Patient, Surgeon, and Health Care Worker Safety during the COVID-19 Pandemic

Abstract

PATIENT SAFETYT he painting of Pablo Picasso from 1897 entitled ''Ciencia y Caridad'' describes 2 aspects of patient safety very well (Fig. 1). At the center of the tableau is a bedridden patient. The physician measures the pulse while looking gravely and concentratedly at his pocket watch. He represents in the interpretation of Picasso, whose uncle was a physician, the rational and scientific aspects of treatment. The nun looks toward the patient, serves fluid, and takes care of the patient's child. She stands in this painting from the century before last for the emotional and practical aspects of care. Both are important for the safety and wellbeing of our patients. The patient should feel secure and confident by virtue of receiving both empathic and scientifically grounded safe treatment under the maxim ''primum nihil nocere.'' ''Patient safety is a framework of organized activities that creates cultures, processes, procedures, behaviors, technologies, and environment in health care that consistently and sustainably lower risks, reduce the occurrence of avoidable harm, make error less likely, and reduce its impact when it does occur.'' 1 Undoubtedly securing patient safety now requires teamwork, but in the case of surgical treatment patient safety nevertheless remains a paramount issue for the surgeon, who will often have been chosen personally by the patient. 2 The surgeon assumes responsibility for his patient and accompanies him during the pre, intra-and postoperative periodslonger than all other contributing allied disciplines. This results in a special, close, and reciprocal relationship and the patient will ultimately see the surgeon as primarily responsible for the success or failure of the treatment as a whole. Burden of Impaired Patient Safety Before the COVID-19 PandemicMany medical centers, health care systems, national and international organizations have made great efforts to analyses the frequency of adverse medical events and to determine their origins to establish best procedures and guidelines for their prevention. [3][4][5][6][7][8] The central aims of these efforts were firstly to reduce the burden of morbidity and mortality borne by patients and their families and secondly to reduce both the enormous costs of subsequent treatment and litigation, and the wider economic consequences of disability and unemployment.On average 1 in every 10 patients experiences an adverse event while receiving hospital care in high-income countries. 1 The most frequently occurring adverse events are health careassociated infections, venous thromboembolism, adverse drug events, pressure injuries, diagnostic errors, and wrong site surgeries. 3 In high-income countries up to 15% of hospital expenditure is spent on preventable safety failures. 3 The WHO Regional Office for Europe reported in 2019 that >750,000 medical errors resulting in harm occur in Europe each year, including 260,000 incidents resulting in permanent disability and almost 100,000 incidents resulting in death; all of which leads to >3.2 million add...

The Fear of Surgery and Coronavirus in Patients Who Will Undergo a Surgical Intervention

“…The COVID-19 pandemic has had a significant impact on patient safety, particularly in health-care-associated illnesses, i.e., nosocomial infections. 3 COVID-19-related anxiety could influence patients' treatment decisions. 4 Surgical interventions other than emergency surgeries have been postponed.…”

The burden of anxiety, depression, and stress, along with the prevalence of symptoms of PTSD, and perceptions of the drivers of psychological harms, as perceived by doctors and nurses working in ICUs in Nepal during the COVID-19 pandemic; a mixed method evaluation

“…Globally, healthcare professionals (HCPs) and specifically those working in ICU and critical care services, arguably were at the frontline of the healthcare response. These HCPs faced the uncertainty of managing this new condition, extended working hours, limited personal protective equipment (PPE), and an increased risk of infection as they provide essential lifesaving interventions, including intubation and non-invasive respiratory management [ 7 , 8 ].…”

Using artificial intelligence for personal protective equipment guidance for healthcare workers in the COVID-19 pandemic and beyond

“…2,[5][6][7] The pandemic has repeatedly shown health services becoming overwhelmed. 8 The influx of COVID-19 patients, additional to regular patient volumes, highlights a critical need to protect HCWs, thereby maintaining adequate staffing levels for patient care and preventing pathogenic spread. During the current period of widespread Omicron variant transmission, essential HCWs are expected to return to work and may be asymptomatic COVID-19 positive.…”

“…9,10 During the early phase of the COVID-19 pandemic (to May 2020), there were 152,888 HCW infected in 130 countries, with up to 17,000 HCW dying, according to Amnesty International. 8 With more availability and effective use of PPE, COVID-19 morbidity and mortality might have been reduced in major centres, resource-limited and remote areas.…”