. Patient safety is also an attribute of health care systems; it minimizes the incidence and impact of, and maximizes recovery from, adverse events.
- Institute for Healthcare Improvement (IHI) – Making care continually safer by reducing harm and preventable mortality
- National Patient Safety Foundation (NPSF) – Create a world where patients and those who care for them are free from harm
- National Quality Forum (NQF) – The prevention and mitigation of harm caused by errors of omission or commission that are associated with healthcare, and involving the establishment of operational systems and processes that minimize the likelihood of errors and maximize the likelihood of intercepting them when they occur
- World Health Organization (WHO) – The prevention of errors and adverse effects to patients associated with health care.
These definitions are variable, focused on the patient, patient and healthcare workers, an attribute, and a discipline. In addition, there are regulations that provide direction to healthcare staff in order to keep patients safe. But, what is patient safety? Who is responsible? Where does it take place? How do we do it? When do we do it?
Patient safety, in my mind, is essentially keeping the patient free from harm related to hospitalization. This is a very broad statement and does not capture all the complexities of healthcare institutions and the variables of human factors.
Who is responsible? Everyone who works in the healthcare organization is responsible for safety measures. Policies and procedures are written to facilitate regulatory compliance and standardize practices. This includes clinical care departments and non-clinical departments. Each department has policies specific to their workflows that are designed to “keep the patient safe.”
Patient safety should take place throughout the medical facility and not just the patient care areas. Pharmacy is not a designated patient care area; however, maintaining the sterility of intravenous drugs will promote safe patient therapy. Dietary is not a designated patient care area; however, washing hands and maintaining a clean work areas minimizes the microorganisms in the environment.
How do we do it? We follow the standards and best practice such as: hand hygiene; communication in a concise, accurate, and professional manner; safe injection practices; medication reconciliation; and identify the patients correctly. In addition, we clean up spills, large or small; we work as a team and help each other; we pay attention and focus on our work; we take our rest and break periods; and we think, critically.
When do we do this? Physicians take the oath to “do no harm.” I believe that means all of the time. Nurses are the closest healthcare provider to the patient. Nurses are in the hospitals 24/7. Nurses need to be attentive to the needs of his/her assignment and have an awareness of the activities on their assigned unit. What about everyone else? I think all staff needs to be attentive and aware of what is transpiring around them. I believe everyone needs to keep their focus on the patient and commit to consistent practices that reduce the risk of injury to a patient.
What exactly is patient safety? Patient safety is a personal commitment to each and every patient, to our co-workers, and to our self; to do the best possible job, regardless of the scope, maximizing our knowledge, skills, abilities, and compliance in order to minimize the risk to patients.