SAFETY CULTURE IN HIGH COMPLEXITY SERVICES IN THE CONTEXT OF THE COVID-19 PANDEMIC

Haas, Luana Elaine; Gaedke, Mari Ângela; Santos, José Augustinho Mendes

doi:10.5380/ce.v27i0.87865

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ORIGINAL ARTICLE • Cogitare Enferm. 27 • 2022 • https://doi.org/10.5380/ce.v27i0.87865 copy

SAFETY CULTURE IN HIGH COMPLEXITY SERVICES IN THE CONTEXT OF THE COVID-19 PANDEMIC

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to evaluate the patient safety culture in high complexity units of a teaching hospital in times of pandemic.

Method:

cross-sectional design, carried out in emergency and intensive care units in 2021. We used the self-administered instrument Hospital Survey on Patient Safety Culture with 103 professionals from the multi-professional team. Descriptive analyses and instrument consistency were performed.

Results:

the strongest areas for patient safety culture were the dimensions teamwork in the unit (79.5%) and expectations and actions of the supervisor/leadership to promote patient safety (73.6%). While the dimensions non-punitive response to error (37.9%) and internal transfers and shift change (31.8%) stood out in the weak areas. A predominance of adverse events underreporting was observed (53.5%).

Conclusion:

critical sectors, even during the pandemic, showed strengthened areas, although fear of punishment and problems regarding information transfers were highlighted by professionals.

DESCRIPTORS:
Patient Safety; Organizational Culture; Critical Care; Interdisciplinary Research; COVID-19.

Variables	n	%
Gender
Female	86	83.5
Male	16	15.5
Age
20 to 29 years old	38	36.9
30 to 39 years old	38	36.9
40 to 49 years old	22	21.4
50 to 59 years old	2	1.9
Position/Function
Nurse	39	37.9
Nursing Auxiliary/ Technician	46	44.7
Physician	11	10.7
Physiotherapist	7	6.8
Time of work in the area/unit
Less than 1 year	54	52.4
1 to 5 years	31	30.1
6 to 10 years	12	11.7
11 to 15 years	2	1.9
21 or more	1	1
Working hours per week in the hospital
20 to 39 hours per week	56	54.4
40 to 59 hours per week	42	40.8
60 to 79 hours per week	2	1.9

Dimensions	α
1 - Teamwork within the units	0.73
2 - Expectations and actions to promote supervisor/leadership safety	0.73
3 - Organizational learning - continuous improvement	0.54
4 - Support from the hospital management for patient safety	0.73
5 - General perception of patient safety	0.52
6 - Feedback of information and communication about errors	0.60
7- Openness for communication	0.45
8 - Frequency of notified events	0.90
9 - Team work among hospital units	0.68
10 - Adequacy of professionals	0.30
11 - Change of shifts and internal transfers	0.66
12 - Non-punitive response to error	0.50

Dimensions	General ICU (%)	Covid ICU (%)	SUS Emergency Care (%)	Private Emergency Health Care Insurance (%)	General (%)
Teamwork in the unit	76.8	94.1	76.8	68.4	79.5
Expectations and actions of the supervisor/leadership for the promotion of patient safety	80.4	77.9	67.3	67.1	73.6
Organizational learning - continuous improvement	61.9	73.1	55.2	73.7	65
Support from hospital management for patient safety	45.2	78.2	56.3	53.5	58.4
General perception of patient safety	38	50	31.6	49.2	41.3
Feedback and communication about errors	49.3	59.9	38.4	60	51
Openness to communication	54.8	67.4	54.1	63.3	59.4
Frequency of communicated events	36.9	50.7	48.7	49.1	38.7
Teamwork between hospital units	39.3	57.4	38.8	51.4	46
Staffing	34.8	54.2	34.0	57.9	43.8
Internal transfers and shifts	31.5	44.6	29.9	49.3	37.9
Non-punitive response to error	29.8	37.5	25.3	36.9	31.8

Units	None		1 to 5		6 to10		11 to 20		20 or more
	n	%	n	%	n	%	n	%	n	%
General ICU	13	50	8	30.8	3	11.5	2	7.7	0	0
ICU COVID	16	64	6	24	1	4	1	4	1	4
Emergency Care SUS	12	41.4	11	37.9	3	10.3	1	3.4	2	6.9
Emergency Health Care insurance	12	63.2	3	15.8	1	5.3	3	15.8	0	0

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E-mail: cogitare@ufpr.br

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[1] Role of Authors:

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work - Haas LE, Gaedke MA, Santos JAM; Drafting the work or revising it critically for important intellectual content - Haas LE, Gaedke MA, Santos JAM; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved - Haas LE, Gaedke MA. All authors approved the final version of the text.