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Cultura de Segurança do Doente no Serviço de Urgência
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RESUMO - Introdução: A Cultura de segurança dos doentes é considerada um dos pilares da segurança dos
doentes, sendo a sua avaliação essencial para a compreensão do comportamento e
perceção individual dos profissionais e da organização de saúde, particularmente num
ambiente altamente complexo e inconstante como é caracterizado o serviço de
urgência.
Metodologia: Com intuito de atingir o objetivo de Caracterizar a Cultura de segurança dos doentes do
serviço de Urgência de um Hospital do distrito de Lisboa, foi utilizada uma metodologia
mista, que consiste na aplicação do HSPSC e na realização de uma entrevista aos
profissionais de saúde que desempenham funções no serviço de urgência.
Resultados: As dimensões do HSPSC com maior percentagem de respostas positivas são o
“Trabalho em equipa” (68%), “Expectativas do supervisor/gestor e ações que promovam
a segurança do doente” (53%), as “Transições” (43%) e as dimensões com uma menor
percentagem de respostas positivas são a “Frequência da notificação” (15%), a
“Dotação de profissionais” (20%) e o “Apoio à segurança dos doentes pela gestão”
(21%).
As categorias que emergiram das entrevistas com uma perceção forte da cultura de
segurança são “Trabalho em equipa”, “Aprendizagem organizacional – melhoria
contínua” e “Resposta não punitiva ao erro”, as categorias com uma perceção fraca da
cultura de segurança são a “Dotação de profissionais”, “Trabalho entre unidades”, a
“Frequência da notificação” e a “Comunicação acerca do erro”.
Conclusão: Os resultados salientam que mais de metade dos profissionais de saúde atribuiu um
grau de cultura de segurança dos doentes no serviço de urgência aceitável, verificando
que todas as dimensões requerem a implementação de estratégias e de ações de
melhoria.
ABSTRACT - Introduction: Patient safety culture is considered one of the patient safety main elements, being the evaluation essential to understand the behaviour and the individual perception of the healthcare professionals and the healthcare organization, particularly in a highly complex and volatile environment such as the emergency department. Methodology: In order to achieve the goal which is Characterizing the Patient Safety Culture of the Emergency Department from a Lisbon District Hospital, it was used a mixed methodology, that consists of applying the HSPSC and doing an interview to the healthcare professionals that work in the emergency department. Results: The HSPSC dimensions with the highest percentages of positive scores were “Teamwork within units” (68%), “Supervisor/manager expectations and actions promoting patient safety” (53%) and “Handoffs and transitions” (43%), the dimensions with the lowest percentages of positive scores were “Frequency of events reported” (15%), “Staffing” (20%) and “Management Support for Patient Safety” (21%). The categories that emerged from the interviews with a strong safety culture perception are “Teamwork within units”, “Organizational learning – continuous improvement” and “Non-punitive response to errors”, the categories with a weak safety culture perception are “Staffing”, “Teamwork across units”, “Frequency of events reported” and “Communications about errors”. Conclusions: The underline results show that half healthcare professionals give an acceptable degree to the patient safety culture in the emergency department, corroborating that all the dimensions require the implementation of improvement strategies and actions.
ABSTRACT - Introduction: Patient safety culture is considered one of the patient safety main elements, being the evaluation essential to understand the behaviour and the individual perception of the healthcare professionals and the healthcare organization, particularly in a highly complex and volatile environment such as the emergency department. Methodology: In order to achieve the goal which is Characterizing the Patient Safety Culture of the Emergency Department from a Lisbon District Hospital, it was used a mixed methodology, that consists of applying the HSPSC and doing an interview to the healthcare professionals that work in the emergency department. Results: The HSPSC dimensions with the highest percentages of positive scores were “Teamwork within units” (68%), “Supervisor/manager expectations and actions promoting patient safety” (53%) and “Handoffs and transitions” (43%), the dimensions with the lowest percentages of positive scores were “Frequency of events reported” (15%), “Staffing” (20%) and “Management Support for Patient Safety” (21%). The categories that emerged from the interviews with a strong safety culture perception are “Teamwork within units”, “Organizational learning – continuous improvement” and “Non-punitive response to errors”, the categories with a weak safety culture perception are “Staffing”, “Teamwork across units”, “Frequency of events reported” and “Communications about errors”. Conclusions: The underline results show that half healthcare professionals give an acceptable degree to the patient safety culture in the emergency department, corroborating that all the dimensions require the implementation of improvement strategies and actions.
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Palavras-chave
Cultura de Segurança do Doente Segurança do doente Serviço de Urgência Profissionais de Saúde Patient Safety Culture Patient Safety Emergency Department Healthcare Professionals