Carvalho, Ricardo José Matos deLima, Paulo Ricardo Fernandes de2022-06-032022-06-032021-12-29LIMA, Paulo Ricardo Fernandes de. Análise da cultura de segurança do paciente em uma maternidade de alta complexidade como uma forma de prevenção e mitigação de eventos adversos: uma contribuição da ergonomia organizacional à segurança do paciente. 2021. 208f. Dissertação (Mestrado em Engenharia de Produção) - Centro de Tecnologia, Universidade Federal do Rio Grande do Norte, Natal, 2021.https://repositorio.ufrn.br/handle/123456789/47542The concern for affirmative action aimed at quality in hospital services has grown a lot in recent decades. One of the measures that gained strength among researchers and managers in the area, recommended by the World Health Organization (WHO), was the investment in patient safety culture (CSP). However, this is not a simple task. The challenges in this field range from the analysis, measurement, evaluation and classification of the type of current culture existing in a system, to the implementation of strategic measures aimed at fostering and strengthening an efficient internal culture. This project aims to analyze and diagnose the patient safety culture (CSP) in a high-complexity public school maternity hospital, located in the city of Natal, Brazil, as a way of understanding the relationship between CSP and the occurrence of events. adverse events and to avoid or mitigate them. Initially, bibliographic searches were carried out on international sites and databases such as Scopus, CAPES and PubMed, focusing on studies and research that addressed the patient safety culture and its relationship with the occurrence of adverse events and patient safety in healthcare services. health. The field research site – the case study – was the Januário Cicco Maternity School (MEJC). The research is classified as descriptive, exploratory, documentary, with a qualitative and quantitative content in a case study. Data collection was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) model, which is a model developed to understand the work system and patient safety, from the systems engineering approach. Some steps of the Ergonomic Work Analysis (AET) were fundamental during the activities. For data collection with Focus Group I (maternity health professionals), the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire, developed by the Agency for Healthcare Research and Quality (AHRQ) of the United States, was applied. if a sample of 98 employees. The research instrument addressed 12 general dimensions that impact the PHC of a health organization. The collected data were processed and presented for discussions with the Focus Group II (maternity managers and leaders), through conversational actions in a meeting with 25 maternity managers and leaders. The verbalizations of the Focus Group II were analyzed via the Collective Subject Discourse (CSD). Cronbach's Alpha coefficient was tested for the purpose of statistical validation of normality, regarding the data obtained by applying the HSOPSC. For data processing, MS Excel, Atlas.Ti, VosViiewer software were used. The research was authorized by the Research Ethics Committee (CEP) of UFRN, under Opinion No. 4,523,836. The results showed that maternity has a patient safety culture with strong bureaucratic or calculative characteristics. In general, the negative perceptions (40.7%) of CSP surpassed the positive ones (30.1%). Almost all the dimensions analyzed presented weaknesses, standing out in this sense with low rates of positivity: Personnel Dimensioning (5.6%); Nonpunitive responses to errors (8.2%) and Patient Care Transition (27.1%). On the other hand, the dimensions that obtained the best feedback were: actions by the supervisor/head of sectors (50.2%) and teamwork in the work unit itself for patient safety actions (47.0%). The main perceived contrasts that negatively impact the CSP of the maternity, with significant levels of negativity and, therefore, contributing to the emergence of adverse events, were: Insufficiency of employees in the maternity to meet the demand (84.7%); influence of daily workload on patient safety (71.4%); loss of important information about patient care between shifts and shifts (71.4%); professionals fear that their individual errors will be recorded in their job records (71.4%). Based on the perceived weaknesses, a set of measures was recommended for their mitigation.Acesso AbertoErgonomia organizacionalSaúdeGestãoCultura de segurança do pacienteAvaliaçãoMaternidademasterThesis