Cultura de segurança do paciente em um município de pequeno porte

Abstract

Introduction: In the current context, it is important to establish safe health services focused on strengthening the culture of patient safety, replacing guilt and punishment with the opportunity to learn from failures and improve health care. The research arose from the need to discuss actions aimed at strengthening the culture of patient safety in the context of a small city in the state of Rio Grande do Norte, (RN). Objective: To carry out an internal cycle of quality improvement aimed at the culture of patient safety from the perspective of professionals in the health services of primary and hospital care in the municipality of Grossos, RN. Method: Improvement Cycle carried out in the 2019-2020 biennium, of the type before and after, target audience professionals from the Extended Family Health Center, from the Family Health Strategy teams, a municipal hospital and health managers, totaling 58 professionals. The questionnaire “Research on Patient Safety Culture for Primary Care” was used, which assessed twelve dimensions of patient safety culture: Open communication, Communication about error, Exchange of information with other institutions, Standardization of processes, Organizational learning, General perception of safety and quality, Leadership support, Care monitoring, safety and quality problems, Team training, Team work, Pressure and work pace. For each assessment, the 95% confidence intervals were calculated for the conformity estimates and the absolute and relative improvement values were estimated. The differences in conformities before and after were tested for statistical significance and the Z value was calculated for the alternative hypothesis of improvement. The analysis also identified the “strengths” of the safety culture with a percentage of positive responses equal to or greater than 75% and “weaknesses” less than 50%. Results: There was a significant increase in the percentage of compliance observed at the end of the cycle from seven to nine of the twelve dimensions of the patient safety culture assessed, with a total absolute improvement of 6.2%. Increase in dimensions recognized as positive from six to nine and reduction in fragile ones from six to three. Conclusion: The completion of the improvement cycle was associated with an increase in the rate of compliance with the dimensions and criteria analyzed, a reduction in non-conformities and a predominance of the positive character in the perception of the safety culture by professionals.