Abstract
ABSTRACT Objective: to analyze the safety culture of women in childbirth and related institutional factors based on the perceptions of nursing and medical professionals. Methods: a mixed, sequential explanatory study, conducted with nursing technicians, nurses and physicians of the obstetric center of a public maternity hospital in the city of Rio de Janeiro. Data collection took place from May to July 2018. The Hospital Survey on Patient Safety Culture questionnaire and descriptive statistical treatment were applied. Then, 12 semistructured interviews and thematic content analysis were applied and, finally, this data set was integrated. Results: most of the dimensions of the safety culture are weakened, especially in the areas of institutional organization, and the team lacks knowledge about the actions of the Patient Safety Center in the institution, the uniformity of care is deficient and the number of personnel for care is limited. The safety management process and work organization need adaptations. Conclusion: the safety culture of women requires improvements in team training, skilled care, work organization, and commitment of local management to qualified and safe care in hospital births.
Highlights
IntroductionIn the area of maternal health, this curative and intervention perspective with regard to healthy pregnant women has been questioned due to its potential to cause more harm than benefits, such as the routine of cesarean sections without clear indications and unfit conducts, such as zero diet; oxytocin; episiotomy; Kristeller’s maneuver, which lack scientific evidence to justify their indication for this clientele without associated morbidity.[1,2]
All 12 safety culture dimensions the respondents assessed had less than 75% of positive responses
Despite these limits imposed on the accuracy of this study in portraying the reality of the safety culture as perceived by nursing and medical professionals at the OC of the maternity hospital under investigation, the findings showed that none of the 12 dimensions measured reached the parameter of a strengthened safety culture
Summary
In the area of maternal health, this curative and intervention perspective with regard to healthy pregnant women has been questioned due to its potential to cause more harm than benefits, such as the routine of cesarean sections without clear indications and unfit conducts, such as zero diet; oxytocin; episiotomy; Kristeller’s maneuver, which lack scientific evidence to justify their indication for this clientele without associated morbidity.[1,2]. These practices may involve disrespectful attitudes that cause pain, fear, and traumatic experiences for pregnant women, especially during childbirth, and cause harm to the physical and mental health of mother and baby. The safety culture aims to prevent errors in the care process and the damage or adverse events caused to patients as a result of these errors, in order to provide safe care to health service clients.[5]
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