Impacto do núcleo de segurança do paciente na cultura de segurança em um hospital especializado
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2018-08-30
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Universidade Federal de Goiás
Resumo
The promotion of safety culture has now been seen as one of the main components of quality and one of the pillars of the movement for patient safety. It represents a strategy foreseen in the Patient Safety (PS) Plan established through the Resolution of the Collegiate Board of Directors (RDC) no 36/2013, by the National Agency of Sanitary Surveillance (ANVISA), which assigned Patient Safety Core (NSP) responsibility for the systemic dissemination of the safety culture. Promoting patient safety culture encourage professionals to identify the risks and weaknesses in care and reflects on the quality of services provided and possible strategies for improvements in work processes, thus preventing patients from being victims of adverse events. To demonstrate the evolution of Safety Culture after the implementation of the Patient Safety Core in a specialized hospital, describing the professional profile of the health professionals of the studied hospital and comparing the perception about PS before and after implantation of NSP in Reference Hospital in Infectious and Dermatological Diseases of the Midwest in Goiânia, State of Goiás, Brazil. Method: This was a serial cross-sectional study, whose data collection was performed in two stages: in 2013 (T0) and 2018 (Tf),when a questionnaire developed by Survey on Patient Safety Culture (HSOPSC) where applied. Participants in the study were professionals of both sexes who had direct contact or interaction with the patients and professionals whose work directly involves the patient care. The sample consisted of 266 (28.7%) professionals in 2013 and 193 (37.5%) in 2018. Results: In 2013, the sample group is mostly female nurses, with a mean of 41.1 years old, working for more than 10 years in the institution. In 2018, the participants' profiles were also women with superior education, but younger, 26.4 years old, and with more professional training. Although a specific strength area was not revealed, the following were the best evaluated areas: general perception of patient safety, frequency of event reporting, supervisor/ chief expectations, patient safety enhancement actions, organizational learning - continuous improvement, information feedback, error communication and hospital management support for patient safety. These dimensions, which presented the best performances, are those in which the participants' perception is that the hospital is taking measures to improve patient safety, and these measures are mostly triggered by the NSP. As critical areas that presented worsening in Tf, were identified: Non-punitive responses to errors, Teamwork within the units. Some areas did not present any change: opening of communication, adequacy of professionals, teamwork between units on duty and transfers. Conclusion: The organization did not present a dimension as a strength area and presented nine of its 12 dimensions as fragile areas, that is, priority attention areas. There is an urgency for initiatives for the development of a human resources policy that invests in practices that prioritize the stability of the workforce, and promotes satisfaction in the work environment, in order to reduce the high rate of rotation. In addition, it is necessary to strengthen a non- punitive culture, which stimulates organizational learning and efficient communication among professionals. Although it is a complex issue, progress in a patient's safety culture is achievable, but requires commitment from all levels of the institution, especially managers, who are responsible for promoting a fair safety culture, where professionals feel safe and are encouraged to rethink the patient care.
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MACEDO, S. A. Impacto do núcleo de segurança do paciente na cultura de segurança em um hospital especializado. 2018. 122 f. Dissertação (Mestrado em Saúde Coletiva) - Universidade Federal de Goiás, Goiânia, 2018.