Clima de seguridad del paciente en la perspectiva de la enfermaría

Estudio transversal desarrollado con 87 profesionales de enfermaría que actúan en tres Unidades de Terapia Intensiva de un hospital público de urgencia de Piauí en el período de octubre y noviembre de 2018. Ha sido utilizado un cuestionario validado de Actitudes de Seguridad – Safety Attitudes Questionnaire (SAQ). En el análisis inferencial, han sido realizados el Teste t de Student, Mann-Whitney e Kruskal-Wallis.

Resultados:

La calificación del SAQ total obtuvo media de 68,57. En análisis de las calificaciones obtenidas para cada dominio en el SAQ general, los dominios Satisfacción en el Trabajo y Clima de Trabajo en Equipo han sido los que obtuvieron las calificaciones más altas y la calificación más baja ha sido para el dominio Percepción de la Gerencia del Hospital.

Conclusión:

Las actitudes de seguridad evaluadas bajo la perspectiva del equipo de enfermaría se ha mostrado desfavorables.

Descriptores:
Seguridad del Paciente; Unidades de Terapia Intensiva; Enfermaría; Administración de la Seguridad; Calidad de la Asistencia a la Salud

Professional profile	n	%
ICU unit
Pediatrics	31	35.6
General	27	31.0
Neurotrauma	29	33.3
Have the professionals filled out the instrument before?
Yes	1	1.1
No	86	98.9
Position
Nurse	15	17.2
Nursing assistant/nursing technician	72	82.8
Gender
Male	10	11.5
Female	77	88.5
Main practice
Adult	55	63.2
Pediatrics	29	33.3
Both	3	3.4
Length of work in the specialty
6 to 11 months	2	2.3
1 to 2 years	6	6.9
3 to 4 years	8	9.2
5 to 10 years	43	49.4
11 to 20 years	25	28.7
21 years or more	3	3.4

Domains	Mean	Median	SD
Total SAQ	68.57	69.51	14.84
Teamwork climate	80.36	83.33	14.57
Safety climate	68.87	71.43	18.15
Job satisfaction	86.26	90.00	12.01
Stress Recognition	73.20	81.25	26.99
Perception of Management
Unit	57.63	62.50	24.35
Hospital	53.94	55.00	23.90
Working Conditions	58.57	58.33	29.19
Question 14 and 33 To 36	66.42	70.00	20.56

Variables	Domains
	Total SAQ	Teamwork climate	Safety climate	Job satisfaction	Stress Recognition	Perception of Management (Unit)	Perception of Management (Hospital)	Working conditions
	Mean ± SD (p value)	Mean ± SD (p value)	Mean ± SD (p value)	Mean ± SD (p value)	Mean ± SD (p value)	Mean ± SD (p value)	Mean ± SD (p value)	Mean ± SD (p value)
ICU
Pediatrics	61.83 ± 15.77	72.85 ± 15.84	61.11 ± 18.18	82.60 ± 13.78	78.23 ± 24.63	45.62 ± 28.72	47.18 ± 26.37	48.92 ± 27.53
General	71.30 ± 13.56	88.58 ± 7.72	69.33 ± 18.22	89.44 ± 10.68	65.05 ± 35.0	60.65 ± 20.16	53.15 ± 23.75	64.20 ± 25.61
Neurotrauma	73.66 ± 12.44 (<0.001) ¹ 1 Kruskal Wallis test;	80.75 ± 14.15 (0.006)¹ 1 Kruskal Wallis test;	76.72 ± 14.77 (0.197)¹ 1 Kruskal Wallis test;	87.24 ± 10.40 (0.422)¹ 1 Kruskal Wallis test;	75.43 ± 18.82 (0.008)¹ 1 Kruskal Wallis test;	67.67 ± 16.95 (0.127)¹ 1 Kruskal Wallis test;	61.90 ± 19.24 (0.065)¹ 1 Kruskal Wallis test;	63.65 ± 32.18 (0.007)¹ 1 Kruskal Wallis test;
Position
Nurse	69.72 ± 13.64	79.17 ± 13.27	69.52 ± 16.36	83.67 ± 16.09	78.33 ± 18.43	66.94 ± 19.32	56.67 ± 20.93	52.50 ± 28.60
assistant / nursing technician	68.51 ± 15.16 (0.603)² 2 Mann-Whitney U test;	80.61 ± 14.90 (0.835)² 2 Mann-Whitney U test;	68.73 ± 18.60 (0.699)² 2 Mann-Whitney U test;	86.80 ± 11.05 (0.750)² 2 Mann-Whitney U test;	72.14 ± 28.44 (0.131)² 2 Mann-Whitney U test;	55.69 ± 24.95 (0.744)² 2 Mann-Whitney U test;	53.37 ± 24.58 (0.343)² 2 Mann-Whitney U test;	59.84 ± 29.35 (0.776)³ 3 Student's T-test
Gender
Male	66.69 ± 11.66	80.42 ± 13.47	65.36 ± 22.78	87.50 ± 10.87	79.38 ± 20.21	55.83 ± 21.44	49.00 ± 16.63	46.67 ± 24.28
Female	68.98 ± 15.24 (0.799)² 2 Mann-Whitney U test;	80.36 ± 14.79 (0.754)² 2 Mann-Whitney U test;	69.33 ± 17.59 (0.856)² 2 Mann-Whitney U test;	86.10 ± 12.21 (0.484)² 2 Mann-Whitney U test;	72.40 ± 27.75 (0.704)² 2 Mann-Whitney U test;	57.87 ± 24.82 (0.333)² 2 Mann-Whitney U test;	54.58 ± 24.71 (0.168)² 2 Mann-Whitney U test;	60.12 ± 29.55 (0.648)² 2 Mann-Whitney U test;
Main practice
Adult	72.31 ± 12.95	84.39 ± 12.14	73.00 ± 16.90	88.09 ± 10.47	70.23 ± 28.26	63.94 ± 18.72	57.28 ± 21.77	63.56 ± 29.08
Pediatrics	63.45 ± 14.98	75.27 ± 13.17	62.13 ± 18.38	83.79 ± 13.41	76.72 ± 24.77	48.19 ± 27.88	50.43 ± 23.98	51.15 ± 27.07
Both	53.66 ± 26.41 (0.001)¹ 1 Kruskal Wallis test;	55.56 ± 31.28 (0.026)¹ 1 Kruskal Wallis test;	58.33 ± 20.62 (0.314)¹ 1 Kruskal Wallis test;	76.67 ± 20.21 (0.201)¹ 1 Kruskal Wallis test;	93.75 ± 10.83 (0.029)¹ 1 Kruskal Wallis test;	33.33 ± 43.30 (0.270)¹ 1 Kruskal Wallis test;	26.67 ± 46.19 (0.080)¹ 1 Kruskal Wallis test;	38.89 ± 38.49 (0.015)¹ 1 Kruskal Wallis test;
Length of work in the specialty
6 to 11 months	66.77 ± 14.23	85.42 ± 20.63	48.21 ± 22.73	92.50 ± 3.53	71.88 ± 39.77	47.92 ± 32.41	55.00 ± 21.21	70.84 ± 29.47
1 to 2 years	61.99 ± 9.47	75.00 ± 18.82	60.12 ± 11.39	78.33 ± 13.29	63.54 ± 19.13	52.08 ± 14.13	50.83 ± 13.20	38.89 ± 35.62
3 to 4 years	80.51 ± 9.82	89.06 ± 9.70	75.45 ± 18.36	95.00 ± 3.78	73.44 ± 38.50	76.56 ± 21.12	75.63 ± 15.68	78.12 ± 17.78
5 to 10 years	69.65 ± 14.52	81.78 ± 14.17	68.04 ± 20.04	87.79 ± 12.92	74.42 ± 27.84	59.50 ± 23.10	55.81 ± 21.29	61.43 ± 28.23
11 to 20 years	64.33 ± 16.56	76.00 ± 15.18	70.07 ± 14.66	81.40 ± 10.16	72.00 ± 24.75	49.57 ± 26.91	44.90 ± 28.69	51.67 ± 28.67
21 years or more	75.27 ± 8.04 (0.347)¹ 1 Kruskal Wallis test;	80.55 ± 4.81 (0.124)¹ 1 Kruskal Wallis test;	84.52 ± 12.54 (0.019)¹ 1 Kruskal Wallis test;	93.33 ± 2.87 (0.651)¹ 1 Kruskal Wallis test;	85.42 ± 15.73 (0.064)¹ 1 Kruskal Wallis test;	65.28 ± 20.55 (0.047)¹ 1 Kruskal Wallis test;	50.00 ± 25.00 (0.127)¹ 1 Kruskal Wallis test;	54.17 ± 41.04 (0.081)¹ 1 Kruskal Wallis test;

Professional position			Type of ICU
	Pediatrics		General		Neurotrauma
	Mean ± SD	p value¹ 1 Mann-Whitney U test;	Mean ± SD	p value² 2 Student's t-test	Mean ± SD	p value¹ 1 Mann-Whitney U test;
Nurse	65.09 ± 13.10	0.548	68.30 ± 11.90	0.576	74.53 ± 15.73	0.813
Nursing assistant / nursing technician	61.22 ± 16.38		71.83 ± 14.00		73.44 ± 11.85

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Herica Emilia Félix de Carvalho. E-mail: herica_emilly@hotmail.com.br