Patient safety in low-income countries

The concept of ‘first do no harm’ is taught to every medical and nursing student. This phrase means that, as professionals, our first duty is to make sure that patients are not harmed as a result of their care. Unfortunately, we know that many patients are harmed when receiving medical care. The World Health Organization (WHO) estimates that up to 10% of patients in high-income countries are harmed in such ‘adverse events’ or ‘critical incidents’ – events or incidents that caused harm to patients and could have been avoided.1 There are many costs associated with harm – costs to the patient in pain, discomfort or distress, financial costs to the patient (e.g. through increased visits to the hospital) and financial costs to the health care system, with patients staying in hospital longer and/or requiring more –and different – treatments. There is also the emergence of legal costs as increasing numbers of patients are suing the hospital or clinician following a critical incident. The large numbers of patients harmed and the resultant costs make a focus on patient safety incredibly important. There are two ways of approaching patient safety: