Percepção da cultura de segurança na emergência de um hospital militar em tempos de pandemia da COVID-19: estudo de método misto

Abstract

Investigations into the assessment of safety culture and the impact on health management are essential for safe care. In December 2019, in Wuhan, there was the identification and characterization of a new coronavirus, SARS-CoV-2, which caused an epidemic of acute respiratory syndrome in humans, being characterized as a pandemic on March 11, 2020. The object of this thesis was the perception of the patient safety culture in the Emergency Service. From the questions: "what is the level of perception about the culture of patient safety by the multiprofessional team of the Emergency Service of a military hospital in times of a COVID-19 pandemic?” and “how to strengthen the perception of the culture of patient safety in the Emergency Service of a military hospital in face of the COVID-19 pandemic?” the following objectives were formulated: General: investigate the perception of the patient safety culture in the Emergency Service of a military hospital during the COVID-19 pandemic. Specific: identify the perception of the safety culture by the multidisciplinary team of the Emergency Service of a military hospital in the face of the COVID-19 pandemic; discuss with the team the perception of the dimensions of the safety culture identified in the unit; and build with the multiprofessional emergency team of a military hospital an action plan, considering the perception of the dimensions of safety culture considered fragile against COVID-19. Methodology: mixed method study of explanatory sequential design. The quantitative approach was transversal, using the survey method, and the data were collected through the application of the HSOPSC in October 2021, answered by 63 professionals; and the qualitative approach used the participatory research method, the data and the action plan were built by the FG composed by 13 participants, in April 2022; carried out in the Emergency Service of a military hospital in the State of Rio de Janeiro, after being submitted and approved by the Research Ethics Committee of UERJ under the number CAAE: 47252821.0.0000.5282 and the IPB of the HNMD under CAAE number: 47252821.0.3001.5256. Results: nine dimensions were considered fragile: “Expectations and actions to promote the safety of supervisors”; “Return information and communication regarding error”; “Open communication – continuous improvement; “Professionals (staff)”; “Management support for patient safety”; “Teamwork between units”; “Shift change or internal transfers”; “General perceptions of patient safety”; and “Frequency of reported events”. Only “Teamwork within the unit” was considered a strong dimension. Organizational learning”; and “Non-punitive response to error” were considered neutral dimensions. Conclusion: the strengthening of organizational culture should be a strategic objective of top management. Goals of performance indicators must be traced, with a view to achieving this objective. The participation of employees in patient safety actions, as well as the means and infrastructure for them to act safely, are fundamental for the provision of safe care.