violence ; to improve their mental health ; to protect them from physical and biological hazards ; to advance national programs for healthcare worker safety , and to connect healthcare worker safety policies to existing patient safety policies .
WHO ( 2020 ) says that data indicate COVID-19 infections among healthcare workers are far greater than those in the general population : “ While health workers represent less than 3 percent of the population in the large majority of countries and less than 2 percent in almost all low- and middle-income countries , around 14 percent of COVID-19 cases reported to WHO are among healthcare workers . In some countries , the proportion can be as high as 35 percent . However , data availability and quality are limited , and it is not possible to establish whether health workers were infected in the workplace 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 healthcare professionals found 1 in 4 reported depression and anxiety , and 1 in 3 suffered insomnia during COVID-19 .”
The WHO ’ s Health Worker Safety Charter outlines the following action steps :
➊ Establish synergies between healthcare worker safety and patient safety policies and strategies :
● Develop linkages between occupational health and safety , patient safety , quality improvement , and infection prevention and control programs .
● Include health and safety skills in personal and patient safety into education and training programs for health workers at all levels .
● Incorporate requirements for health worker and patient safety in healthcare 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 programs for occupational health and safety of health workers :
➋ Develop and implement national programs 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
➌ 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 labor 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 wellbeing
➍ 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 healthcare 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 .
➎ 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 healthcare 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 healthcare 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 licensed 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 .
Personal protective equipment ( PPE ) is one of the most critical weapons against SARS-CoV-2 in the healthcare worker ’ s arsenal against infection , although studies have shown that HCP use of protective barriers is generally suboptimal .
Although it came early in the pandemic , a Cochrane Review by Verbeek , et al . ( 2020 ) summarized the state of the evidence