Title : Perception of safety climate in Brazilian private health institutions
Abstract:
Introduction: Safety Climate essentially refers to the perception of individuals in their working environment and can be used as an indicator for organizational safety culture. The analysis of this indicator is considered an important instrument in determining actions that aggregate value in patient care. It is also used for observing changes in safety culture over time.
Objective: To verify the perception by nursing professionals on Safety Climate in NotreDame Intermédica Group (GNDI) institutions which initiated the preparatory program for the Qmentum International Certification.
Method: The analysis of the perception of Safety Climate was made based on the modified version of the Patient Safety Climate in Health Care Organizations (PSCHO) and Canadian Patient Safety Climate Survey (Can-PSCS). This form is composed of thirty-eight items distributed in ten dimensions, whose answers are evaluated with the Likert scale. The application of the instrument to nursing professionals was conducted in five GNDI institutions located in the state of São Paulo, Brazil, by a form structured through Google Form, from November to December 2018. The answers were categorized into: Positive for Agree, Attention for Partially Agree, Negative for Do not agree and Not Applicable. The dimensions with negative results above 30% were considered unfavorable safety climate perception and positive results and attention above 70%, favorable.
Results: The total number of employees was 3016 and from this total, 2817 (93.4%) answered the questionnaire. From the total that answered, 1060 (35.2%) were nursing professionals, of which 296 (9.8%) were nurses and 764 (25.3%) were nursing assistants. From the total number of nursing professional respondents, 87% acknowledged that patient safety is a strategic priority. Among nursing assistants, the main negative perceptions were related to Security Resources (28%); Team Recognition (22.3%); Team Leadership (19.3%); Psychological Security (19.3%) and Communication (17.2%). The main negative perceptions identified amongst nurses were: Security Resources (27.9%); Team Recognition (23.5%) and Team Leadership (19.7%). The analysis showed that the favorable results for nursing assistants are related to High Leadership (88.7%); Learning (87.8%) and Work Norms (87.5). For the group of nurses, we verified that the same results are repeated with only changes in the percentages: High Leadership (87.5%); Learning (88.8%) and Work Norms (87.7%).
Conclusion: Recognition that patient safety is a strategic priority was the positive response observed. The main items identified as negative perception of the nursing team were: Team recognition, Team Leadership, Psychological Safety and Communication. Given this finding, in February 2019 the GNDI High Leadership launched the Welcoming Project with expectation of positive impact in the next evaluation. The GNDI with 4.6 million clients in the country and 19,000 employees seeks through the implementation of quality and safety programs to improve the generation of value to the client, patient, investors, their professionals and society.
Take Away Notes:
• To compare the perception of safety climate over time
• To direct the high leadership in the definition of strategies of improvement from the dimensions of the negative perception
• Use research as a quantitative tool to evaluate the safety of the health sector perceived by health professionals
• Redesigning work processes
• Review roles and responsibilities of the nursing team
