Avaliação da Cultura de Segurança do Paciente em Ambiente Hospitalar: estudo comparativo em hospital universitário e público do Rio de Janeiro e do Porto

• Autor(a) principal: Fassarella, Cíntia Silva
• Data de Publicação: 2016
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/11117
• topic: Patient Safety; Organizational Culture; Quality of Health Care; Hospitals; Nurses; Segurança do paciente; Cultura organizacional; Qualidade da assistência à saúde; Hospitais; Enfermeiros; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM

The object of this study is the perception nursing professionals have about patient safety culture in the hospital environment in two public, university hospitals, one in Brazil and one in Portugal. The aims are to analyze different characteristics of nursing professionals who described patient safety culture in the two institutions, to compare strengths and weaknesses of patient safety culture based on the perception of nursing professionals of the investigated hospitals. This investigation attempts at understanding whether patient safety culture is different for nursing professionals working in accredited hospitals compared to those working in non-accredited hospitals. It is a transversal, quantitative survey comparing two institutions in two different countries which enables benchmarking of results. The study included 195 Brazilian nurses and 567 Portuguese nurses. Data was collected in 2014 by means of Hospital Survey on Patient Safety Culture questionnaire. Results indicate similarities and differences in nurses profile. Main similarities are young women with average age of 36 years, working in clinical practice and surgery, having direct contact with patients and not participating in the patients´ quality and safety nucleus; and main differences are number of working hours, whether having or not a graduate degree and professional experience in the institution and in their respective units. Four common weaknesses were identified in the two hospitals: "Non-punitive reaction to errors", "Frequency of notified events", "Professionals", and "Management support for safety". Statistically, when we compare data from the two institutions, there were relevant differences in seven dimensions, between the Brazilian and the Portuguese hospital, respectively: Team work inside the units, Information feedback and communication about specific errors, Team work between different units, Information feedback and communication about specific errors, Team work between units, Conveying information between shifts or internal transfers, General perception on patient safety, Professionals, Managers support to safety. Nurses of the Portuguese hospital identified only one strong dimension: "Team work inside the units", whereas none were identified in the Brazilian hospital. The Brazilian institution displayed lower positive percentages, indicating weaker aspects regarding a safety culture, including results for safety grade and frequency of notification. The weak points may guide risk managers of both institutions and allow for the implementation of continued improvement in the institutions´ patient safety culture. Making patient safety needs to become a strategic priority in both hospitals, with the realization that safety is an investment, focusing most importantly on measures to prevent non-punitive response to errors, to gear notifications toward organizational learning, proper sizing and adequacy of personnel, and active participation of management. For that to happen, it is necessary to invest in change, beginning with the culture which must encompass all those involved so as to provide safer and more effective health care.