Impact of COVID‐19 on professional nursing practice environments and patient safety culture

Abstract

Aim To analyse the impact of COVID‐19 on professional nursing practice environments and patient safety culture. Background The relationship between work environments and patient safety has been internationally recognized. In 2020, the pandemic imposed enormous challenges, yet the impact on these variables remains unknown. Method This is a quantitative observational study, conducted in a Portuguese hospital, with 403 registered nurses. A self‐completion questionnaire was used. Results The impact on the Structure and Outcome components of nursing professional practice environments was positive. Although the Process component remained favourable to quality of care, a negative trend was confirmed in almost all dimensions. The results regarding safety culture showed weaknesses; ‘teamwork within units’ was the only dimension that maintained a positive culture. Conclusion Positive responses regarding patient safety were significantly associated with the quality of the nursing professional practice environment. The need to invest in all dimensions of safety culture emerges to promote positive professional environments. Implications for nursing management Improving professional nursing practice environments can be achieved through managers' investment in the participation and involvement of nurses in the policies and functioning of institutions, as well as promoting an open, fair and participatory safety culture that encourages reporting events and provides adequate support for professionals.

Desafios na implantação da cultura de segurança do paciente no Brasil: revisão integrativa da literatura

“…Neste sentido, a ausência de capacitação foi apontada como um dos entraves na atuação dos Núcleos de SP, interferindo no estabelecimento da cultura de segurança nas equipes de saúde (Caldana et al, 2015;Mira et al, 2020;Coslop et al, 2022;Pimenta Lopes Ribeiro et al, 2022). Moreira et al, (2019), ressaltam a importância das ações de educação permanente para a SP.…”

“…Ademais, a presença da cultura punitiva frente à ocorrência de erros e a alta carga de trabalho configuram obstáculos para implantação da cultura de segurança do paciente (Colosp et al, 2022;Pimenta Lopes Ribeiro et al, 2022;Araripe et al, 2020;Mira et al, 2020;Mendonça et al, 2018). Nesta perspectiva, Clark e Lake (2020), salientam a importância de reconhecer, relatar e estudar os erros, sem penalizar os profissionais, a fim de prevenir a sua ocorrência e reduzir os danos aos pacientes.…”

The impact of nursing practice environments on patient safety culture in primary health care: a scoping review

“…Recent research on the relationship between work environments and job satisfaction, burnout, omitted care, and the intention to leave the profession has led to a better understanding of this relationship. 9 , 10 Work environments have a significant impact on professionals' wellbeing and contribute to a variety of outcomes for professionals as well as patients. 8 Heavy workloads, shortage of human and material resources, lack of communication and teamwork, 4 or even low involvement of professionals in the definition of organisational policies and decision-making increase the risk of adverse events 8 and reduce patient safety-related scores.…”

“…Because of its comprehensive nature, primary health care focuses a significant portion of the population’s care. 9 – 13 Primary health care is understood by the WHO as 'a whole-of-society approach to health that aims at ensuring the highest possible level of health and wellbeing and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment'. 14 Primary health care includes services for health promotion; disease prevention; community promotion and development; and curative, rehabilitative, and palliative care, and constitutes first-level, appropriate, and evidence-based care.…”

“…Recent research on the relationship between work environments and job satisfaction, burnout, omitted care, and the intention to leave the profession has led us to a better understanding of this relationship [9,10] . Work environments have a significant impact on professionals' well-being and contribute to a variety of outcomes for professionals as well as patients [8] .…”