Assessment of the culture of safety in public hospitals in Brazil

Abstract

Objective: to assess the culture of safety in three public hospitals.Method: transversal study undertaken in three Brazilian public hospitals, with health professionals through applying the Safety Attitudes Questionnaire (SAQ). Scores greater than or equal to 75 were considered positive.Results: a total of 573 professionals participated in the study, including nurse technicians and auxiliary nurses 292 (51%), nurses 105 (18.3%), physicians 59 (10.3%), and other professionals 117 (20.4%). The mean of the SAQ varied between 65 and 69 in the three hospitals. Among the domains, however, 'Job satisfaction' presented a higher score, and the opposite was observed for the domain 'Perceptions of management'. The outsourced professionals presented a better perception of the culture of safety than did the statutory professionals. The professionals with higher education presented a better perception of the stressing factors than did the professionals educated to senior high school level.Conclusion: the level of the culture of safety found is below the ideal. The managerial actions are considered the main contributing factor to the culture's weakness; however, the professionals demonstrated themselves to be satisfied with the work.

Clima de segurança do paciente entre trabalhadores de enfermagem: fatores contribuintes

“…(16) In addition, the factors that contribute to the positive result in this score are: an institution having a favorable working environment, staff satisfied with the work they perform, and, thus, contribution to safety attitudes. (24) When scores are above 80, the results demonstrate a strong consensus among professionals about the safety climate. (22) The teamwork climate in the institutions investigated was positive.…”

“…Authors of this study infer that Brazilian professionals are more satisfied at work compared to professionals from other countries. (24) In this context, professional satisfaction is directly related to the lower occurrence of adverse events, and may influence the safety culture. (16) In addition, the factors that contribute to the positive result in this score are: an institution having a favorable working environment, staff satisfied with the work they perform, and, thus, contribution to safety attitudes.…”

“…(14,27) This study showed a better perception among professionals who had worked less than six months in the institution, and this result relates to adaptation to the work environment, since staff positively perceived the organization. (24) Also, the divergence among professionals with different years of work time may be related to the new methods of qualification, selection, and evaluation of professionals when entering the job market. Characteristics such as flexibility, knowledge, experience, and accessibility stimulate professionals to work in teams and, in this way, positively reflect staff satisfaction.…”

Percepção da enfermagem frente ao clima de segurança do paciente em instituições públicas e privadas

“…In Brazil, the subject gained the spotlight in 2013 with the creation of the patient safety programme. This programme establishes that the quality of care is only achieved when safety is the fundamental principle managed by institutions (3) . In the care practice, the safety culture is the result of a complex system of policies, programmes, and management support for the workers directly involved with patients to ensure they have the conditions to provide safe care at all stages.…”

“…Studies conducted in different Brazilian states using validated instruments revealed weaknesses in assessing the perception of nursing staff of the safety climate (8)(9)(10) . A review of papers on this subject found safety climate assessments in public hospitals (3) , in a private hospital (11) and in public and private hospitals (12) , without correlating the outcomes of these institutions. Therefore, the following question arises: is there a significant difference between the perception of health workers of private and public institutions in relation to the safety climate?…”