Cultura de segurança do paciente em maternidades de alto risco de um estado da região nordeste do Brasil

Abstract

INTRODUCTION: Pregnancy and birth, in most cases, occurs uneventfully, but in many cases complications may arise that may be related to the assistance offered, either in relation to the structure of birthplaces, as well as due to errors in the work process and that may lead to adverse events. It can be seen that there are still many challenges to be overcome and, consequently, immediate interventions are needed to make care safer. Before that, it is important to evaluate the safety culture so that professionals are made aware of the importance of promoting Patient Safety P. OBJECTIVE: To evaluate the patient safety culture in high-risk maternity hospitals of a state in the Northeast region of Brazil. METHODS: This is a descriptive study of quantitative nature of the survey type, conducted in two high-risk maternity hospitals of a state in the northeastern region of Brazil. Data collection was performed in the period December 2020 to April 2021, through the instrument "Patient Safety Survey in Hospitals", which in addition to evaluating the profile of professionals, has 42 items divided into 12 dimensions that assesses the Patient Safety Culture (CSP). After collection, the data were validated and analyzed using descriptive statistics through the JASP Software. The research was approved by the Research Ethics Committee of the Federal University of Alagoas. RESULTS: A total of 318 professionals participated in the study, being the majority female, with a mean age of 41.7 years, with a post-graduation in specialization and most of them are part of the nursing team and with a mean time of work in the profession of 14.5 years. As for the time of work in the hospital/maternity, it was observed that the highest percentages concentrated between 16 to 20 years and 1 to 5 years, in addition, regarding the time of work in the current area, the percentages were also concentrated in the aforementioned intervals. The professionals' workload was predominantly from 20 to 39 hours per week. Regarding the dimensions of CSP, no dimension was rated as strong for CSP. We highlight the dimensions that were evaluated with the highest percentages of positive answers, however, being considered neutral, namely: supervisor's expectations and actions for patient safety, teamwork in the unit, organizational learning-continuous improvement and openness to communication. The other eight dimensions were considered as weak for CSP. When assessing the number of AE notifications made by professionals in the last 12 months, it was observed that 77.3% had not made any notifications. Regarding the patient safety score assigned to the work unit, 49.0% perceived safety as regular. CONCLUSION: We observed several weak points for the CSP, which urges the need for a reflective analysis by professionals and managers about the quality of care. Improvements in the 12 dimensions of CSP are necessary, especially regarding the non-punitive responses to errors, because if professionals believe that they will be penalized for the errors and AEs committed, they will end up neglecting the notifications. It is noteworthy that it is important the commitment of all to transform this culture of blame into a just culture, which establishes balance between the responsibility of the professional and the organization.