Perception of the nursing team of a Surgical Center regarding Hospital Accreditation at a University Hospital

Fernandes, Hellen Maria de Lima Graf; Peniche, Aparecida de Cássia Giani

doi:10.1590/S0080-623420150000700004

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Sumário

Original Article • Rev. esc. enferm. USP 49 (spe) • Dec 2015 • https://doi.org/10.1590/S0080-623420150000700004 copy

Perception of the nursing team of a Surgical Center regarding Hospital Accreditation at a University Hospital^* * Extracted from the dissertation entitled “Acreditação Hospitalar: A percepção da equipe de enfermagem do Centro Cirúrgico de um Hospital Universitário”, Escola de Enfermagem, Universidade de São Paulo, 2014.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To analyze the perception of nursing teams at a surgical center regarding the process of hospital accreditation, in the evaluative aspects of structure, process, and result.

Method

The study takes a quantitative and exploratory-descriptive approach, carried out at a university hospital.

Result

The population consisted of 69 nursing professionals, and the data collection was performed in the months of January and February 2014 by way of a questionnaire, utilizing the Likert scale. The methodology used a Cronbach’s Alpha equal to 0.812. In the comparison of the three aspects, the one with the highest favorability score was “result”, with an average of 47.12 (dp±7.23), and the smallest was “structure,” with an average of 40.70 (dp±5.19).

Conclusion

This situational diagnostic can assist in the restructuring of the vulnerable areas evaluated in these three aspects, mainly in the aspect of structure, with a goal of level 2 accreditation by the ONA (Brazilian’s National Organization for Accreditation) defended by the Institution.

Health Evaluation; Hospital Accreditation; Surgery Department; Hospital; Operating Room Nursing

Statement	Likert Scale (%)

	TD	PD	I	PA	TA
Equipment was acquired for the Surgical Center because of the accreditation process.	2.9	4.4	13.0	53.6	26.1
Investments in the physical structure of the Surgical Center were made with its insertion into the ONA accreditation process.	5.8	8.7	8.7	42.0	34.8
The collaborators from the Surgical Center were not familiar with the ONA guidelines.	11.6	24.6	13.1	29.0	21.7
The accreditation process has a financial cost to the institution.	2.9	2.9	11.6	17.4	65.2
The errors noted in the work processes served to instigate reprimands and administrative sanctions.	23.2	21.7	14.5	29.0	11.6
The standards of the ONA manual were inconsistent with the reality of the sector.	18.8	20.3	29.0	26.1	5.8
The physical structure of the Surgical Center is old and does not favor the accreditation process.	24.6	24.6	5.8	36.3	8.7
The ONA accreditation process provided improvements in the assistance processes.	2.9	2.9	5.8	24.6	63.8
There was an increase in forms and paperwork with the ONA accreditation process.	10.1	10.1	11.6	14.5	53.7
The training of the nursing team is carried out with a focus on the necessities of the assistance sector.	5.8	10.1	2.9	37.7	43.5
There was an increase in the nursing staff in the sector due to the accreditation process.	52.2	14.5	14.5	13.0	5.8
The number of trainings held in the sector diminished after the achievement of accreditation.	33.3	17.4	24.6	16.0	8.7

Statement	Likert Scale (%)

	TD	PD	I	PA	TA
The accreditation promoted the integration of a multi-professional team.	4.4	7.2	13.0	46.4	29.0
With accreditation, there has been a standardization of practices and behavior in the nursing team.	2.9	8.7	5.8	46.4	36.2
I was trained and qualified to carry out my duties in the Surgical Center independently of the accreditation process.	4.4	10.1	0.0	18.8	66.7
The surgeon’s team did not adhere to the protocol for safe surgery.	14.5	14.5	13.0	50.7	7.3
The anesthetic team did not adhere to the protocol for safe surgery.	27.5	15.9	10.2	37.7	8.7
The nursing team did not adhere to the protocol for safe surgery.	52.2	20.3	5.8	17.4	4.3
The presence of students hindered the ONA Level 1 accreditation process.	2.9	10.2	36.2	11.6	39.1
The nurses supervised the quality-control processes in the surgical center.	1.5	4.4	7.2	33.3	53.6
The nursing team was familiar with the existent risk management tools in the surgical center.	4.3	8.7	5.8	52.2	29.0
The quality control process is exclusively the responsibility of leadership.	66.7	20.3	4.3	2.9	5.8
The night shift is involved in the accreditation process by the leadership.	8.7	7.2	20.3	26.1	37.7
The processes aimed at accreditation are revisited only on the occasion of new ONA certifications.	23.2	26.1	7.3	24.6	18.8

Statement	Likert Scale (%)

	TD	PD	I	PA	TA
Accreditation fostered more profitability for the hospital.	1.5	2.9	21.7	30.4	43.5
The nursing professional who works in an accredited hospital does not have a resume that stands out competitively in the market.	63.8	17.4	1.5	13.0	4.3
The seal of ONA accreditation promotes a higher prominence for the hospital.	0.0	0.0	8.7	34.8	56.5
The standardization of patient charts in the surgical center complicated communication among the multidisciplinary team	68.1	13.0	7.3	8.7	2.9
The accreditation process worsened work conditions for nursing.	75.4	13.1	1.4	8.7	1.4
Accreditation brought more safety to the patients attended in this institution.	1.5	1.5	4.3	21.7	71.0
The surgical center is more disorganized after the accreditation process.	63.8	15.9	5.8	8.7	5.8
The results obtained in the performance metrics of the sector are used in the management of the unit.	2.9	5.8	15.9	20.3	55.1
The employees benefited in some way by the accreditation.	14.5	14.5	5.8	37.7	27.5
The assistance performance metrics of the surgical center were divulged to the multidisciplinary team in a systematic way after the accreditation process.	13.0	11.6	23.2	29.0	23.2
Reprimands increased in the sector with the implementation of the quality control process.	26.1	21.7	10.2	26.1	15.9
The demands imposed by the accreditation process triggered stress and overwork.	18.9	8.7	2.9	30.4	39.1

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Correspondence Addressed to: Aparecida de Cássia Giani Peniche Av. Dr. Enéas de Carvalho Aguiar, 419 – Cerqueira César CEP 05403-000 – São Paulo, SP, Brazil ggphe@usp.br