The
World Health Organization (WHO) is calling on governments and health care
leaders to address persistent threats to the health and safety of health
workers and patients.
“The
COVID-19 pandemic has reminded all of us of the vital role health workers play to
relieve suffering and save lives,” said Dr Tedros Adhanom Ghebreyesus, WHO
Director-General. “No country, hospital or clinic can keep its patients safe
unless it keeps its health workers safe. WHO’s Health Worker Safety Charter is
a step towards ensuring that health workers have the safe working conditions,
the training, the pay and the respect they deserve.”
The pandemic has also highlighted the extent to which protecting health workers is key to ensuring a functioning health system and a functioning society.
The Charter, released today for World Patient Safety Day, calls on governments and those running health services at local levels to take five actions to better protect health workers. These include steps to protect health workers from violence; to improve their mental health; to protect them from physical and biological hazards; to advance national programmes for health worker safety, and to connect health worker safety policies to existing patient safety policies.
Mounting reports of infections, illness and attacks among health workers fighting COVID-19
COVID-19 has exposed health workers and their families to unprecedented levels of risk. Although not representative, data from many countries across WHO regions indicate that COVID-19 infections among health workers are far greater than those in the general population.
While
health workers represent less than 3% of the population in the large majority
of countries and less than 2% in almost all low- and middle-income countries,
around 14% of COVID-19 cases reported to WHO are among health workers. In some
countries, the proportion can be as high as 35%. However, data availability and quality are
limited, and it is not possible to establish whether health workers were
infected in the work place or in community settings. Thousands of health
workers infected with COVID-19 have lost their lives worldwide.
In
addition to physical risks, the pandemic has placed extraordinary levels of
psychological stress on health workers exposed to high-demand settings for long
hours, living in constant fear of disease exposure while separated from family
and facing social stigmatization. Before COVID-19 hit, medical professionals
were already at higher risk of suicide in all parts of the world. A recent
review of health care professionals found one in four reported depression and
anxiety, and one in three suffered insomnia during COVID-19[1]. WHO recently highlighted an alarming rise in
reports of verbal harassment, discrimination and physical violence among health
workers in the wake of COVID-19.
5 steps to improve health worker safety and patient safety
On
World Patient Safety Day, WHO reminds governments that they have a legal and
moral responsibility to ensure the health, safety and wellbeing of health
workers. The Organization’s health worker charter calls on all Member States and relevant
stakeholders to take steps to:
·
Include health and
safety skills in personal and patient safety into education and training
programmes for health workers at all levels.
·
Incorporate requirements
for health worker and patient safety in health care licensing and accreditation
standards.
·
Integrate staff safety
and patient safety incident reporting and learning systems.
·
Develop integrated
metrics of patient safety, health worker safety and quality of care indicators,
and integrate with health information system.
Develop and implement national programmes for occupational health and safety of health workers:
·
Develop and implement
national programmes for occupational health for health workers in line with
national occupational health and safety policies.
·
Review and upgrade,
where necessary, national regulations and laws for occupational health and
safety to ensure that all health workers have regulatory protection of their
health and safety at work.
·
Appoint responsible
officers with authority for occupational health and safety for health workers
at both the national and facility levels.
·
Develop standards,
guidelines, and codes of practice on occupational health and safety.
·
Strengthen intersectoral
collaboration on health worker and patient safety, with appropriate worker and
management representation, including gender, diversity and all occupational
groups.
Protect health workers from violence in the workplace
·
Adopt and implement in
accordance with national law, relevant policies and mechanisms to prevent and
eliminate violence in the health sector.
·
Promote a culture of
zero tolerance to violence against health workers
·
Review labour laws and
other legislation, and where appropriate the introduction of specific
legislation, to prevent violence against health workers.
·
Ensure that policies and
regulations are implemented effectively to prevent violence and protect health
workers.
·
Establish relevant
implementation mechanisms, such ombudspersons and helplines to enable free and
confidential reporting and support for any health worker facing violence.
Improve mental health and psychological well-being
·
Establish policies to
ensure appropriate and fair duration of deployments, working hours, rest break
and minimizing the administrative burden on health workers.
·
Define and maintain
appropriate safe staffing levels within health care facilities.
·
Provide insurance
coverage for work-related risk, especially those working in high-risk areas.
·
Establish a ‘blame-free’
and just working culture through open communication and including legal and
administrative protection from punitive action on reporting adverse safety
events.
·
Provide access to mental
well-being and social support services for health workers, including advice on
work-life balance and risk assessment and mitigation.
Protect health workers from physical and biological hazards
·
Ensure the
implementation of minimum patient safety, infection prevention and control, and
occupational safety standards in all health care facilities across the health
system.
·
Ensure availability of
personal protective equipment (PPE) at all times, as relevant to the roles and
tasks performed, in adequate quantity and appropriate fit and of acceptable
quality. Ensure an adequate, locally held, buffer stock of PPE. Ensure adequate
training on the appropriate use of PPE and safety precautions.
·
Ensure adequate
environmental services such as water, sanitation and hygiene, disinfection and
adequate ventilation at all health care facilities.
·
Ensure vaccination of
all health workers at risk against all vaccine-preventable infections,
including Hepatitis B and seasonal influenza, in accordance with the national immunization
policy, and in the context of emergency response, priority access for health
workers to newly licenced and available vaccines.
·
Provide adequate
resources to prevent health workers from injuries, and harmful exposure to
chemicals and radiations; provide functioning and ergonomically designed
equipment and work stations to minimize musculoskeletal injuries and falls.
In
addition to the Health Worker Safety Charter, WHO has also outlined specific
World Patient Safety Day 2020 Goals for health care leaders to invest in,
measure, and improve health worker safety over the next year. The goals are
intended for health care facilities to address five areas: preventing sharps injuries; reducing
work-related stress and burnout; improving the use of personal protective
equipment; promoting zero tolerance to violence against health workers, and
reporting and analyzing serious safety related incidents.
Credit:WHO