PHA-Exch> WORLD HEALTH ORGANIZATION AND PARTNERS CALL FOR INTENSIFIED RESEARCH TO IMPROVE PATIENT SAFETY

[Claudio Schuftan]

From: Vern Weitzel <vern at coombs.anu.edu.au>
From:   Judy Ladinsky jlladins at wisc.edu

WORLD HEALTH ORGANIZATION AND PARTNERS CALL FOR INTENSIFIED RESEARCH
TO IMPROVE PATIENT SAFETY

*Porto, Portugal/Geneva -* Today, the World Health Organization (WHO)
and its partners called for increased research to improve patient
safety at a major international conference in Porto, Portugal. The
conference,/ Patient safety research:  shaping the European agenda/
will examine evidence showing that harm from medical care poses a
substantial burden in terms of suffering and death in Europe, and
around the world.

WHO estimates that tens of millions of patients worldwide endure
disabling injuries or death each year, directly attributed to unsafe
medical practices and care.  In Europe alone, an average of one in
every ten patients admitted to hospital suffers some form of
preventable harm. However, more research is needed to better
understand the full impact of poor patient safety.

Much of the existing research evidence on the burden of harm in health
care is from developed countries, although some evidence from
developing nations suggests that unsafe care is a major problem.
Research is needed not only on individual health care areas, but also
on the underlying processes and organizational structures that
contribute to unsafe care.

Examples of areas where further research is needed include:

*Health care-associated infection* is estimated to affect some
       1.4 million people at any given time. In developed countries the
       toll is 5% to 10% of patients and in some developing countries,
       as many as a quarter of patients may be affected. With the sharp
       rise of antimicrobial resistance (AMR) in the world, it is key
       that research now focuses on AMR and the spread of multidrug
       resistant pathogens.
*Adverse drug event* research estimates
       shows that between 7% and 10% of patients in acute care settings
       experience an adverse drug event of which some 28-56% are
       preventable. Hospital admissions due to adverse drug reactions
       (ADR) may be more than 10% of the total in some countries. More
       research is needed in this area, focusing on developing
       countries, where it is suggested that rates of adverse drug
       events are even higher than in the developed world.
*Surgery and
       anaesthesia* are among the most complex procedures for health
       systems to deliver and can be among the costliest.  Evidence in
       developed countries indicates that adverse events in the
       operating room account for at least 50% of all adverse events.
       In developing countries, surgical care is constrained by poor
       facilities, lack of trained staff, inadequate technologies and
       limited supply of drugs and materials. Research is needed to
       explore the reasons for geographical differences in the
       incidence of surgical and anaesthesia errors.
*Unsafe injection
       practices* data show that, worldwide, up to 40% of injections
       are given with syringes and needles reused without sterilization
       and in some countries this proportion is as high as 70%. Unsafe
       injection practices cause an estimated 1.3 million deaths each
       year, worldwide, a loss of 26 million years of  life and an
       annual burden of US$535 million in direct medical costs. Future
       research should focus on evaluating the impact of injection
       practices on the burden of diseases transmitted through unsafe
       injections.
*Unsafe blood products.* An estimated 5-15% of HIV
       infections in developing countries are due to unsafe blood
       transfusions. A WHO study showed that about 60 countries were
       not able to screen all donated blood for one or more infections
       including HIV, and other blood-borne infections. Research is
       urgently needed on the broader aspects of blood safety,
       including the effectiveness of blood safety strategies and
       behaviour risk factors among blood donors,  particularly in
       developing countries.
*Adverse medical device events* also
       result in patient harm.  In the United States, more than 1
       million such events occur annually. In some developing countries
       as much as one half of medical equipment is unusable or only
       partly usable. Effective research and surveillance programmes
       are needed to detect types, frequency and clinical settings of
       such events.
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