Objective: to evaluate the perception of healthcare professionals about the safety culture in the operating room of a public hospital, large-sized, according to the domains of the Safety Attitudes Questionnaire (SAQ). Method: descriptive, cross-sectional and quantitative research, with the application of the SAQ to 226 professionals. Descriptive data analysis, instrument consistency and exploratory factor analysis. Results: participants were distributed homogeneously between females (49.6%) and males (50.4%); mean age of 39.6 (SD±9.9) years and length of professional experience of 9.9 (SD±9.2) years. And Cronbach's ( of 0.84. It was identified six domains proposed in the questionnaire: stress perception (74.5) and job satisfaction (70.7) showed satisfactory results; teamwork environment (59.1) and climate of security (48.9) presented scores below the minimum recommended (75); unit's management perceptions (44.5), hospital management perceptions (34.9) and working conditions (41.9) presented the lowest averages. Conclusions: the results showed that, from the perspective of the professionals, there is weakness in the values, attitudes, skills and behaviors that determine the safety culture in a healthcare organization.

Oferta e demanda por média complexidade/SUS: relação com atenção básicaSupply and demand of the medium-complexity/SUS: relation with primary health careResumo Investiga-

OBJECTIVE: To present an overview of systematic reviews on throughput interventions to solve the overcrowding of emergency departments. METHODS: Electronic searches for reviews published between 2007 and 2018 were made on PubMed, Cochrane Library, EMBASE, Health Systems Evidence, CINAHL, SciELO, LILACS, Google Scholar and the CAPES periodicals portal. Data of the included studies was extracted into a pre-formatted sheet and their methodological quality was assessed using AMSTAR 2 tool. Eventually, 15 systematic reviews were included for the narrative synthesis. RESULTS: The interventions were grouped into four categories: (1) strengthening of the triage service; (2) strengthening of the ED’s team; (3) creation of new care zones; (4) change in ED’s work processes. All studies observed positive effect on patient’s length of stay, expect for one, which had positive effect on other indicators. According to AMSTAR 2 criteria, eight revisions were considered of high or moderate methodological quality and seven, low or critically low quality. There was a clear improvement in the quality of the studies, with an improvement in focus and methodology after two decades of systematic studies on the subject. CONCLUSIONS: Despite some limitations, the evidence presented on this overview can be considered the cutting edge of current scientific knowledge on the topic.

Avalia-se o uso das unidades básicas e de urgências do Sistema Único de Saúde (SUS) de Belo Horizonte (BH). Objetivos: identificar o principal problema de saúde que o cidadão leva à Unidade de Pronto-atendimento (UPA) e à Unidade Básica de Saúde (UBS), considerando as especificidades dos níveis de atenção; caracterizar os principais procedimentos de atenção básica e de média complexidade utilizados nesses serviços, comparativamente. Pesquisa do tipo survey, com aplicação direta de questionário fechado a 997 entrevistados, distribuídos em 10 UBSs e 7 UPAs. A demanda que chega aos serviços investigados é por consultas médicas e por procedimentos de enfermagem, motivada por afecções leves, passíveis de atendimento na atenção básica. Os usuários vão à UBS por ser um serviço próximo da residência, de rápido atendimento e de fácil deslocamento, caracterizando boa oferta e capilaridade da Saúde da Família. Verificou-se duplicidade na utilização dos serviços, o que contribui para outras investigações.

OBJECTIVE To describe the stages of construction and validation of an instrument in order to analyze the adherence to best care practices during labour and birth. METHOD Methodological research, carried out in three steps: construction of dimensions and items, face and content validity and semantic analysis of the items. RESULTS The face and content validity was carried out by 10 judges working in healthcare, teaching and research. Items with Content Validity Index (CVI) ≥ 0.9 were kept in full or undergone revisions as suggested by the judges. Semantic analysis, performed twice, indicated that there was no difficulty in understanding the items. CONCLUSION The instrument with three dimensions (organization of healthcare network to pregnancy and childbirth, evidence-based practices and work processes) followed the steps recommended in the literature, concluded with 50 items and total CVI of 0.98.

Infecção e óbitos de profi ssionais da saúde por COVID-19: revisão sistemática Infection and death in healthcare workers due to COVID-19: a systematic review Infección y muerte de profesionales de la salud por COVID-19: revisión sistemática

Objective: to assess the perception of health professionals regarding safety culture of a high complexity public hospital of the Federal District, Brazil. Method: cross-sectional and descriptive study. The Safety Attitudes Questionnaire was used in electronic format. Descriptive and inferential analyses were carried out. Results: 358 professionals participated, with 242 (67.6%) being female. Of these, 224 (62.6%) worked directly or indirectly with patients in assistance activities; 79 (22.1%) in administrative activities; 14 (3.9%) in management; and 41 (11.5%) in others. The total score was 57.1. Job satisfaction factors and stress perception had the most expressive results, 76.2 and 68.8, respectively. The category "working conditions" presented the lowest result, 40.7. Conclusion: the results are below the score of 75, value recommended as indicative of a positive safety atmosphere. We suggest the implementation of actions for the promotion of safety culture and new studies with representative samples of all segments of workers.

ResumoO presente trabalho teve como objetivos identificar as produções científicas sobre análise de políticas de saúde que utilizaram o modelo dos múltiplos fluxos de Kingdon e examinar as contribuições e os limites do modelo no estudo das políticas públicas de saúde, no contexto do SUS. Realizou-se uma revisão integrativa de publicações disponíveis nas bases de dados ProQuest, Portal de Periódicos e Banco de Teses e Dissertações da Capes e Scientific Electronic Library Online, com uso das palavras-chave Kingdon Model, multiple streams model (modelo dos múltiplos fluxos) e políticas públicas de saúde. Os critérios de inclusão foram: estudos completos em português e inglês, disponíveis on-line nas bases de dados; e análises de políticas públicas de saúde com uso do modelo Kingdon em experiências nacionais ou internacionais. Foram excluídos estudos de revisão e relatos de experiência. Foram levantados 4 teses de doutorado, 6 artigos e 2 dissertações de mestrado, publicados entre 1994 a 2009. O modelo de Kingdon mostrou-se aplicável a análises de políticas de saúde em diferentes sistemas políticos nacional e internacional, em períodos prolongados de tempo e na atuação dos governos. As contribuições desse modelo de análise para o SUS incluem: a) a incorporação da ambiguidade nas decisões; b) a valorização da consistência das ideias contidas nas propostas; c) a análise das diferentes interpretações sobre os problemas complexos da saúde brasileira pelos tomadores de decisão. Dentre os limites, aponte-se a ênfase na atuação dos atores em detrimento do marco institucional que delimita suas decisões. Palavras-chave: Políticas públicas; Políticas de saúde; Sistema de saúde.