Patient safety culture from the perspective of nursing technicians of an emergency sector*

Objective: to characterize the culture of patient safety from the perspective of nursing technicians of an emergency sector. Methods: cross-sectional study, developed in the emergency sector of a state hospital with 175 nursing technicians, from a 12-dimensional instrument on safety culture. The analysis of the data made based on the percentages of positive, negative and neutral responses of each dimension. Results: the culture of patient safety was characterized positively from the dimension Expectations about its supervisor/head and actions promoting patient safety (56.6%); negatively in the sphere Adequacy of professionals (75.5%); and in a neutral way, in the scope of Organizational Learning continuous improvement (61.1%). Conclusion: it was understood that nursing technicians characterize the culture of patient safety in the emergency sector as an important aspect of the work environment, but that it needs to be optimized. Descriptors: Licensed Practical Nurses; Patient Safety; Emergencies; Organizational Culture; Safety Management. RESUMO Objetivo: caracterizar a cultura de segurança do paciente na perspectiva de técnicos de enfermagem de um setor de emergência. Métodos: estudo transversal, desenvolvido no setor de emergência de um hospital estadual com 175 técnicos de enfermagem, a partir de um instrumento composto por 12 dimensões sobre a cultura de segurança. A análise dos dados feita com base nos percentuais de respostas positivas, negativas e neutras de cada dimensão. Resultados: a cultura de segurança do paciente foi caracterizada positivamente a partir da dimensão Expectativas sobre o seu supervisor/chefe e ações promotoras de segurança do paciente (56,6%); negativamente na esfera Adequação de profissionais (75,5%); e de forma neutra, no âmbito do Aprendizado organizacional melhoria contínua (61,1%). Conclusão: compreendeu-se que os técnicos de enfermagem caracterizam a cultura de segurança do paciente no setor de emergência como um aspecto importante no ambiente de trabalho, mas que precisa ser otimizado. Descritores: Técnicos de Enfermagem; Segurança do Paciente; Emergências; Cultura Organizacional; Gestão da Segurança. *Extracted from the dissertation entitled “Cultura de segurança da equipe de enfermagem no serviço de urgência e emergência”, Universidade Federal do Rio Grande do Norte, 2017. 1Universidade Federal do Rio Grande do Norte. Natal, RN, Brazil. 2Hospital Universitário Onofre Lopes. Natal, RN, Brazil. Corresponding author: Manacés dos Santos Bezerril Avenida Senador Salgado Filho, 3000, Lagoa Nova. CEP: 59064-741. Natal, RN, Brazil. E-mail: manacesbezerril@hotmail.com EDITOR IN CHIEF: Viviane Martins da Silva ASSOCIATE EDITOR: Renan Alves Silva Micheline da Fonseca Silva1 Manacés dos Santos Bezerril1 Flávia Tavares Barreto Chiavone1 Soraya Helena Medeiros de Morais1 Maria Eduarda Gonçalves da Costa1 Marianny Nayara Paiva Dantas2 Viviane Euzébia Pereira Santos1 How to cite this article: Silva MF, Bezerril MS, Chiavone FTB, Morais SHM, Costa MEG, Dantas MNP, et al. Patient safety culture from the perspective of nursing technicians of an emergency sector. Rev Rene. 2021;22:e60734. DOI: https://doi.org/10.15253/2175-6783.20212260734 Silva MF, Bezerril MS, Chiavone FTB, Morais SHM, Costa MEG, Dantas MNP, et al Rev Rene. 2021;22:e60734. 2 Introduction The culture of patient safety is configured in the ideals, actions, perspectives, beliefs and individual/collective knowledge of the professionals, present in the health field, which directly imply in the care provided to the patient(1-2). Although it is essential in health services and despite the wide benefits, it is perceived that there are obstacles to its implementation, as a result of punitive measures historically employed in these environments, which still predominate in the perception of professionals. Therefore, there is a blockage about the discussion of this subject and a delay in the improvement of care(3-4). Although the occurrence of adverse events is evident, it should be noted that the adoption of an institutional educational and non-punitive culture is the most appropriate in order to promote quality care(1). The importance of the active participation of all health professionals, and among them, the nursing team, is also highlighted. This category is more susceptible to make mistakes, since it has the largest number of workers working in the most diverse sectors and levels of health care, besides carrying out work tasks involving the patient more directly(3-4). In the nursing team itself, the performance of the nursing technician stands out, due to the number of activities developed with the patient being greater when compared to the number of activities developed by the other members of the professional team and, mainly, to the high number of nursing technicians, depending on the work shift and the level of care per patient(4). Thus, according to the needs of the sector and the demand of patients, the complexity and number of procedures to be performed change and may offer greater risk, both to the patient and to the professional present in this environment, due to the overload of work and/or the knowledge deficit for the execution of these activities, as is the case of the emergency and emergency units(2,5). These sectors stand out for being appropriate for the priority care of patients with acute diseases, with higher risk of death. In this sense, a specialized, fast and efficient team work becomes essential. Moreover, most of the time, these emergency environments have an excessive number of patients, scarcity of resources, insufficient quantity of professionals, overload of the nursing team and, consequently, increase in the degree of stress(5). For these characteristics, it is essential the implementation of the culture of safety of the patient in emergency and emergency environments, due to the search for a standard of effectiveness in health care, performed particularly by nursing technicians. Therefore, when the perception of these subjects is investigated, it is possible to identify which gaps permeate and contribute to the existence of flaws in the practices developed by them, and thus, to formulate strategies that can minimize these weaknesses. It is noted the importance of exploring the culture of safety of the patient according to the point of view of nursing technicians in the midst of aspects related to structure, process and result. These elements can directly interfere in the quality of the care provided in a critical and precise assistance environment, as is the emergency sector, especially in the national context, because these workers are in the category of Nursing Vocational High School with the highest quantity in the health services and that, for several times, does not have this subject during the formation, besides there are no investigations that cover this professional class in this work scope. Therefore, the following guiding question arises: how is the patient’s safety culture characterized by nursing technicians from an emergency department of a state hospital in the Northeast of Brazil? The objective was to characterize the culture of safety of the patient in the perspective of technicians of nursing of a sector of emergency.