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OBJECTIVES: to assess patient safety culture during the COVID-19 pandemic and identify the dimensions that need to be improved in hospital settings and which sector, open or closed, direct or indirect care, exhibits a higher level of safety culture. METHODS: a descriptive and cross-sectional study. The validated version for Brazil of the Hospital Survey on Patient Safety Culture instrument was applied to assess patient safety culture. Those dimensions with 75% positive responses were considered strengthened. RESULTS: all dimensions presented results lower than 75% of positive responses. Closed sectors showed a stronger safety culture compared to open ones. Indirect care sectors had a low general perception of patient safety when compared to direct care sectors. CONCLUSIONS: with the pandemic, points of weakness became even more evident, requiring attention and incisive interventions from the institution's leaders.
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COVID-19 , Pandemias , Seguridad del Paciente , SARS-CoV-2 , Humanos , Estudios Transversales , COVID-19/epidemiología , Brasil/epidemiología , Seguridad del Paciente/normas , Seguridad del Paciente/estadística & datos numéricos , Encuestas y Cuestionarios , Administración de la Seguridad/métodos , Administración de la Seguridad/normas , Hospitales , Cultura OrganizacionalRESUMEN
INTRODUCTION: The concept of safe care permeates health institutions around the world, however, it is necessary to understand the safety culture of an institution to improve the provision of safety to patients and professionals. METHODOLOGY: Cross-sectional study with a quantitative approach. The sample was made up of 119 health professionals who made up the multidisciplinary team at the surgical center from August to September 2021, where data collection took place. The Hospital Survey on Patient Safety Culture (HSOPSC) instrument was used to evaluate the twelve dimensions that make up patient safety culture. Data analysis was carried out using descriptive statistics, to evaluate the reliability of the responses to the HSOPSC instrument, the Cronbachs Alpha test was used. RESULTS: Of the twelve dimensions evaluated, there was no dimension considered strong for patient safety in the unit. The dimensions with potential for patient safety were "Expectations and actions of the supervisor/manager to promote patient safety"; "Teamwork within units" and "Organizational learning - continuous improvement", while all other dimensions were evaluated as weak for patient safety. 39.50% of participants consider patient safety in the unit to be regular, despite this, 89.91% of participants reported not having made any event notifications in the last 12 months. CONCLUSION: The study highlighted the need to strengthen all dimensions of the patient safety culture by the team at the hospital studied, as none of them were identified as strong.
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Quirófanos , Grupo de Atención al Paciente , Seguridad del Paciente , Estudios Transversales , Humanos , Seguridad del Paciente/normas , Grupo de Atención al Paciente/organización & administración , Brasil , Quirófanos/organización & administración , Quirófanos/normas , Masculino , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/normas , Femenino , Administración de la Seguridad/organización & administración , Cultura Organizacional , Adulto , Actitud del Personal de Salud , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To analyze the association between patient safety culture and professional quality of life in nursing professionals. METHOD: Correlational study carried out in a hospital in Salvador, Bahia, Brazil, with 180 participants. The data were collected through the Hospital Survey on Patient Safety Culture and Professional Quality of Life Scale and analyzed with correlation tests. RESULTS: The use of the Quality of Professional Life model, which encompasses Compassion Satisfaction, Burnout and Traumatic Stress, showed that a better assessment of the safety culture was negatively associated with Burnout. Regarding the dimensions of culture, better evaluations of the general perception of safety, teamwork and staffing were negatively associated with Burnout and Traumatic Stress. Higher Burnout was negatively associated with better handoffs and greater Traumatic Stress was positively associated with error communication. CONCLUSION: Higher levels of Burnout were associated with worse perception of safety culture and worse teamwork evaluations; staffing and general perception of safety were associated to a higher level of Burnout and Traumatic Stress, which emphasizes the importance of investment in these areas.
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Agotamiento Profesional , Seguridad del Paciente , Calidad de Vida , Humanos , Masculino , Femenino , Adulto , Agotamiento Profesional/epidemiología , Persona de Mediana Edad , Personal de Enfermería en Hospital/psicología , Estudios Transversales , Administración de la Seguridad/organización & administración , Cultura Organizacional , Adulto Joven , Correlación de Datos , BrasilRESUMEN
INTRODUCTION: To verify whether the COVID-19 pandemic has had an impact on the safety climate based on the perception of the multiprofessional team in the operating room and to analyze the domains of the safety climate during the pre-pandemic and pandemic period of COVID-19, demonstrating the intersections of quantitative and qualitative approaches. METHODS: Mixed-method research using a convergent approach strategy, carried out in the operating room of a university hospital, located in Rio de Janeiro, Brazil. The nature of the quantitative phase was cross-sectional, and the nature of the qualitative phase was descriptive. We used the Pillar Integration Process to integrate the data. This research considered the pre-pandemic period was defined as before March 2020 and for the pandemic period, the 2nd and 3rd global waves. Research was approved by the institution's board management and ethics committee. RESULTS: 145 health professionals participated in the quantitative approach, and 20 in the qualitative approach. The impact of the COVID-19 pandemic was highlighted in the domains 'Perceived stress' (p-value = 0.017); 'Working conditions' (p-value = 0.040). Six categories emerged from the qualitative analysis, namely: Stress and professional performance due to COVID-19; Patient safety protocols in the operating room; Responsibility for patient safety, lack of effective communication and performance feedback; Biosafety of the professional staff in the operating room; Security culture maturity; Fair culture, organizational learning, and reporting mistakes. As a result of the data integration, 6 pillars were identified: Perception of communication in the operating room; Evolution of safety culture; Overview of protocol management and implementation; Fair organizational culture; Perception of stress due to COVID-19; Perception of professional performance due to COVID-19. CONCLUSIONS: The impact that COVID-19 had on the safety climate in the operating room is evident. It underlines the need to implement strategies that support the solidification of attitudes aimed at patient safety, even in emergencies.
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COVID-19 , Quirófanos , Pandemias , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Brasil/epidemiología , Estudios Transversales , Masculino , Femenino , SARS-CoV-2/aislamiento & purificación , Adulto , Administración de la Seguridad/organización & administración , Personal de Salud/psicología , Cultura Organizacional , Persona de Mediana EdadRESUMEN
OBJECTIVE: to analyze the safety attitudes of health and support areas professionals working in Surgical Center. METHOD: sequential explanatory mixed methods study. The quantitative stage covered 172 health and support professionals in eight Surgical Centers of a hospital complex. The Safety Attitudes Questionnaire/Surgical Center was applied. In the subsequent qualitative stage, 16 professionals participated in the Focus Group. Photographic methods were used from the perspective of ecological and restorative thinking, and data analysis occurred in an integrated manner, through connection. RESULTS: the general score, by group of Surgical Centers, based on the domains of the Safety Attitudes Questionnaire/Surgical Center, reveals a favorable perception of the safety climate, with emphasis on the domains Stress Perception, Communication in the Surgical Environment, Safety Climate and Perception of Professional Performance. The overall analysis of the domain Communication and Collaboration between Teams appears positive and is corroborated by data from the qualitative stage, which highlights the importance of interaction and communication between healthcare teams as fundamental for daily work. CONCLUSION: the perception of safety attitudes among health and support professionals was positive. The perception of the nursing team stands out as closer or more favorable to attitudes consistent with the safety culture.
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Actitud del Personal de Salud , Administración de la Seguridad , Humanos , Administración de la Seguridad/normas , Femenino , Masculino , Seguridad del Paciente/normas , Adulto , Centros Quirúrgicos/normas , Centros Quirúrgicos/organización & administración , Cultura Organizacional , Persona de Mediana EdadRESUMEN
OBJECTIVE: To analyze the relationship between the emotional intelligence of healthcare workers in a hospital environment and their perception of the safety climate in the COVID-19 pandemic. METHOD: Cross-sectional, analytical study, carried out with 81 health workers who worked in hospitals during the pandemic, between September and November 2021. Data collection was carried out using an electronic form, which included a sociodemographic/occupational questionnaire and the Brazilian versions of the Safety Attitudes Questionnaire and the Schutte Self Test. Spearman's correlation test and simple and multiple linear regression analyses were applied. RESULTS: An increase of 1 point in emotional intelligence levels resulted in an increase of 0.487 points in the perception of the safety climate. The most significant predictor of this perception was the ability to manage other people's emotions (ß=0.334; p=0.003; R2=0.168). CONCLUSION: A higher level of emotional intelligence in hospital healthcare workers was related to a greater perception of the safety climate during the COVID-19 pandemic.
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COVID-19 , Inteligencia Emocional , Personal de Hospital , Humanos , COVID-19/psicología , COVID-19/epidemiología , Estudios Transversales , Masculino , Femenino , Adulto , Brasil/epidemiología , Personal de Hospital/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , Pandemias , Actitud del Personal de Salud , Administración de la Seguridad , Personal de Salud/psicología , HospitalesRESUMEN
OBJECTIVE: To determine the importance of the supervision of the essential patient safety actions (AESP) in the different Medical Units of the different levels of care in Mexico City. METHOD: The concern for quality in health care, understood as the safety of patients, is a fundamental aspect that involves the authorities and operational personnel. Supervisions were carried out in the different medical units of Mexico City. RESULTS: Positive correlations were observed between the implementation of the AESP and the number of damages, incidents, events and errors existing in the medical units. CONCLUSIONS: The supervision of the AESP program should be aimed at the prevention and management of risks in health care, recognizing the occurrence of adverse events as a reality resulting from a gradual work of a whole process of continuous improvement.
OBJETIVO: Determinar la importancia de la supervisión de las acciones esenciales de seguridad del paciente (AESP) en las diferentes unidades médicas de los distintos niveles de atención en la Ciudad de México. MÉTODO: La preocupación por la calidad en la atención de salud, entendida como la seguridad de los pacientes, es un aspecto fundamental que involucra a las autoridades y al personal operativo. Se realizaron supervisiones en las diferentes unidades médicas de la Ciudad de México. RESULTADOS: Se observaron correlaciones positivas entre la supervisión de las AESP y el número de daños, incidentes, eventos y errores existentes en las unidades médicas. CONCLUSIONES: La supervisión del programa de AESP debe estar destinado a la prevención y gestión de los riesgos en la atención de salud, reconociendo la ocurrencia de eventos adversos como una realidad producto de un trabajo paulatino de todo un proceso de mejora continua.
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Errores Médicos , Seguridad del Paciente , Seguridad del Paciente/normas , Humanos , México , Errores Médicos/prevención & control , Administración de la Seguridad/organización & administración , Unidades Hospitalarias/organización & administración , Unidades Hospitalarias/normasRESUMEN
BACKGROUND: Safety design covers proactive actions as it analyzes accident risks early in the enterprise life cycle, and considers the designer acting on accident prevention as a member of the construction team. OBJECTIVE: This paper proposes an accident investigation to establish links between accident causes and design to support Prevention through Design (PtD) tools. METHODS: This article analyzed more than a thousand severe and fatal accident cases in the construction sector. A systematic analysis method was structured based on descriptions of accident causes and measures that could be taken to avoid accidents. RESULTS: Analyzing the severe and fatal accidents, the safety measures implemented in the project design could avoid at least 23.6% of the events. As a result, the architectural and structural designs were more effective in accident prevention. The reference percentages and the design types that are more effective in preventing accidents are analyzed through a representative sample of the analysis of the accident. CONCLUSIONS: This research contributes to applying safety guidelines in design projects, directly assisting in project and construction management.
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Accidentes de Trabajo , Industria de la Construcción , Humanos , Accidentes de Trabajo/prevención & control , Administración de la Seguridad/métodos , Administración de la Seguridad/normas , Salud Laboral/normasRESUMEN
OBJECTIVE: This study developed, implemented, and evaluated the feasibility of executing an organizational capacity building intervention to improve bus driver safety and well-being in a Chilean transportation company. Method: Through an implementation science lens and using a pre-experimental mixed methods study design, we assessed the feasibility of implementing a participatory organizational intervention designed to build organizational capacity. Result: We identified contextual factors that influenced the intervention mechanisms and intervention implementation and describe how the company adapted the approach for unexpected external factors during the COVID-19 pandemic and social and political unrest experienced in Chile. Conclusions: The intervention enabled the organization to create an agile organizational infrastructure that provided the organization's leadership with new ways to be nimbler and more responsive to workers' safety and well-being needs and was robust in responding to strong external forces that were undermining worker safety and well-being.
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COVID-19 , Creación de Capacidad , Estudios de Factibilidad , Salud Laboral , SARS-CoV-2 , COVID-19/prevención & control , COVID-19/epidemiología , Humanos , Chile , Creación de Capacidad/organización & administración , Transportes , Administración de la Seguridad/organización & administración , Pandemias , LiderazgoRESUMEN
En este artículo se relaciona el trabajo en equipo con la seguridad del paciente y la importancia de su enseñanza en las carreras universitarias. Esto surge ante la creciente complejidad del sistema de salud que presenta mayores posibilidades de error. De esta manera aparece el trabajo en equipo como una herramienta fundamental para el ejercicio profesional. El avance tecnológico llevó a una transformación cultural y a la horizontalización de la estructura organizacional, aunque la figura del líder sigue resultando de importancia para no perder el tradicional enfoque humanístico. La enseñanza universitaria debe tratar este problema desde que el estudiante ingresa hasta que egresa para mejorar las tomas de decisiones y brindar seguridad
This article relates teamwork to patient safety and the importance of teaching it in university courses. This arises due to the growing complexity of the health system, which presents greater possibilities of error. In this way, teamwork appears as a fundamental tool for professional practice. Technological advancement led to a cultural transformation and the horizontalization of the organizational structure, although the figure of the leader continues to be important so as not to lose the traditional humanistic approach. University education must address this problem from the moment the student enters until he or she graduates to improve decision-making and provide security
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Humanos , Masculino , Femenino , Grupo de Atención al Paciente/organización & administración , Administración de la Seguridad/organización & administración , Educación Médica/organización & administraciónRESUMEN
OBJECTIVE: To identify whether safety huddle implementation enabled a change in patient safety culture. METHOD: Quasi-experimental research that assessed patient safety culture before and after safety huddle implementation. RESULTS.: The study revealed that 53.98% completed the two safety culture assessments, with 60.1% adherence from the nursing team, with a statistically significant difference in the second assessment regarding perception of patient safety and adverse events notified (p < 0.00). Regarding good practice indicators, a statistically significant difference (p < 0.00) was observed in item 43 and improvement in almost all dimensions in the second safety culture assessment. The huddles totaled 105 days, with 100% adherence from the nursing team. Regarding checklist items, all presented satisfactory responses (above 50%). CONCLUSION: Safety huddles proved to be an effective tool for communication between healthcare professionals and managers, demonstrating positive impacts on good practice indicators and most safety culture dimensions.
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Grupo de Atención al Paciente , Administración de la Seguridad , Humanos , Comunicación , Grupo de Enfermería , Seguridad del PacienteRESUMEN
Approaches to safety culture assessment may have many limits if supported exclusively by quantitative methods. Based on this, a research team developed a quantitative-qualitative approach to assess the maturity of the safety culture on an oil platform. To that end, the team sought to develop and test a method consisting of an initial ethnographic phase followed by four other distinct phases: definition of homogeneous groups; production of customized questionnaires; quantitative evaluation; and qualitative assessment. The results show the emergence of trends, from pre-defined themes in safety culture to specific levels of maturity for each of the homogeneous groups. At the same time, it was perceived that the maturity level of the groups is defined from the daily work practices developed by each one of them. This experience allowed us to propose a framework for assessing the maturity levels of safety culture for the oil and gas industry.
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Industria del Petróleo y Gas , Administración de la Seguridad , Humanos , IndustriasRESUMEN
Introducción: En la actualidad existe la necesidad de un modelo de formación de la competencia profesional gestión de seguridad de las personas enfermas en cuidados intensivos. Objetivo: Diseñar un modelo de formación de competencia profesional gestión de la seguridad de personas enfermas en cuidados intensivos. Métodos: Se realizó una investigación cualitativa-descriptiva en la Filial Ciencias Médicas de Baracoa de la Universidad Ciencias Médicas Guantánamo, Cuba, desde 2016 a 2018. El universo estuvo constituido por 74 docentes de la provincia. Se seleccionó una muestra por el método aleatorio simple de 21 docentes de Enfermería, equivalente al 30 por ciento, se emplearon los métodos holístico-configuracional, modelación, análisis documental para la fundamentación de presupuestos epistemológicos, filosóficos, psicológicos y pedagógicos que lo sustentan. Se aplicó un cuestionario mediante entrevista a directivos y profesores. Luego se procedió a estructurar el modelo. Resultados: El modelo comprende tres dimensiones: cognitivo-afectiva de los cuidados intensivos, orientación cultural profesional y valoración reflexiva en la seguridad de la persona enferma en cuidados intensivos. De ellas se estructuraron las configuraciones, a partir de sus relaciones internas y emergieron las cualidades: cognitiva-intelectual de Enfermería en cuidados intensivos, procedimental-motriz y actitudinal-afectiva. Conclusiones: El modelo se conforma como síntesis dialéctica en la integración funcional del saber, saber hacer y saber ser, que le permiten al estudiante garantizar una atención de calidad a partir de identificar, evaluar, reducir o eliminar el riesgo de que se produzca un evento adverso que afecte a: personas enfermas, familiares, población, profesionales y a la propia institución(AU)
Introduction: Nowadays, there is a need for a training model aimed at the professional competence management of safety of sick people in intensive care. Objective: To design a training model for the professional competence management of safety of sick people in intensive care. Methods: A qualitative-descriptive research was conducted in the Baracoa municipality's medical sciences campus of Universidad de Ciencias Médicas de Guantánamo, Cuba, from 2016 to 2018. The universe was made up of 74 professors of the province. Using the simple random method, a sample of 21 Nursing professors was selected, accounting for 30 percent. The holistic-configurational, modeling and documental analysis methods were used for the substantiation of epistemological, philosophical, psychological and pedagogical assumptions that support it. A questionnaire was applied by means of an interview to academic managers and professors. The model was then structured. Results: The model comprises three dimensions: the cognitive-affective dimension of intensive care, professional cultural orientation, and reflective assessment in the safety of the sick person in intensive care. From these, the configurations were structured, based on their internal relationships; and the qualities emerged: cognitive-intellectual of intensive care nursing, procedural-motor and attitudinal-affective. Conclusions: The model is shaped as a dialectical synthesis in the functional integration of knowledge, know-how and know-how to be (values), which allows the student to ensure quality care upon identifying, assessing, reducing or eliminating the risk of an adverse event affecting sick people, their family members, the population, professionals and the institution itself(AU)
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Humanos , Competencia Profesional , Calidad de la Atención de Salud , Cuidados Críticos , Docentes de Enfermería , Enfermería de Cuidados Críticos , Administración de la Seguridad , Investigación CualitativaRESUMEN
Abstract Objective: to assess the psychometric characteristics of the Hospital Survey on Patient Safety Culture, to characterize the patient safety culture, and to assess the influence of the sociodemographic and professional variables on the safety culture dimensions. Method: a methodological, observational, analytical and cross-sectional study conducted with 360 nurses in which the Hospital Survey on Patient Safety Culture questionnaire was used. The data were submitted to descriptive and inferential analysis, as well as to feasibility and validity studies. Results: the nurses' mean age is 42 years old, their mean time of professional experience is 19 years, and they are mostly female. Good internal consistency was obtained (Cronbach's alpha: 0.83), as well as acceptable model fit quality indices. Teamwork within units, Supervisor expectations and Feedback and communication about errors were the dimensions that obtained scores above 60%. Non-punitive response to error, Frequency of events reported, Support for patient safety and Staffing presented scores below 40%. These dimensions are influenced by age, schooling level and professional experience. Conclusion: the psychometric properties of the questionnaire certify its good quality. Teamwork can be considered as an enhancing factor for the safety culture. Assessing the safety culture allowed identifying problematic dimensions, thus enabling planning of future interventions.
Resumo Objetivo: avaliar as caraterísticas psicométricas do Hospital Survey on Patient Safety Culture, caracterizar a cultura de segurança do doente e avaliar a influência das variáveis sociodemográficas e profissionais nas dimensões da cultura de segurança. Método: estudo metodológico, observacional, analítico, transversal, realizado com 360 enfermeiros, utilizando o questionário Hospital Survey on Patient Safety Culture. Os dados foram submetidos à análise descritiva, inferencial e estudos de fiabilidade e validade. Resultados: os enfermeiros possuem em média 42 anos de idade, 19 anos de experiência profissional e são maioritariamente do sexo feminino. Obteve-se boa consistência interna (alfa de Cronbach - 0,83) e índices aceitáveis de qualidade de ajustamento do modelo. O trabalho em equipa dentro das unidades, expetativas do supervisor, feedback e comunicação sobre o erro, foram dimensões que apresentaram scores acima dos 60%. A resposta ao erro não punitiva, frequência da notificação, apoio à segurança pela gestão, dotação de profissionais, apresentaram scores abaixo dos 40%. Estas dimensões são influenciadas pela idade, escolaridade e experiência profissional. Conclusão: as propriedades psicométricas do questionário certificam a sua qualidade. O trabalho em equipa pode ser considerado um fator potenciador da cultura de segurança. Avaliar a cultura de segurança permitiu identificar dimensões problemáticas, possibilitando o planeamento de intervenções futuras.
Resumen Objetivo: evaluar las características psicométricas de la Hospital Survey on Patient Safety Culture, caracterizar la cultura de seguridad del paciente y evaluar la influencia de variables sociodemográficas y profesionales en las dimensiones de la cultura de seguridad. Método: estudio metodológico, observacional, analítico, transversal, realizado con 360 enfermeros, utilizando el cuestionario Hospital Survey on Patient Safety Culture. Los datos fueron sometidos a análisis descriptivo e inferencial y estudios de confiabilidad y validez. Resultados: los enfermeros tienen en promedio 42 años de edad, 19 años de experiencia profesional y la mayoría es de sexo femenino. Se obtuvo buena consistencia interna (alfa de Cronbach - 0,83) e índices aceptables de bondad de ajuste del modelo. El trabajo en equipo dentro de las unidades, las expectativas del supervisor, el feedback y la comunicación del error fueron las dimensiones que presentaron puntajes superiores al 60%. La respuesta al error no punitiva, la frecuencia de notificación, el apoyo a la seguridad por parte de los gestores, la dotación de personal, presentaron puntajes por debajo del 40%. Estas dimensiones son influenciadas por la edad, la educación y la experiencia profesional. Conclusión: las propiedades psicométricas del cuestionario certifican su calidad. El trabajo en equipo puede considerarse un factor que potencia la cultura de seguridad. La evaluación de la cultura de seguridad permitió identificar las dimensiones que tenían problemas y poder planificar futuras intervenciones.
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Humanos , Masculino , Femenino , Adulto , Cultura Organizacional , Estudios Transversales , Administración de la Seguridad , Seguridad del Paciente , Enfermeras y Enfermeros , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To evaluate the perception of the patient safety climate in primary health care associated with professional categories, health centers, and previous experience of participation in the National Program for the Improvement of Access and Quality of Primary Care. METHOD: Cross-sectional study with 119 health professionals in a city in the interior of the state of São Paulo, between August 2019 and February 2020, using the Brazilian version of the Primary Care Safety Questionnaire. RESULTS: The safety climate was favorable, with better evaluation for communication and leadership and worse evaluation for workload. There were differences among health centers regarding teamwork (p=0.0010), workload (p=0.0001) and total score (p=0.0185). Professionals with previous experience participating in the improvement program have a better perception of the climate. CONCLUSION: The perception of climate did not differ between professional categories but differed between health centers.
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Actitud del Personal de Salud , Personal de Salud , Humanos , Estudios Transversales , Brasil , Encuestas y Cuestionarios , Seguridad del Paciente , Atención Primaria de Salud , Administración de la Seguridad , Cultura OrganizacionalRESUMEN
BACKGROUND: Every year, millions of patients suffer injuries or die due to unsafe and poor-quality healthcare. A culture of safety care is crucial to prevent risks, errors and harm that may result from medical assistance. Measurement of patient safety culture (PSC) identifies strengths and weaknesses, serving as a guide to improvement interventions; nevertheless, there is a lack of studies related to PSC in Latin America. AIM: To assess the PSC in South American hospitals. METHODS: A multicentre international cross-sectional study was performed between July and September 2021 by the Latin American Alliance of Health Institutions, composed of four hospitals from Argentina, Brazil, Chile and Colombia. The Hospital Survey on Patient Safety Culture (HSOPSC V.1.0) was used. Participation was voluntary. Subgroup analyses were performed to assess the difference between leadership positions and professional categories. RESULTS: A total of 5695 records were analysed: a 30.1% response rate (range 25%-55%). The highest percentage of positive responses was observed in items related to patient safety as the top priority (89.2%). Contrarily, the lowest percentage was observed in items regarding their mistakes/failures being recorded (23.8%). The strongest dimensions (average score ≥75%) were organisational learning, teamwork within units and management support for patient safety (82%, 79% and 78%, respectively). The dimensions 'requiring improvement' (average score <50%) were staffing and non-punitive responses to error (41% and 37%, respectively). All mean scores were higher in health workers with a leadership position except for the hospital handoff/transitions item. Significant differences were found by professional categories, mainly between physicians, nurses, and other professionals. CONCLUSION: Our findings lead to a better overview of PSC in Latin America, serving as a baseline and benchmarking to facilitate the recognition of weaknesses and to guide quality improvement strategies regionally and globally. Despite South American PSC not being well-exploited, local institutions revealed a strengthened culture of safety care.
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Seguridad del Paciente , Administración de la Seguridad , Humanos , Estudios Transversales , Hospitales , BrasilRESUMEN
OBJECTIVE: To evaluate and synthesise the factors determining patient safety culture in hospitals. METHODS: The scoping review protocol was based on the criteria of the Joanna Briggs Institute. Eligibility criteria were as follows: (1) empirical study published in a peer-reviewed journal; (2) used methods or tools to assess, study or measure safety culture or climate; (3) data collected in the hospital setting and (4) studies published in English. Relevant literature was located using PubMed, CINAHL, Web of Science and PsycINFO databases. Quantitative and qualitative analyses were performed using RStudio and the R interface for multidimensional analysis of texts and questionnaires (IRaMuTeQ). RESULTS: A total of 248 primary studies were included. The most used instruments for assessing safety culture were the Hospital Survey on Patient Safety Culture (n=104) and the Safety Attitudes Questionnaire (n=63). The Maslach Burnout Inventory (n=13) and Culture Assessment Scales based on patient perception (n=9) were used in association with cultural instruments. Sixty-six articles were included in the qualitative analysis. In word cloud and similarity analyses, the words 'communication' and 'leadership' were most prominent. Regarding the descending hierarchical classification analysis, the content was categorised into two main classes, one of which was subdivided into five subclasses: class 1a: job satisfaction and leadership (15.56%), class 1b: error response (22.22%), class 1c: psychological and empowerment nurses (20.00%), class 1d: trust culture (22.22%) and class 2: innovation worker (20.00%). CONCLUSION: The instruments presented elements that remained indispensable for assessing the safety culture, such as leadership commitment, open communication and learning from mistakes. There was also a tendency for research to assess patient and family engagement, psychological safety, nurses' engagement in decision-making and innovation.
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Agotamiento Profesional , Hospitales , Humanos , Administración de la Seguridad , Satisfacción en el Trabajo , Encuestas y CuestionariosRESUMEN
OBJECTIVES: to analyze the association between the risk of occupational exhaustion (burnout) and safety culture in Primary Health Care. METHODS: ross-sectional study conducted in 18 Primary Health Care Units in the Northeast of Brazil. Three questionnaires were used: sociodemographic, Maslach Burnout Inventory, and the Medical Office Survey on Patient Safety Culture. The study was approved by the Research Ethics Committee. RESULTS: seventy-eight healthcare workers participated, of which 64.1% presented a reduced risk of burnout; and 11.5%, a high risk (p=0.000). The following were identified as weakened dimensions of safety culture: Work pressure and pace; Owner, managing partners, leadership support; Overall ratings on quality; and Overall rating on patient safety. CONCLUSIONS: an association was found between low risk of developing burnout syndrome and positive evaluation of safety culture.
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Agotamiento Profesional , Humanos , Agotamiento Profesional/etiología , Seguridad del Paciente , Estudios Transversales , Encuestas y Cuestionarios , Administración de la Seguridad , Atención Primaria de SaludRESUMEN
AIMS: In this study, we aimed to identify the relationship between nursing practice environments (NPEs) and safety perceptions with patient safety culture (PSC) during COVID-19. DESIGN: We conducted a quantitative, non-experimental, correlational, and cross-sectional study. We interviewed 211 nurses from Peru using two scales: PES-NWI and HSOPSC. We used the Shapiro-Wilk test and Spearman's coefficient and estimated two regression models. RESULTS: NPE was reported as favorable by 45.5% of the participants, and PSC was reported as neutral by 61.1%. Safety perception, the workplace, and NPE predict PSC. All NPE factors were correlated with PSC. However, safety perception, support of nurses subscale, the nurse manager's ability, and leadership were predictors of PSC. CONCLUSION: To promote a safe work culture, health institutions should foster leadership that prioritizes safety, strengthens managers' abilities, encourages interprofessional collaboration, and considers nurses' feedback for constant improvement.
Asunto(s)
COVID-19 , Enfermeras Administradoras , Personal de Enfermería en Hospital , Humanos , Estudios Transversales , Cultura Organizacional , COVID-19/epidemiología , Administración de la Seguridad , Lugar de Trabajo , Percepción , Encuestas y Cuestionarios , Satisfacción en el TrabajoRESUMEN
OBJECTIVE: to assess the psychometric characteristics of the Hospital Survey on Patient Safety Culture, to characterize the patient safety culture, and to assess the influence of the sociodemographic and professional variables on the safety culture dimensions. METHOD: a methodological, observational, analytical and cross-sectional study conducted with 360 nurses in which the Hospital Survey on Patient Safety Culture questionnaire was used. The data were submitted to descriptive and inferential analysis, as well as to feasibility and validity studies. RESULTS: the nurses' mean age is 42 years old, their mean time of professional experience is 19 years, and they are mostly female. Good internal consistency was obtained (Cronbach's alpha: 0.83), as well as acceptable model fit quality indices. Teamwork within units, Supervisor expectations and Feedback and communication about errors were the dimensions that obtained scores above 60%. Non-punitive response to error, Frequency of events reported, Support for patient safety and Staffing presented scores below 40%. These dimensions are influenced by age, schooling level and professional experience. CONCLUSION: the psychometric properties of the questionnaire certify its good quality. Teamwork can be considered as an enhancing factor for the safety culture. Assessing the safety culture allowed identifying problematic dimensions, thus enabling planning of future interventions.