Patient safety culture at Neonatal Intensive Care Units: perspectives of the nursing and medical team.

Andréia Tomazoni,Sabrina De Souza,Patrícia Kuerten Rocha,Hamilton Filipe Correia De Malfussi,Jane Cristina Anders

doi:10.1590/0104-1169.3624.2477

Andréia Tomazoni, Sabrina De Souza + Show 3 more

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https://doi.org/10.1590/0104-1169.3624.2477

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Abstract

OBJECTIVE: to verify the assessment of the patient safety culture according to the function and length of experience of the nursing and medical teams at Neonatal Intensive Care Units. METHOD: quantitative survey undertaken at four Neonatal Intensive Care Units in Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected between February and April 2013 through the application of the Hospital Survey on Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and Cronbach's Alpha coefficient were used. Approval for the research project was obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121. RESULTS: differences in the number of positive answers to the Hospital Survey on Patient Safety Culture, the safety grade and the number of reported events were found according to the professional characteristics. A significant association was found between a shorter Length of work at the hospital and Length of work at the unit and a larger number of positive answers; longer length of experience in the profession represented higher grades and less reported events. The physicians and nursing technicians assessed the patient safety culture more positively. Cronbach's alpha demonstrated the reliability of the instrument. CONCLUSION: the differences found reveal a possible relation between the assessment of the safety culture and the subjects' professional characteristics at the Neonatal Intensive Care Units.

Highlights

Patient safety is related to factors like human fallibility, weaknesses in health organizations, problems with technological devices, communication and inappropriate dimensioning between teams and professionals, as well as with the task burden and limited knowledge about safety[1].One of the safety pillars is the institutional culture, which is based on good communication, trust, organizational learning, commitment of the hospital management to safety, leadership, non-punitive approach of errors and a shared perception of the importance of this theme[2,3]
A proposal for cultural changes related to safety stood out in Brazil through Article 5 of Ministry of Health Decree 529, issued on April 1st 2013, which defines the strategies for the implementation of the National Patient Safety Program
The data were collected between February and April 2013 through the application of the Agency for Healthcare Research and Quality’s (AHRQ) Hospital Survey on Patient Safety Culture (HSOPSC), which consists of 42 items related to the patient safety culture, besides requesting the subjects’ opinion on the patient safety grade at their service, the number of events reported and the respondents’ professional characteristics[3]

Summary

Introduction

Patient safety is related to factors like human fallibility, weaknesses in health organizations, problems with technological devices, communication and inappropriate dimensioning between teams and professionals, as well as with the task burden and limited knowledge about safety[1].One of the safety pillars is the institutional culture, which is based on good communication, trust, organizational learning, commitment of the hospital management to safety, leadership, non-punitive approach of errors and a shared perception of the importance of this theme[2,3]. The health institutions need to promote a culture based on these values to improve the patient safety. A proposal for cultural changes related to safety stood out in Brazil through Article 5 of Ministry of Health Decree 529, issued on April 1st 2013, which defines the strategies for the implementation of the National Patient Safety Program. These strategies include the promotion of the safety culture, which emphasizes learning and organizational improvement, the engagement of professionals and patients in accident prevention, with emphasis on safe systems, avoiding individual accountability processes[4]. The literature shows that the assessment of the patient safety culture differs among the hospital organizations depending on the size, accreditation, specialty, and can vary among the professionals, depending on the function, length of experience and age[5,6,7,8,9]

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