Assessment of the culture of safety in public hospitals in Brazil

Patient safety culture in times of the COVID-19 pandemic: a cross-sectional study in a hospital

OBJECTIVES

to assess patient safety culture during the COVID-19 pandemic and identify the dimensions that need to be improved in hospital settings and which sector, open or closed, direct or indirect care, exhibits a higher level of safety culture.

METHODS

a descriptive and cross-sectional study. The validated version for Brazil of the Hospital Survey on Patient Safety Culture instrument was applied to assess patient safety culture. Those dimensions with 75% positive responses were considered strengthened.

RESULTS

all dimensions presented results lower than 75% of positive responses. Closed sectors showed a stronger safety culture compared to open ones. Indirect care sectors had a low general perception of patient safety when compared to direct care sectors.

CONCLUSIONS

with the pandemic, points of weakness became even more evident, requiring attention and incisive interventions from the institution's leaders.

Factors determining safety culture in hospitals: a scoping review

OBJECTIVE

To evaluate and synthesise the factors determining patient safety culture in hospitals.

METHODS

The scoping review protocol was based on the criteria of the Joanna Briggs Institute. Eligibility criteria were as follows: (1) empirical study published in a peer-reviewed journal; (2) used methods or tools to assess, study or measure safety culture or climate; (3) data collected in the hospital setting and (4) studies published in English. Relevant literature was located using PubMed, CINAHL, Web of Science and PsycINFO databases. Quantitative and qualitative analyses were performed using RStudio and the R interface for multidimensional analysis of texts and questionnaires (IRaMuTeQ).

RESULTS

A total of 248 primary studies were included. The most used instruments for assessing safety culture were the Hospital Survey on Patient Safety Culture (n=104) and the Safety Attitudes Questionnaire (n=63). The Maslach Burnout Inventory (n=13) and Culture Assessment Scales based on patient perception (n=9) were used in association with cultural instruments. Sixty-six articles were included in the qualitative analysis. In word cloud and similarity analyses, the words 'communication' and 'leadership' were most prominent. Regarding the descending hierarchical classification analysis, the content was categorised into two main classes, one of which was subdivided into five subclasses: class 1a: job satisfaction and leadership (15.56%), class 1b: error response (22.22%), class 1c: psychological and empowerment nurses (20.00%), class 1d: trust culture (22.22%) and class 2: innovation worker (20.00%).

CONCLUSION

The instruments presented elements that remained indispensable for assessing the safety culture, such as leadership commitment, open communication and learning from mistakes. There was also a tendency for research to assess patient and family engagement, psychological safety, nurses' engagement in decision-making and innovation.

Analysis of relationship of psychosocial factors with patient safety culture in a Brazilian hospital: Study with structural equation modeling analysis

INTRODUCTION AND OBJECTIVES

The scenario of the health system can develop physical and emotional impacts on health professionals, due to work overload and failure to manage the system. It is necessary to consolidate the theory that the safety of care provided by health services is affected by organizational conditions. The aim of this study is to assess whether safety culture is related to job satisfaction, depressive symptoms, and burnout syndrome among hospital professionals.

MATERIALS AND METHODS

This is an analysis with structural equation modeling, conducted in a teaching hospital in Brazil. Data collection was made via psychometric instruments, which sought to analyze job satisfaction (Job Satisfaction Survey), depressive symptoms (Patient Health Questionnaire), burnout syndrome (Maslach Burnout Inventory), as well as the relationship between this factors and patient safety culture (Safety Attitudes Questionnaire). The Pearson correlation coefficient (r) and the partial least squares structural equation modeling (PLS-SEM) were used for analysis.

RESULTS

A higher work satisfaction was associated with a higher perception of safety culture (r=0.69; P<0.001). Depressive symptoms and burnout dimensions showed an inverse relationship with the safety culture (P<0.05). PLS-SEM enabled us to understand the behavior of this association. Thus, satisfaction at work and the absence of burnout proved to be predictive factors for the implementation of an ideal patient safety culture (P<0.001).

CONCLUSIONS

Patient safety culture is related to job satisfaction and burnout among hospital professionals. These findings suggest that the psychosocial work environment influences the quality of care provided.

Evaluation of patient safety culture as perceived by nurses during the COVID-19 pandemic

Objectives: A good patient safety culture (PSC) is linked to a reduced risk of patient problems and minimal undesirable occurrences. This study investigated the PSC levels from nurses’ perspectives during the COVID-19 pandemic.

Methods: A descriptive cross-sectional design was applied. The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was administered to 315 nurses working at 2 major hospitals in Jeddah, Saudi Arabia. The data were analyzed using descriptive statistics, a t-test, and a one-way ANOVA test. The statistical significance of the correlation was determined at the 0.05 level.

Results: PSC was rated as medium overall according to the nurses, with a weighted mean of 2.88–0.76 and a relative weight of 57.57%. In addition, all PSC composites were rated from medium to high, except organizational learning, which was rated low. The correlation between sociodemographic variables as well as PSC levels was investigated using the t-test and one-way ANOVA test. The association is statistically significant when P ≤ 0.05. The findings revealed a statistically significant correlation between nurse nationality (t = −4.399, P = 0.000), age (F = 7.917, P = 0.000), experience in years (F = 3.760, P = 0.024), and hospital (t = −0.401, P = 0.689).

Conclusions: The nurses in this study had a medium overall PSC level, and all PSC composites ranged from a medium to a high level, except organizational learning, which had a low level. In addition, the findings showed that there is a significant relationship between PSC levels, nurses’ nationalities, experience in years, and the hospital itself.

Cultura de Seguridad del Paciente en el Servicio de Emergencias Médicas: estudio transversal

Introducción: Los problemas relacionados con la seguridad del paciente en el contexto prehospitalario son poco explorados, pero esenciales, dada la vulnerabilidad a incidentes. Objetivo: analizar el clima de seguridad del paciente desde la perspectiva del equipo multidisciplinario que actúa en la Atención Prehospitalaria Móvil (APS). Materiales y Métodos: estudio transversal, realizado en una Atención Prehospitalaria Móvil. La recolección de datos se realizó a través de Seguridad actitudes Cuestionario (SAQ), con muestreo por conveniencia y tasa de participación del 94,3% de los profesionales elegibles. Para el análisis de los datos se utilizó estadística descriptiva y la prueba de Mann-Whitney. Resultados: Entre los 151 profesionales participantes, predominaron los del sexo masculino (54,6%), auxiliares y técnicos de enfermería (42,0%), con 10 o más años de actuación (61,0%), en la atención de adultos y pediátrica (93,4%). El SAQ Total tuvo una mediana de 70, indicando una percepción negativa de los participantes sobre la seguridad del paciente en la APH. Los dominios con percepción negativa fueron: Clima de Seguridad, Reconocimiento del Estrés, Percepción de la Gestión y Condiciones de Trabajo; mientras que los dominios Clima de Trabajo en Equipo y Satisfacción Laboral mostraron una percepción positiva. En el análisis comparativo entre profesionales, se observaron diferencias entre algunas categorías para los dominios de Satisfacción en el Trabajo, Reconocimiento del Estrés y Condiciones de Trabajo. Conclusiones: Este estudio presenta las peculiaridades de los servicios médicos de emergencia y la necesidad de sensibilizar a los profesionales y gestores sobre la seguridad del paciente, con el fin de comprender mejor el escenario actual y las posibilidades de reducción de eventos adversos para mejorar la atención ofrecida. Como citar este artículo: João, Virgilio Malundo; Dias, Bruna Moreno; Oliveira, Marília Pilotto de; Laus, Ana Maria; Bernardes, Andrea; Gabriel, Carmen Silvia.  Cultura de Segurança do Paciente no Serviço Médico de Urgência: estudo transversal. Revista Cuidarte. 2023;14(1):e2531. http://dx.doi.org/10.15649/cuidarte.2531

Attitudes of Critical Care Nurses towards Teamwork and Patient Safety in Saudi Arabia: A Descriptive Cross-Sectional Assessment

The study aimed to assess the teamwork and safety attitudes among the critical care unit (CCU) nurses in Saudi Arabia. A descriptive cross-sectional study was carried out in public tertiary hospitals in Al-Madinah, Saudi Arabia. All participants answered a three-part questionnaire that included demographic data, a teamwork attitude questionnaire (T-TAQ), and the Safety Attitudes Questionnaire (SAQ). The analysis revealed that the majority of the nurses were female, n = 52 (76.5%), and almost half of the nurses were aged from 29 to 39 years, n = 29 (42.6%). Teamwork attitude values are found to be relatively stable in all subscales, ranging from 1.63 (SD = 1.23) to higher at 2.92 (SD = 1.32). Of the six dimensions of SAQ, job satisfaction (M = 70, SD 21.46) had the highest positive rate and was approached with a positive attitude, followed by teamwork (M = 66.09, SD 15.12) and safety climate (M = 67.11, SD 17.70). The analysis also shows work experience was the influencing factor of teamwork attitude and safety attitude of nurses, recording beta values of 0.24, p < 0.05 and 0.10, p < 0.001, respectively. The results also identified an association between teamwork and safety attitudes. The study reflected the positive attitudes towards teamwork and less positive attitudes toward patient safety among critical care nurses in Saudi Arabia. Collaborative team performance among nurses improves the medical care quality and patients’ safety, decreasing the occurrence rate of adverse events.

Improving the culture of safety among healthcare workers: Integration of different instruments to gain major insights and drive effective changes

The Safety Attitude Questionnaire (SAQ) and Manchester Patient Safety Framework (MaPSaF) are known as effective tools to assess patient safety culture and climate and develop targeted strategies. However, they are seldom applied in an integrated way. The aim of this study was to conduct an implementation project through a novel use of both instruments to gain unique insights. The Italian version of MaPSaF and SAQ were administered to 1,759 healthcare workers from three Italian hospitals (response rate: MaPSaF 70.5%, SAQ 61.6%). MaPSaF evaluation proved an overall bureaucratic level of patient safety culture. SAQ scores showed a predominance of neutral scores (75.99%). The dimension perception of management gained the lowest mean score (53.32), while Stress recognition obtained the highest (75.17). Safety climate perception differed significantly among groups: working in a small hospital, in a medical department, and being a physician were associated with the most positive results. The majority (67.1%) of responders to both MaPSaF and SAQ considered the two instruments as providing with different and complementary information. Overall, results showed that an integrated approach in the evaluation of an organisation's safety culture may result useful for an in-depth analysis of the criticalities and the adoption of appropriate improvement strategies.

Safety culture in the perception of public-hospital health professionals

OBJECTIVE

Evaluating safety culture in the perception of professionals working in public hospitals of the Unified Health System (SUS) of Distrito Federal, Brazil, three years after the implementation of the National Patient Safety Program (PNSP).

METHODS

Analytical cross-sectional study conducted in eleven public hospitals using the Safety Attitudes Questionnaire (SAQ) in electronic format. Stratified sampling was estimated according to the proportion of the total number of professionals in each hospital, as well as the representativeness of each professional group. The results of the total score and domains equal to or greater than 75 were considered positive. Descriptive and inferential analyses of professional groups and hospitals were carried out.

RESULTS

909 professionals participated. The total score by professional group was negative (62.5 to 69.5) and the domains differed statistically in all cases. The eleven hospitals had a negative total score (61.5 to 68.6). The domains to attain positive performance were job satisfaction, stress recognition and teamwork climate. The lowest results were in working conditions and management perception domains, for which none of the hospitals had an average above 75. Differences were also found for domain means across hospitals, except in management perception.

DISCUSSION

Three years after the implementation of PNSP, the safety culture in eleven hospitals evaluated was weak, although the domains of job satisfaction, stress recognition and teamwork climate had positive results. The results can contribute to decision-making by managers, as safety culture is an essential element in the implementation of patient safety policy.

Study and promotion of safety culture using mixed methods research

Objective

With a positive safety culture, institutions offer the best quality and safe care to their patients. The objective of this study was to analyze patient safety culture from the perspective of the multidisciplinary team, to identify factors that influence patient safety culture, and to create/promote—jointly with the study participants—strategies for improving processes of change.

Methods

The study design represented a mixed methods research approach, with a sequential explanatory design. A multidisciplinary team of workers at a general hospital was eligible for the study. To collect quantitative data, we administered the Safety Attitudes Questionnaire (SAQ). The qualitative phase was accomplished via focus groups (FGs), with participants from the first phase of the study using the principles of deliberative dialogue (DD) as a knowledge-translation strategy. The STROBE guideline was used to develop the study.

Results

The overall SAQ score was positive (75.1 ± 10.4). Negative scores were found in the fields of Safety Climate, Working Conditions, and Stress Recognition. Focus group discussions identified the aspects that create a negative impact on safety culture, such as ineffective communication, punitive approach in the event of errors, the lack of commitment and adherence to the protocols, and the non-recognition of the stress and the mistakes. Actions for the promotion of safety culture were developed and implemented during the study.

Conclusions

The use of the principles of DD as a strategy for knowledge translation (KT) made it possible to identify and plan for joint actions to generate improvements in safety culture.

Safety attitudes build safety culture: Nurse/midwife leaders improving health care using quantitative data

AIM

We aim to determine safety attitudes of nurses and midwives across a Local Health District in Australia and compare results 1 year later following facilitated feedback of results.

BACKGROUND

Positive safety cultures are imperative for positive patient and staff outcomes. Staff member's attitude contribute to an organisations safety culture but can differ between health professional groups and across different subcultures.

METHOD

The Safety Attitudes Questionnaire (SAQ-Short version) was administered to all nurses and midwives within a Local Health District in NSW, Australia in 2019 and 2020. Results were facilitated back to nursing/midwifery leadership teams with an expectation of developing and enacting an action plan, based on results.

RESULTS

Of the six domains in the SAQ-Short version, five domains scores increased significantly (p < .001) over the time period.

CONCLUSIONS

Measures over time are important to establish differences in perceptions and feedback on impact of actions. Facilitated feedback of results shows meaning when nursing/midwifery leadership staff have data explained and an opportunity to discuss and plan.

IMPLICATIONS FOR NURSING MANAGEMENT

This study shows that facilitated feedback of quantitative survey results brings improved results when a survey is replicated. Nurse managers should enact a contextualized action plan with teams based on survey results to influence improvement in safety attitudes of staff.

Estresse ocupacional, Burnout e cultura de segurança do paciente em unidades de perioperatório

Objetivou-se avaliar a relação entre estresse ocupacional, burnout e cultura de segurança de profissionais da saúde de unidades de perioperatório. Estudo transversal, desenvolvido com profissionais de saúde de um hospital escola, do Rio Grande do Sul, Brasil. Utilizou-se um questionário contendo características biossociais e do trabalho; o Safety Attitudes Questionnaire, a Job Stress Scale e o Inventário Maslach de Burnout. Empregou-se análise estatística descritiva e inferencial. Os participantes avaliaram negativamente a cultura de segurança do paciente (média=63,8). Prevaleceu profissionais em trabalho de alta exigência (40,4%), com alto desgaste emocional (34,9%), alta despersonalização (44,5%) e alta realização profissional (40,4%). Observou-se correlação baixa e negativa entre despersonalização (p=-0,254), demanda psicológica (p=-0,246) e percepção da cultura de segurança. Ter realização profissional apresentou correlação baixa e positiva com a cultura de segurança (p=0,256). A ocorrência de estresse ocupacional e burnout possui correlação inversa e significativa com a cultura de segurança. 

Effect of the organizational culture for patient safety in the hospital setting: A systematic review

Objective: To identify the effect of the organizational culture on patient safety in the hospital context. Materials and methods: A systematic review, without meta-analysis, registered in PROSPERO with number CRD42020162981. Cross-sectional and observational studies were selected that assessed the safety environment and safety culture published between 2014 and 2020 in journals indexed in the EMBASE, Latin American and Caribbean Literature in Health Sciences (Literatura Latinoamericana e do Caribe em Ciências da Saúde, LILACS) via the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), Medline (International Literature in Health Sciences) via PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Results: The findings show that a positive safety environment exerts a beneficial effect on the safety culture, favors the notification of events, and enables improvements in the quality of health care. Conclusions: The effective interaction between safety culture and organizational culture is still scarce in the literature. Most of the studies carried out investigate the situational diagnosis and little progress is made in terms of deepening the implications for the professional practice and the repercussions for the safety of hospitalized patients.

Professional interaction in management of the triad: Permanent Education in Health, patient safety and quality

Objective:

to understand how professional interaction takes place in the hospital organizational structure for the management of Permanent Education in Health, to guarantee patient safety and the quality of nursing care.

Method:

this is a qualitative study, which used the structuralist aspect of the Grounded Theory as a methodological framework. 27 interviewers participated in the study, who made up four sample groups.

Results:

six categories and 13 subcategories were presented, representing the studied phenomenon and highlighting particularities of the public health system and the influence of the manager’s support and management priority, the disposition of the organizational structure, the institutional culture, the external encouragement to institution, and the nurses’ initiative and leadership in the professional interaction for the management of the Permanent Education in Health, patient safety, and quality of care triad, revealing the need for cultural change through interdisciplinarity.

Conclusion:

the professional interaction in the hospital organizational structure requires the creation of new management models with an emphasis on more participative management, in order to improve the care processes in hospital institutions.

Factors related to the patient safety climate in an emergency hospital

Objective:

to verify the relationship between the socio-demographic and work profile of the nursing professionals and the patient safety climate in a public emergency hospital.

Method:

a cross-sectional study carried out with 177 nursing professionals from a public emergency hospital. For data collection, the Safety Attitudes Questionnaire - Short Form 2006 was used, validated and cross-culturally adapted to the Portuguese language. To check the factors related to the instrument’s domains, bivariate and multivariate analyses were performed.

Results:

working in the medical and surgical clinic or emergency room, on a night shift, and having the intention to leave nursing, reduced the general safety climate in the multiple regression analysis. The younger professionals, with less than four years in the institution, and those who worked in the night shift had a lower safety climate related to the perception of the management. On the other hand, having a work contract with a hired worker improved the general safety climate and workplace satisfaction.

Conclusion:

identifying predictors on patient safety scores is an important management tool that allows diagnosing, planning and executing activities from the domains that need to be improved.

The effect of education around ethical principles on nurses' perception to patient safety culture in an Iranian mental health inpatient unit: a pilot study

Background & objectives

Patient safety is a crucial factor in the provision of quality healthcare and is therefore a global health concern. It is an area in which ethical concerns and high-quality clinical practice are inextricably linked. This study investigates the effect of education around ethical principles on nurses’ perception of patient safety in a psychiatric unit.

Materials & methods

This pre- and post-test descriptive study was conducted in a mental health inpatient unit in a hospital in Tehran, capital of Iran, in 2018. A total of 33 nurses, selected by census sampling, participated in the study. Data was collected using a demographics questionnaire and Hospital Survey on Patient Safety Culture (HSOPSC), and was analyzed with SPSS21.

Results

The mean score of patient safety was 116.85 ± 9.98 before the educational intervention, 143.58 ± 7.21 immediately after intervention, and 153.12 ± 9.47 1 month after intervention. The rate of error report by most participants over the past 12 months was 3–5 and 6–10 events before intervention, and 6–10 events immediately after and 1 month after intervention. Also, 42.4% of the participants assessed patient safety after intervention as very good and 36.4% assessed it as acceptable and very good 1 month after intervention whereas most of the participants (45.5%) assessed patient safety as acceptable before intervention.

Conclusion

Education on ethical principles exerts a positive effect on nurses’ perception of patient safety culture. Thus, it is recommended as an effective method of promoting nurses’ perception of this variable. In this way, healthcare quality and enhanced patient safety can be achieved.

Patient safety culture from the perspective of all the workers of a general hospital

ABSTRACT Objective: To assess the patient safety culture among the workers of a hospital institution in southern Brazil. Method: This is a cross-sectional study, which was performed with 630 hospital workers, at Santa Rosa, Rio Grande do Sul, Brazil, through the Safety Attitudes Questionnaire tool, in the month of April 2017. Results: We found positive scores in all the safety culture domains, except for the perceived stress domain. Conclusion: Job satisfaction and teamwork spirit showed better scores for nursing and health professionals, when compared to the support team. Schooling, gender, operation time and the choice of workplace positively influenced the safe atmosphere.

Safety attitudes, perceived organizational culture and knowledge of the physiologically deteriorating patient among mental health nurses: Cross-sectional, correlational study

Mental health nurses have traditionally lagged in terms of physical healthcare skills and have been found to have poorer cultural safety-related attitudes relative to other nurses. Organizational culture, including safety-related culture, is associated with important aspects of care quality. The aim of the current study was to examine the relationships between safety-related attitudes, physical healthcare-related knowledge and organizational culture among mental health nurses. By doing so, the intention was to inform decisions about interventions to improve attitudes and care related to severe physiological deterioration among mental health nurses. The study design was cross-sectional and correlational. The safety-related attitudes of N = 133 nurses from the inpatient mental health services of one Local Health District in New South Wales, Australia, were examined in terms of a range of potential predictor variables of safety attitudes (Safety Attitudes Questionnaire) including individual organizational-perceiver type (Organisational Climate Assessment Inventory), knowledge of emergency medical healthcare (Lambeth In situ Training Questionnaire), use and perception of medical emergency teams (purpose-designed questionnaire) and a range of demographic variables. Regression analyses revealed that those who perceived the organization to have a primarily market-oriented culture had poorer safety-related attitudes than those who perceived a more clan-type culture. Number of years qualified was negatively associated with safety attitudes. To our knowledge, this is the first study in mental health which demonstrates a link between organizational culture-perception and safety attitudes related to physical healthcare. Results suggest that, among nurses, individuals have quite different perceptions of the organizational culture. In turn, this suggests that the 'one-size fits all' approach to changing organizational culture may be inappropriate.

Safety culture of multidisciplinary teams from neonatal intensive care units of public hospitals

OBJECTIVE

analyze the safety culture of multidisciplinary teams from three neonatal intensive care units of public hospitals in Minas Gerais, Brazil.

METHOD

a cross-sectional survey conducted with 514 health professionals, using the Hospital Survey on Patient Safety Culture; data were subjected to a descriptive statistical analysis in software R-3.3.2.

RESULTS

the findings showed that none of the dimensions had a positive response score above 75% to be considered as a strength area. The dimension 'Nonpunitive response to error' was classified as a critical area of the patient safety culture, present in 55.45% of the responses. However, areas with potential for improvements were identified, such as 'Teamwork within units' (59.44%) and 'Supervisor/manager's expectations and actions to promote patient safety' (49.90%).

CONCLUSION

none of the dimensions was considered as a strength area, which indicates safety culture has not been fully implemented in the evaluated units. A critical look at the weaknesses of the patient safety process is recommended in order to seek strategies for the adoption of a positive safety culture to benefit patients, family members and health professionals.

Female dental students' perceptions of patient safety culture: a cross sectional study at a middle eastern setting

BACKGROUND

Patient safety is an integral part of all health care specialties, including dentistry. Dental students are exposed to patient safety culture during their clinical training. The aim of this study was to evaluate the perception of female students enrolled in dental degrees and dental hygiene programs towards patient safety culture and to determine its associated factors at a Middle Eastern setting.

METHODS

This is a cross sectional study, based on a self-administered, English language questionnaire distributed by convenience among female dental students enrolled in two major Colleges of dentistry in Riyadh, Saudi Arabia. Participants had fulfilled at least one year of clinical training. Sample characteristics included the specialty and years of clinical training. Student's perception was measured using the validated Safety Attitude Questionnaire (SAQ) that consists of 36 statements, distributed over six domains. Responses were rated on a five point Likert scale and the average positive response rate (APRR) was calculated. Binary logistic regression models were constructed to determine factors significantly associated with positive perceptions.

RESULTS

The response rate of both student programs was 221/312(70.8%). Students of dental sciences and dental hygiene programs were 133(60.2%) and 88(39.8%) respectively. Almost 42% of students were in their 1st and 2nd years of clinical training. The APRR of: Team Work Climate domain was 54.4 ± 28.0, Safety Climate domain was 51.4 ± 29.7, Job Satisfaction domain was 64.5 ± 33.8, Stress Recognition domain was 56.2 ± 37.8, Perceived Management Support domain was 50.7 ± 37.7, and Working conditions was 55.3 ± 32.1. Female students in their 3rd and 4th year of clinical were adj.OR = 2.3[1.3-4.0] times more likely to have positive perception regarding the team work climate domain when compared to 1st and 2nd year clinical students, P = 0.005. At each of the six individual domains, the odds of having a positive perception were also significantly higher among dentistry students in comparison to dental hygiene students with a range of adj.OR 2.6-4.6.

CONCLUSIONS

Apparently patient safety is a concern among female dental students enrolled in dental degree and dental hygiene programs. This requires more attention from the staff, dental college's leadership/management, and faculty/students. Perception of dental students towards patient safety culture is expected to improve with the increase of clinical training.

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

Resumo Objetivo: Mensurar o clima de segurança e os fatores contribuintes na perspectiva de trabalhadores de enfermagem de instituições hospitalares do Sul do Brasil. Métodos: Estudo transversal, com 648 profissionais de três hospitais do noroeste do Estado do Rio Grande do Sul. Para coleta dos dados, utilizou-se o Questionário de Atitudes de Segurança. A análise dos dados se deu por estatísticas descritivas (Kolmogorov-Smirnov, Alfa de Cronbach, média, desvio padrão), e analíticas (Kruskai-Wallis e Manny Witney). Resultados: Participaram do estudo 648 profissionais de enfermagem, destes 66,5% trabalham em hospitais filantrópicos e 43,5% em hospital privado. Identificou-se média positiva nos domínios satisfação de trabalho, clima de trabalho em equipe e condições de trabalho, com diferença estatística nas condições de trabalho entre hospital filantrópico e público. Verificou-se melhor avaliação entre os profissionais enfermeiros, que atuam a tempo inferior a cinco anos e na pediatria. Conclusão: A respeito da percepção do clima de segurança quando comparado às categorias profissionais, os enfermeiros demonstram escores maiores do que auxiliares/técnicos de enfermagem, com diferença estatística nos domínios clima de trabalho, percepção de stress e gerência da unidade. Na perspectiva dos trabalhadores de enfermagem evidenciou-se escores positivos para clima de trabalho em equipe e satisfação do trabalho.