Patient safety culture according to nursing professionals of an accredited hospital

Melo, Eliana; Balsanelli, Alexandre Pazetto; Neves, Vanessa Ribeiro; Bohomol, Elena

doi:10.1590/1983-1447.2020.20190288

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Original Article • Rev. Gaúcha Enferm. 41 • 2020 • https://doi.org/10.1590/1983-1447.2020.20190288 copy

Patient safety culture according to nursing professionals of an accredited hospital

Cultura de seguridad del paciente según profesionales de enfermería de un hospital acreditado

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the perception of the nursing team regarding the patient safety culture of an accredited hospital and to identify the differences between shifts, professional category and units.

Method:

Cross-sectional study, conducted in a private hospital in the city of São Paulo, SP, Brazil, with application of the Survey on Patient Safety Culture Hospital to 497 nursing professionals. Descriptive analysis, instrument consistency and generalized linear mixed model were performed.

Results:

The organizational learning and continuous improvement dimension was considered a strong area (77%) and the personal adequacy (47%), shift / shift change and transfer (47%) and non-punitive response to errors (25%) dimensions were considered. fragile. Differences in perception were found between the professional categories in two dimensions; between shifts in six and between units in seven dimensions.

Conclusion:

The nursing team identified weaknesses in the patient safety culture in the hospital, with the need to standardize the improvement processes.

Keywords:
Patient safety; Organizational culture; Health services research; Hospitals; Nursing

Variables	n	%
Gender
Female	433	87.1
Male	64	12.9
Professional category
Nursing assistant	184	37.0
Nursing technician	313	63.0
Education
High school	268	53.9
Higher education	127	25.6
Specialization	100	20.1
Master’s degree	2	0.4
Shift
Morning	160	33.8
Afternoon	157	33.2
Night	156	33.0
Time in sector
Less than 1 year	28	6.0
1 to 5 years	291	62.3
6 to 10 years	101	21.6
11 to 15 years	26	5.6
16 years or more	21	4.5
Formation time
Less than 1 year	3	0.6
1 to 5 years	173	34.8
6 to 10 years	166	33.4
11 to 15 years	90	18.1
16 years or more	65	13.1

Dimension	Average ± standard deviation	Positive answers %	Cronbach's Alpha
Supervisor/manager expectations and actions promoting safety	3.5 ± 0.9	61	0.80
Organizational learning and continuous improvement	3.8 ± 0.6	77	0.57
Teamwork within the units	3.5 ± 0.7	63	0.72
Communication opening	3.4 ± 0.9	50	0.62
Feedback and communication about errors	3.9 ± 0.9	64	0.67
Non-punitive response to errors	2.6 ± 0.7	25	0.45
Staff adequacy	3.1 ± 0.6	47	0.45
Hospital management support for patient safety	3.7 ± 0.6	69	0.59
Teamwork between units	3.3 ± 0.6	52	0.56
Shift change/shift and internal transfers	3.2 ± 0.8	47	0.78
General perception of patient safety	3.4 ± 0.6	60	0.51
Frequency of reported events	4.0 ± 1.0	68	0.91

Dimension	Nursing assistant (n=184)	Nursing technician (n=313)	p *
Supervisor/manager expectations and actions promoting safety	63	60	<0.001
Organizational learning and continuous improvement	79	77	0.364
Teamwork within the units	63	63	0.993
Communication opening	51	49	0.518
Feedback and communication about errors	67	62	0.077
Non-punitive response to errors	27	24	0.175
Staff adequacy	47	48	0.656
Hospital management support for patient safety	68	70	0.537
Teamwork between units	52	52	0.864
Shift change/shift and internal transfers	43	50	0.043
General perception of patient safety	59	61	0.616
Frequency of reported events	73	65	0.384

Dimension	Morning (n=180)	Afternoon (n=158)	Night (n=159)	p *
Supervisor/manager expectations and actions promoting safety	64	65	55	0.021
Organizational learning and continuous improvement	82	77	74	0.049
Teamwork within the units	60	67	64	<0.001
Communication opening	52	52	45	0.122
Feedback and communication about errors	67	66	58	0.031
Non-punitive response to errors	26	27	21	0.142
Staff adequacy	46	47	49	0.612
Hospital management support for patient safety	70	73	66	0.139
Teamwork between units	54	57	48	0.038
Shift change/shift and internal transfers	45	51	47	0.4
General perception of patient safety	63	64	53	<0.001
Frequency of reported events	70	66	67	0.89

Dimension	SC (n=37)	ONCO BMT (n=18)	AER (n=62)	CER (n=17)	IU (n=185)	CICU (n=24)	AICU (n=154)	p *
Supervisor/manager expectations and actions promoting safety	55	82	46	90	66	76	56	<0.001
Organizational learning and continuous improvement	74	85	71	86	81	82	74	0.064
Teamwork within the units	44	76	71	84	65	74	56	<0.001
Communication opening	44	67	45	73	51	47	46	0.007
Feedback and communication about errors	45	82	57	82	65	69	64	0.001
Non-punitive response to errors	29	24	22	49	24	42	22	0.001
Staff adequacy	39	53	33	46	44	65	56	<0.001
Hospital management support for patient safety	69	78	66	77	71	72	66	0.563
Teamwork between units	47	71	52	63	56	53	44	0.001
Shift change/shift and internal transfers	48	56	46	54	49	54	42	0.41
General perception of patient safety	63	61	56	78	58	57	62	0.084
Frequency of reported events	63	80	57	92	63	79	75	0.09

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[1] Corresponding author:
Alexandre Pazetto Balsanelli Email: alexandre.balsanelli@unifesp.br