Clima de seguridad del paciente en la atención hospitalaria de cardiología: instrumento para la gestión de la seguridad

Vitorio, Aline Mirema Ferreira; Tronchin, Daisy Maria Rizatto

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. bras. enferm. 73 (Suppl 5) • 2020 • https://doi.org/10.1590/0034-7167-2019-0549 copiar

Clima de seguridad del paciente en la atención hospitalaria de cardiología: instrumento para la gestión de la seguridad

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Evaluar el clima de seguridad bajo la perspectiva de los profesionales de salud en las unidades de internación y de cuidados intensivos de un hospital público especializado en cardiología, de la ciudad de Río de Janeiro. Métodos: Se trata de un estudio cuantitativo, exploratorio, descriptivo, en el que se utilizó el instrumento "Safety Attitudes Questionnaire" (Cuestionario para Evaluar Comportamientos Seguros e Inseguros). Los hallazgos se analizaron según la estadística descriptiva e inferencial, con nivel de significación del 5%.

Resultados:

El clima de seguridad general obtuvo un promedio del 66,6; la mejor puntuación correspondía al dominio Satisfacción en el trabajo (80,8) y la menor, a la Percepción de gestión del hospital (52,5). Las puntuaciones medias fueron estadísticamente significativas en términos de empleo, género y categoría profesional.

Conclusión:

Existen inconsistencias en el clima de seguridad relacionadas con la gestión y con el vínculo estatutario, en términos de pertenecer al género masculino y al equipo de enfermería.

Descriptores:
Gestión de la Seguridad; Evaluación de los Servicios de Salud; Servicio de Cardiología Hospitalario; Seguridad del Paciente; Cultura Organizacional

Statements	Answers
Statements	TD and PD (%)	Neutral	TA and PA (%)
1. The nurses' suggestions are well received in this area.	8.3	9.7	82
2. In this area, it is difficult to speak openly if I notice a problem with the patient care.	59.5	5.8	34.7
3. In this area, disagreements are resolved appropriately (e.g. It is not about who is right, but what is best for the patient).	18.3	7.2	74.5
4. I have the support I need from other team members to care for patients.	10.2	5.2	84.6
5. It is easy for professionals working in this area to ask questions when there is something they do not understand.	11.3	7	81.7
6. Here, physicians and nurses work together as a well-coordinated team.	20.5	8.2	71.3
7. I would feel safe if I were treated here as a patient.	13	9.4	77.6
8. Errors are dealt with appropriately in this area.	22.7	16	61.3
9. I know the appropriate means to address issues related to patient safety in this area.	18.9	10.8	70.3
10. I receive appropriate feedback on my performance.	32	10.3	57.7
11. In this area, it is difficult to discuss about errors.	40.8	12.4	46.8
12. I am encouraged by my colleagues to report any concerns I may have about patient safety.	17.6	12.8	69.6
13. The culture in this area makes it easy to learn from the errors of others.	26.4	18.2	55.4
14. My safety suggestions would be put into action if I expressed them to management.	35.5	23.3	41.2
15. I like my job.	2.7	3.7	93.6
16. Working here is like being part of a big family.	17.4	8.1	74.5
17. This is a good place to work.	6.6	3.9	89.5
18. I am proud to work in this area.	5.2	5.1	89.7
19. Morale is high in this area.	21.8	16.5	61.7
20. When my workload is excessive, my performance is impaired.	8.8	4.3	86.9
21. I am less efficient at work when I am tired.	11.0	5.1	83.9
22. I am more likely to make mistakes in tense or hostile situations.	21.8	6.6	71.6
23. Tiredness impairs my performance during emergency situations (e.g. cardiorespiratory resuscitation, seizures).	38.9	8.3	52.8
24. Management supports my daily efforts (unity).	18.4	9.5	72.1
24. Management supports my daily efforts (hospital).	33.4	31.5	35.1
25. Management does not consciously compromise patient safety (unit).	26.8	13.8	59.4
25. Management does not consciously compromise patient safety (hospital).	27.0	30.6	42.4
26. Management is doing a good job (unit).	12.8	14.4	72.8
26. Management is doing a good job (hospital).	20.1	30.8	49.1
27. Troubled team members are treated constructively by our unit.	34.8	19.3	45.9
27. Troubled team members are treated constructively by our hospital.	32.7	39.6	27.7
28. I receive appropriate and timely information about events that may affect my work at the unit.	25.5	9.9	64.6
28. I receive appropriate and timely information about events that may affect my work at the hospital.	33.9	24.9	41.2
29. In this area, the number and qualification of professionals are enough to deal with the quantity of patients.	52.0	5	43
30. This hospital does a good job of training new team members.	35.7	14.3	50
31. All information needed for diagnostic and therapeutic decisions is routinely available to me.	32.9	12	55.1
32. Interns in my profession are adequately supervised.	18.9	10.3	70.8
33. I experience good collaboration with nurses in this area.	9.7	4.5	85.8
34. I experience good collaboration with the team of physicians in this area.	16.6	7.1	76.3
35. I experience good collaboration with pharmacists in this area.	21.5	25.3	53.2
36. Communication failures that lead to service delays are common.	33.2	13.6	53.2

SAQ domains	Mean	Standard derivation
Teamwork climate	73.8	18.7
Safety climate	64.2	20.4
Job satisfaction	80.8	19.6
Stress recognition	73.3	23.8
Unit management perception	60	27.6
Hospital management perception	52.5	22.3
Working conditions	61.2	27.7
Total SAQ	66.6	15

Variables	Questionnaire domains
Variables	Teamwork climate	Safety climate	Job Satisfaction	Stress recognition	Hospital management perception	Unit management perception	Working condition
Professional category
Nursing team	71.9(dp=17.9)	65.1(dp=19.2)	81.8(dp=18.2)	70.9(dp=25)	56.7(dp=22.4)	56.7(dp=28.1)	56.1(dp=29.2)
Other professionals	76.3(dp=19.7)	62.9(dp=22.1)	79.54(dp=21.2)	76.6(dp=21.8)	54.2(dp=21.9)	64(dp=26.2)	67.8(dp=23.8)
p value	0.022^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.	0.308	0.257	0.021^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.	0.126	0.010^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.	*<0.001^ * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.**
Gender
Female	72.3(dp=19.2)	63.7(dp=20.8)	80.7(dp=20.2)	74.2(dp=23.5)	51.8(dp=21.8)	58.2(dp=27.6)	58.6(dp=28.4)
Male	78.9(dp=16.8)	65.4(dp=20.1)	80.9(dp=18)	71.6(dp=24.7)	53.6(dp=23.5)	64.7(dp=27.2)	69.2(dp=23.2)
p value	0.003^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.	0.483	0.910	0.370	0.506	0.047^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.	*< 0.001^ * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.**
Employment relationship
Statutory	72.1(dp=20)	61.8(dp=21.5)	77.2(dp=21.2)	74.3(dp=22.3)	50(dp=28.1)	59.2(dp=22.2)	57.6(dp=28)
Contact	76.8(dp=14.6)	69(dp=17.7)	88(dp=14.7)	67.6(dp=26)	58.9(dp=27.6)	60.5(dp=20.9)	66.9(dp=26)
p value	0.004^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.	0.006^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.	*< 0.001^ * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.**	*< 0.001^ * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.**	0.003^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.	0.320	0.008^* * p value<0.05; ANOVA test, Student's t test, Welch's correction, Games-Howell post hoc test.

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[1] Corresponding author: Aline Mirema Ferreira Vitorio. E-mail: alinemirema2011@gmail.com