Evolução da cultura de segurança em hospitais antes e após a implantação do programa nacional de segurança do paciente

Abstract

Introdution: Promoting Patient Safety Culture (CSP) in health organizations has been recommended as a practice that contributes to reducing the risk of unnecessary harm associated with health care, but there is no evidence of public health interventions They should be deployed. The Brazilian health system has regulated a series of measures for this purpose, but its effectiveness has not been evaluated. Objective: To analyze the effect of Patient Safety National Program (PNSP) on Patient Safety Culture. Method: This is a longitudinal quase-exprimental design with descriptive and analytical approach. The CSP was evaluated in three hospitals with different profiles, three months before (n = 215) and fifteen months (n = 450) the implementation of national patient safety program. We used a validated instrument and adapted to the Brazilian reality (Hospital Survey On Patient Safety Culture). The development of CSP was evaluated by simple indicators 14 and 2 compounds. Results: The CSP had positive developments consistently following the implementation of PNSP. Hospitals improved CSP in 14 of the 16 indicators assessed, including 11 of the 12 dimensions evaluated, the total Positive Response Percent, the average score for patient safety and the CSP index. The hospital with the highest improvement was the state followed by federal and private, it shows that PNSP was an inducer of improving of services in Brazil, since this order was reversed culture level before PNSP. Conclusion: This study shows a consistent improvement of CSP in hospitals after PNSP, pointing to the effectiveness of external national regulation, which in turn appear to be modulated by the variability of the internal context.