The World Health Organization (WHO) calls on governments and health care leaders to address ongoing threats to the health and safety of healthcare professionals and patients.
“The COVID-19 pandemic has reminded us of the vital role that health professionals play in alleviating suffering and saving lives,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “No state, hospital or clinic can protect their patients if they do not protect health workers. The WHO Healthcare Safety Charter is a step towards ensuring that healthcare workers have the safe working conditions, training, pay and respect they deserve. “
The pandemic also highlighted the extent to which the protection of health workers is key to ensuring a functioning health system and a functioning society.
Charter, published today for World Patient Safety Day, calls on governments and those running health services at the local level to take five actions to better protect health workers. These include steps to protect health workers from violence; improve your mental health; to protect them from physical and biological hazards; improve national health worker safety programs and link health worker safety policies with existing patient safety policies.
Collecting reports of infections, diseases and attacks among health professionals fighting COVID-19
COVID-19 exposed health workers and their families to an unprecedented level of risk. Although not representative, data from many countries across WHO regions show that COVID-19 infections among healthcare workers are far higher than infections in the general population.
Although health workers represent less than 3% of the population in the vast majority of countries and less than 2% in almost all low- and middle-income countries, about 14% of COVID-19 cases reported to the WHO are among health workers. In some countries the share can be up to 35%. However, the availability and quality of data is limited and it is not possible to determine whether health workers are infected in the workplace or in the community environment. Thousands of health workers infected with COVID-19 have lost their lives around the world.
In addition to physical risks, the pandemic has placed an extraordinary level of psychological stress on health workers who have long been exposed to high-demand settings, living in constant fear of exposure to disease while separated from family and facing social stigma. Prior to the COVID-19 strike, medical workers were already at higher risk of suicide in all parts of the world. AND recent review found health workers one in four reported depression and anxiety, and one in three suffered insomnia during COVID-19. WHO recently highlighted an alarming increase in reports of verbal harassment, discrimination, and physical violence among health care workers after COVID-19.
5 steps to improve healthcare worker safety and patient safety
On World Patient Safety Day, the WHO reminds governments that they have a legal and moral responsibility to ensure the health, safety and well-being of healthcare professionals. The Charter of Health Organization calls on all Member States and relevant stakeholders to take steps to:
Establish synergies between health worker safety policy and strategy and patient safety:
- Develop links between health and safety at work, patient safety, quality improvement and infection prevention and control programs.
- Incorporate health and safety skills into personal safety and patient safety in education and training programs for health professionals at all levels.
- Incorporate healthcare and patient safety requirements into healthcare licensing and accreditation standards.
- Integrate incident reporting and learning systems related to staff safety and patient safety.
- Develop integrated measurement data on patient safety, healthcare worker safety and quality of care indicators and integrate with the health information system.
Develop and implement national programs for health and safety at work of health workers:
- Develop and implement national occupational health programs for health workers in accordance with national occupational safety policies.
- Review and upgrade, where necessary, national occupational safety and health regulations to ensure that all healthcare professionals have regulatory protection for their health and safety at work.
- Appoint responsible officials with health and safety at work powers for health workers at both national and institutional levels.
- Develop standards, guidelines and codes of practice on health and safety at work.
- Strengthen cross-sectoral cooperation on health professionals and patient safety, appropriate representation of workers and management, including gender, diversity and all professional groups.
Protect healthcare workers from workplace violence
- Adopt and implement, in accordance with national legislation, relevant policies and mechanisms for the prevention and elimination of violence in the health sector.
- Promote a culture of zero tolerance for violence against health professionals
- Review labor and other laws and, if necessary, introduce special laws to prevent violence against health workers.
- Ensure that policies and regulations are effectively enforced to prevent violence and protect health professionals.
- Establish relevant enforcement mechanisms, such as ombudsmen and helplines, to provide free and confidential reporting and support to any health worker facing violence.
Improve mental health and psychological well-being
Establish policies that will ensure adequate and fair duration of scheduling, working hours, rest, and minimizing the administrative burden for health care workers.
Define and maintain an appropriate level of staff in health facilities.
Provide compensation and insurance for work-related risk, especially for those working in high-risk areas.
Establish a “culture without blame” and fair work through open communication and including legal and administrative protection against criminal acts for reporting harmful security incidents.
Provide access to mental well-being and social support services for health professionals, including advice on work-life balance and risk assessment and mitigation.
Protect healthcare workers from physical and biological hazards
- Ensure the application of minimum patient safety, infection prevention and control and occupational safety standards in all healthcare facilities throughout the healthcare system.
- Ensure the availability of personal protective equipment (PPE) at all times, in accordance with the roles and tasks performed, in the appropriate quantity and appropriate adjustment and acceptable quality. Provide adequate PPE protection at the local level. Provide appropriate training on the proper use of PPE and safety precautions.
- Provide appropriate environmental services such as water, sanitation and hygiene, disinfection and adequate ventilation in all healthcare facilities.
- Ensure vaccination of all healthcare workers at risk of all vaccine-preventable infections, including hepatitis B and seasonal influenza, in accordance with national immunization policy and, in the context of an emergency response, priority access to healthcare professionals to newly licensed and available vaccines.
- Provide adequate resources to prevent injuries to healthcare workers and harmful exposure to chemicals and radiation; provide functional and ergonomically designed equipment and workstations to minimize injuries and falls of the musculoskeletal system.
In addition to the Healthcare Safety Charter, the WHO also highlighted the specific World Patient Safety Day 2020 Goals for healthcare leaders to invest, measure and improve the safety of healthcare professionals over the next year. The goals are intended for health facilities to address five areas: prevention of acute injuries; reduction of work-related stress and burnout; improving the use of personal protective equipment; promoting zero tolerance for violence against health professionals; and reporting and analyzing serious security incidents.
For more information on World Patient Safety Day campaign
 Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, VG, Papoutsi, E., and Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, behavior and immunity, S0889-1591 (20) 30845-X. Advanced online publication. https://doi.org/10.1016/j.bbi.2020.05.026
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