Cultura de segurança na percepção dos profissionais de saúde de hospitais públicos

Autores

DOI:

https://doi.org/10.11606/s1518-8787.2021055002838

Palavras-chave:

Segurança do Paciente, Gestão da Segurança, organização & administração, Equipe de Assistência ao Paciente, Conhecimentos, Atitudes e Prática em Saúde, Avaliação de Programas e Projetos de Saúde

Resumo

OBJETIVO Avaliar a cultura de segurança na percepção dos profissionais que trabalham nos hospitais públicos do Sistema Único de Saúde (SUS) do Distrito Federal, Brasil, três anos após a implantação do Programa Nacional de Segurança do Paciente (PNSP). MÉTODOS estudo transversal analítico realizado em onze hospitais públicos por meio do Safety Attitudes Questionnaire em formato eletrônico. A amostragem estratificada foi calculada, obedecendo à proporção do total de profissionais em cada hospital, assim como a representatividade de cada grupo profissional. Os resultados do escore total e dos domínios iguais ou maiores que 75 foram considerados positivos. Realizadas análises descritivas e inferenciais dos grupos profissionais e dos hospitais. RESULTADOS Participaram 909 profissionais. O escore total por grupo profissional foi negativo (62,5 a 69,5) e por domínio diferiram estatisticamente entre si em todos. Os onze hospitais tiveram escore total negativo (61,5 a 68,6). Os domínios com desempenho positivo foram satisfação no trabalho, percepção do estresse e clima de trabalho em equipe. Os resultados mais baixos foram condições de trabalho e percepção da gerência, e nenhum dos hospitais obteve média superior à 75 nesses domínios. Também foram encontradas diferenças nas médias dos domínios entre os hospitais, exceto em percepção da gerência. DISCUSSÃO Após três anos de implantação no PNSP, a cultura de segurança nos onze hospitais avaliados se mostrou fragilizada, embora os domínios satisfação no trabalho, percepção do estresse e clima de trabalho em equipe tiveram resultados positivos. Os resultados podem contribuir para a tomada de decisão dos gestores, pois a cultura de segurança é um elemento essencial na implementação da política de segurança do paciente.

Referências

Ministry of Health (BR); Oswaldo Cruz Foundation; National Health Surveillance Agency. Reference Document for the National Patient Safety Program. Brasília, DF: MS; 2014 [cited 2019 Oct 19]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/documento_referencia_programa_nacional _seguranca.pdf [ Links ]

Bezerra ALQ, Silva AEBC, Branquinho NCSS, Paranaguá TTB. Analysis of technical complaints and adverse events reported in a sentinel hospital. Rev Enferm UERJ. 2009;17(18):467-72. [cited 2019 Oct 19] 17(4):467-72. Available from: https://repositorio.bc.ufg.br/bitstream/ri/15900/5/Artigo%20-%20Ana%20L%c3%bacia%20Queiroz%20Bezerra%20-%202009.pdf [ Links ]

Flin R, Burns C, Mearns K, Yule S, Robertson EM. Measuring safety climate in health care.Which Saf Health Care. 2006;15(2):109-15. https://doi.org/10.1136/qshc.2005.014761 [ Links ]

Nieva V, Sorra J. Safety culture assessment: a tool for improving patient safety in healthcare organizations. Qual Saf Health Care. 2003;12 Suppl 2:ii17-ii23. https://doi.org/10.1136/qhc.12.suppl_2.ii17 [ Links ]

Halligan M, Zecevic A. Safety culture in healthcare: a review of concepts. dimensions, measures and progress. Qual Saf Health Care. 2011;20(4):338-43. https://doi.org/10.1136/bmjqs.2010.040964 [ Links ]

World Health Organization. Conceptual framework for the International Classification for Patient Safety: final technical report. Version 1.1. Geneva (CH): WHO; 2009 [cited 2019 Oct 19]. Available from: https://www.who.int/patientsafety/taxonomy/icps_full_report.pdf [ Links ]

Contandriopoulos AP, Rey L, Brousselle A, Champagne F. Évaluer une intervention complexe: enjeux conceptuels, méthodologiques, et opérationnels. Can J Program Eval. 2011 [cited 2019 Dec 10];26(3):1-16. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900871/pdf/nihms2584.pdf [ Links ]

Carvalho REFL, Cassiani SHB. Cross-cultural adaptation of the Safety Attitudes Questionnaire - Short Form 2006 for Brazil. Rev Lat Am Enfermagem. 2012;20(3):575-82. https://doi.org/10.1590/S0104-11692012000300020 [ Links ]

Carvalho REFL, Arruda LP, Nascimento NKP, Sampaio RL, Cavalcante MLSN, Costa ACP. Assessment of the culture of safety in public hospitals in Brazil. Rev Lat Am Enfermagem. 2017;25:e2849. https://doi.org/10.1590/1518-8345.1600.2849 [ Links ]

Oliveira ICL, Cavalcante MLSN, Aires SF, Freitas RJM, Silva BV, Marinho DMF, et al. Safety culture: perception of health professionals in a mental hospital. Rev Bras Enferm. 2018;71 Supl 5:2316-22. https://doi.org/10.1590/0034-7167-2018-0125 [ Links ]

Luiz RB, Simões ALA, Barichello E, Barbosa MH. Factors associated with the patient safety climate at a teaching hospital. Rev Lat Am Enfermagem. 2015;23(5):880-7. https://doi.org/10.1590/0104-1169.0059.2627 [ Links ]

Rigobello MCG, Carvalho REFL, Guerreiro JM, Motta APG, Atila E, Gimenes FRE. The perception of the patient safety climate by professionals of the emergency department.Int Emerg Nurs. 2017;33:1-6. https://doi.org/10.1016/j.ienj.2017.03.003 [ Links ]

Göras C, Unbeck M, Nilsson U, Ehrenberg A. Interprofessional team assessments of the patient safety climate in Swedish operating rooms: a cross-sectional survey. BMJ Open. 2017;7(9):e015607. https://doi.org/10.1136/bmjopen-2016-015607 [ Links ]

Chaboyer W, Chamberlain D, Hewson-Conroy K, Grealy B, Elderkin T, Brittin M, et al. CNE article: safety culture in Australian intensive care units: establishing a baseline for quality improvement. Am J Crit Care. 2013;22(2):93-102. https://doi.org/10.4037/ajcc2013722 [ Links ]

Berry JC, Davis JT, Bartman T, Hafer CC, Lieb LM, Khan N, et al. Improved safety culture and teamwork climate are associated with decreases in patient harm and hospital mortality across a hospital system. J Patient Saf. 2020;16(2):130-6. https://doi.org/10.1097/PTS.0000000000000251 [ Links ]

Huang CH, Wu HH, Lee YC. The perceptions of patient safety culture: a difference between physicians and nurses in Taiwan. Appl Nurs Res. 2018;40:39-44. https://doi.org/10.1016/j.apnr.2017.12.010 [ Links ]

Smiley K, Ofori L, Spangler C, Acquaah-Arhin R, Deh D, Enos J, et al. Safety culture and perioperative quality at the Volta River Authority Hospital in Akosombo, Ghana. World J Surg. 2019;43(1):16-23. https://doi.org/10.1007/s00268-018-4763-y [ Links ]

Abu-El-Noor NI, Hamdan MA, Abu-El-Noor MK, Radwan AKS, Alshaer AA. Safety culture in neonatal intensive care units in the Gaza Strip, Palestine: a need for policy change. J Pediatr Nurs. 2017;33:76-82. https://doi.org/10.1016/j.pedn.2016.12.016 [ Links ]

Buljac-Samardzic M, Wijngaarden JD, Dekker-van Doorn CM. Safety culture in long-term care: a cross-sectional analysis of the Safety Attitudes Questionnaire in nursing and residential homes in the Netherlands. BMJ Qual Saf. 2016;25(6):424-31. https://doi.org/10.1136/bmjqs-2014-003397 [ Links ]

Odell DD, Quinn CM, Matulewicz RS, Johnson J, Engelhardt KE, Stulberg JJ, et al. Association between hospital safety culture and surgical outcomes in a statewide surgical quality improvement collaborative. J Am Coll Surg. 2019;229(2):175-83. https://doi.org/10.1016/j.jamcollsurg.2019.02.046 [ Links ]

Olsson C, Forsberg A, Bjerså K. Safety climate and readiness for implementation of evidence and person centered practice: a national study of registered nurses in general surgical care at Swedish university hospitals. BMC Nurs. 2016;15:54. https://doi.org/10.1186/s12912-016-0174-2 [ Links ]

Dunstan E, Coyer F. Safety culture in two metropolitan Australian tertiary hospital intensive care units: a cross-sectional survey. Aust Crit Care. 2020;33(1):4-11. https://doi.org/10.1016/j.aucc.2018.11.069 [ Links ]

Yu B, Wen CF, Lo HL, Liao HH, Wang PC. Improvements in patient safety culture: a national Taiwanese survey, 2009-16. Int J Qual Health Care. 2020;32(1):A9-A17. https://doi.org/10.1093/intqhc/mzz099 [ Links ]

Daedot P, Laval C. Común. Barcelona (ES): Gedisa; 2015. p.549 [ Links ]

Soh SE, Morello R, Rifat S, Brand C, Barker A. Nurse perceptions of safety climate in Australian acute hospitals: a cross-sectional survey. Aust Health Rev. 2018;42(2):203-9. https://doi.org/10.1071/AH16172 [ Links ]

Lee YC, Wu HH, Hsieh WL, Weng SJ, Hsieh LP, Huang CH. Applying importance-performance analysis to patient safety culture. Int J Health Care Qual Assur. 2015;28(8):826-40. https://doi.org/10.1108/IJHCQA-03-2015-0039 [ Links ]

Lee YC, Zeng PS, Huang CH, Wu HH. Causal relationship analysis of the patient safety culture based on safety attitudes questionnaire in Taiwan. J Healthc Eng. 2018;2018;4268781 https://doi.org/10.1155/2018/4268781 [ Links ]

Klemenc-Ketis Z, Deilkås ET, Hofoss D, Bondevik GT. Variations in patient safety climate and perceived quality of collaboration between professions in out-of-hours care. J Multidiscip Healthc. 2017;10:417‐23. https://doi.org/10.2147/JMDH.S149011 [ Links ]

Profit J, Sharek PJ, Cui X, Nisbet CC, Thomas EJ, Tawfik DS, et al. The correlation between neonatal intensive care unit safety culture and quality of care. J Patient Saf. 2018;16(4):e310-6 https://doi.org/10.1097/PTS.0000000000000546 [ Links ]

Sammer CE, Lykens K, Singh KP, Mains DA, Lackan NA. What is patient safety culture? A review of the literature. J Nurs Scholarsh. 2010;42(2):156-65. https://doi.org/10.1111/j.1547-5069.2009.01330.x [ Links ]

Publicado

2021-09-03

Edição

Seção

Artigos Originais

Como Citar

Carvalho, P. A., Amorim, F. F., Casulari, L. A., & Gottems, L. B. D. (2021). Cultura de segurança na percepção dos profissionais de saúde de hospitais públicos. Revista De Saúde Pública, 55, 56. https://doi.org/10.11606/s1518-8787.2021055002838