**3. Physiotherapy and patient safety**

Physiotherapy is a much more recent profession than either medicine or nursing. Although it has gained widespread acceptance and is increasingly understood, greater efforts are needed to increase awareness of its function and role among the general population and other health care professionals [16, 18–20].

The World Confederation of Physical Therapy (WCPT) is the sole international voice for physiotherapists. Through national member organizations, it represents, regulates, and coordinates both profession and its practitioners, and its mission is to promote high standards of practice, education, and research [21–23]. The WCPT defines physiotherapy as services provided "to develop, maintain and restore maximum movement and functional ability throughout the lifespan", including "services in circumstances, where movement and function are threatened by aging, injury, pain, diseases, disorders, conditions, and/or environmental factors and with the understanding that functional movement is central to what it means to be healthy" [21].

The process of physiotherapy care involves the following stages: examination, evaluation, diagnosis and prognosis, intervention or treatment, re-examination, and discharge. Interventions and treatments include therapeutic exercise; functional training in self-care and home management; functional training in work, community and leisure; manual therapy (including mobilization and manipulation); prescription, application, and, as appropriate, fabrication of devices and equipment (assistive, adaptive, orthotic, protective, supportive, and prosthetic); airway clearance; integumentary repair and protection; electrotherapeutic modalities; physical agents and mechanical modalities; patient-related instruction; and coordination, communication, and documentation [21]. Services also include specialized interventions, such as intravaginal exercises for incontinence and dry needling.

Physiotherapists are autonomous practitioners who manage and treat chronic, subacute, and acute conditions. Direct access to physiotherapy (the ability to consult a regulated physiotherapist without the need for referral) is now an option in some (Australia, The Netherlands, or Canada) countries [20, 24–26]. Enormous advances have been made in professional autonomy and evidence-based practice in physiotherapy [4, 21, 27]. Nonetheless, while evidence-based practice is now widely recognized in this field, awareness of a number of basic bioethical principles that have been fully integrated into other professions, such as medicine or nursing is still lacking in physiotherapy [14, 16, 19, 28, 29].

The practice of physiotherapy involves the application of active and passive techniques, as described above. These techniques are generally viewed as harmless, as they do not result in serious AEs [22]. The perception, however, that standard physiotherapy care causes minimal or no harm favors a culture where errors are not recognized,

*Patient Safety in Physiotherapy: Are Errors that Cause or Could Cause Harm Preventable? DOI: http://dx.doi.org/10.5772/intechopen.107847*

reported, registered, or analyzed for corrective or preventive action. Physiotherapists are increasingly involved in the care of in-hospital patients, particularly intensive care patients and those requiring early rehabilitation after complex surgery [30–32]. Because work of this nature can significantly interfere with the outcomes of physiotherapeutic treatments and result in serious AEs, general awareness of patient safety is increasing in these settings [14, 17]. Like in other health care professions, errors can also occur during the application of increasingly sophisticated technologies. That said the vast majority of physiotherapists work in non-hospital settings and private practices [33]. Private practice work could be a barrier to the development of effective data collection processes and creates a reliance on internal control systems for reporting and recording incidents and notifying the pertinent authorities.

AE reporting, recording, and analysis are the pillars of patient safety systems [9] and must be implemented across all areas of health care, both in and outside hospitals and in the public and private sectors [7].
