Análise do clima de segurança do paciente no centro cirúrgico no período pré-pandêmico e pandêmico da COVID-19: estudo misto

• Autor(a) principal: Ferreira, Rosilene Alves
• Data de Publicação: 2023
• Outros Autores: [e-mail]
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/20258
• topic: Organizational culture; Patient safety; Surgicenters; Patient care team; COVID-19; Cultura organizacional; Segurança do paciente; Centros cirúrgicos; Equipe de assistência ao paciente; COVID-19; CIENCIAS DA SAUDE::ENFERMAGEM::ENFERMAGEM MEDICO-CIRURGICA

The objective of the study was to evaluate the safety climate through the perception of the multidisciplinary team of a surgical center in the pre-pandemic and pandemic period of COVID-19. Mixed methodology study with a convergent approach strategy. The scenario was the surgical center of a university hospital located in the city of Rio de Janeiro. The quantitative stage was cross-sectional in nature using the Safety Attitudes/Operating Room Version (SAQ/OR). In the qualitative phase, with a descriptive character, an interview script was used. 145 health professionals participated in the survey in the quantitative approach, and 20 in the qualitative approach. Quantitative data underwent inferential statistical analysis with calculations being performed in the R program, version 4.2.1. Qualitative data underwent discursive textual analysis with the support of Iramuteq software version 0.7 alpha 2. After quantitative and qualitative analysis, data integration was carried out, identifying convergences and divergences of results, through the Pillar Integration Process. As for the quantitative results, satisfactory scores were obtained in the domain 'Communication in the surgical environment' in the pre-pandemic (75.52) and pandemic (76.82) periods. Only the domain 'Perception of professional performance' showed a correlation between the period and team variables (p-value= 0.003). There was a significant association between the variables age and time of professional experience with the domains 'Perception of stress' and 'Communication in the surgical environment'. The impact of the COVID-19 pandemic is observed in the domains 'Perception of stress' (p-value=0.017) and 'Working condition' (p-value=0.040). Qualitative analysis emerged 6 classes: 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 professionals in the surgical center; Safety culture maturity; Fair culture, organizational learning and reporting errors. Data integration resulted in 6 pillars: Perception of communication in the operating room; Evolution of safety culture; Vision on the management and implementation of protocols; Fair organizational culture; Perception of stress due to COVID-19; Perception of professional performance due to COVID-19. It is concluded that the COVID-19 pandemic impacted the patient safety climate, specifically the 'Perception of stress' and 'Working conditions' domains. The results reveal differences in the climate domains between the teams, in addition to the association of age and length of professional experience as a possible influencer on the safety climate. The study allowed for an in-depth understanding of the safety climate, in addition to identifying, through data integration, the intersections of quantitative and qualitative approaches.