Clima de segurança no ambiente cirúrgico: estudo qualitativo
DOI:
https://doi.org/10.4025/ciencuidsaude.v24i1.73451Palavras-chave:
Cultura organizacional, Centros cirúrgicos, Enfermagem, Segurança do paciente, COVID-19Resumo
Objetivo: compreender a percepção das equipes multiprofissionais em centros cirúrgicos universitários sobre os domínios de clima de segurança durante a pandemia da Covid-19. Método: estudo com abordagem qualitativa e delineamento descritivo-exploratório realizado em dois hospitais universitários. Utilizou-se um roteiro de entrevista semiestruturado criado a partir dos domínios do Questionário de Atitudes de Segurança/Centro Cirúrgico. A coleta dos dados ocorreu de fevereiro a maio de 2021 e de junho a julho de 2022, mediante aceite do profissional e a assinatura do Termo de Consentimento Livre e Esclarecido. Para análise de dados utilizou-se o IRaMuTeQ. Resultados: a comunicação em ambos os cenários foi considerada dificultosa. A percepção da gerência demonstrou-se considerável diante dos desafios do momento pandêmico, percepção trazida pelo fornecimento de equipamentos de proteção individual pelas unidades, porém com críticas a precária troca de informações entre gestão e equipe. Os profissionais sofreram com medo, ansiedade, além de cansaço físico e mental. Considerações finais: é necessário que a gestão avance construindo em conjunto com os profissionais, ouvindo-os e abandonando a cultura punitiva. É valioso adotar uma aprendizagem idealizada a partir dos erros e espaços onde a saúde mental dos profissionais possa ser valorizada.
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Referências
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7. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357. Doi: https://doi.org/10.1093/intqhc/mzm042
8. Souza MAR de, Wall ML, Thuler AC de MC, Lowen IMV, Peres AM. O uso do software IRAMUTEQ na análise de dados em pesquisas qualitativas. Rev Esc Enferm USP. 2018;52:e03353. Doi: https://doi.org/10.1590/S1980-220X2017015003353
9. Costa CJND, D’Artibale EF, Duarte ÊRM, Ribeiro MRR, Martins ETJ, Ferreira GE. Clima de segurança em saúde no contexto de pandemia da covid-19 em um hospital universitário. renome. 2022;10(2):47–56. Doi: https://doi.org/10.46551/rnm23173092202100206
10. Macedo LL, Silva AMR, Silva JFM, Haddad MCFL, Girotto E. A cultura em torno da segurança do paciente na atenção primária à saúde: distinções entre categorias profissionais. Trab educ saúde. 2020;18(1):e0023368. Doi: https://doi.org/10.1590/1981-7746-sol00233
11. Seo JK, Lee SE. Mediating roles of patient safety knowledge and motivation in the relationship between safety climate and nurses’ patient safety behaviors: a structural equation modeling analysis. BMC Nurs. 2022;21(1):335. Doi: https://doi.org/10.1186/s12912-022-01123-6
12. Gurková E, Zeleníková R, Friganovic A, Uchmanowicz I, JaroÅ¡ová D, Papastavrou E, et al. Hospital safety climate from nurses’ perspective in four European countries. Int Nurs Ver. 2020;67(2):208-217. Doi: https://doi.org/10.1111/inr.12561
13. Burlakov N, Rozani V, Bluvstein I, Kagan I. The association between quality and safety climate of a hospital ward, family members’ empowerment, and satisfaction with provided care. J Nurs Scholarsh. 2021;53:727-736. Doi: https://doi.org/https://doi.org/10.1111/jnu.12682
14. Martins KN, Bueno A de A, Mazoni SR, Machado VB, Evangelista RA, Bolina AF. Management process in surgicenters from the perspective of nurses. Acta Paul Enferm. 2021;34:eAPE00753. Doi: https://doi.org/10.37689/acta-ape/2021AO00753
15. Hoffmann M, Schwarz CM, Schwappach D, Banfi C, Palli C, Sendlhofer G. Speaking up about patient safety concerns: view of nursing students. BMC Health Serv Res. 2022;22:1547. Doi: https://doi.org/10.1186/s12913-022-08935-x
16. Ribeiro OMPL, Trindade LL, Fassarella CS, Pereira SCA, Teles PJFC, Rocha CG, et al. Impact of COVID-19 on professional nursing practice environments and patient safety culture J Nurs Manag. 2022;30(5):1105–1114. Doi: https://doi.org/10.1111/jonm.13617
17. Skegg E, McElroy C, Mudgway M, Hamill J. Debriefing to improve interprofessional teamwork in the operating room: A systematic review. J Nurs Scholarsh. 2023;55(6):1179–88. Doi: https://doi.org/10.1111/jnu.12924
18. Diaz-Navarro C, Enjo-Perez I, Leon-Castelao E, Hadfield A, Nicolas-Arfelis JM, Castro-Rebollo P. Implementation of the TALK© clinical self-debriefing tool in operating theatres: a single-centre interventional study. Br J Anaesth. 2024;133(4):853-861. Doi: https://doi.org/10.1016/j.bja.2024.05.044
19. Van Dalen ASH, Swinkels JA, Coolen S, Hackett R, Schijven MP. Improving teamwork and communication in the operating room by introducing the theatre cap challenge. J Perioper Pract. 2022;32(1–2):4–9. Doi: https://doi.org/10.1177/17504589211046723
20. Silva LC, Caldas CP, Fassarella CS, Souza PS. Effect of the organizational culture for patient safety in the hospital setting: A systematic review. Aquichan. 2021;21(2):e2123. Doi: https://doi.org/10.5294/aqui.2021.21.2.3
21. Nyberg A, Olofsson B, Fagerdahl A, Haney M, Otten V. Longer work experience and age associated with safety attitudes in operating room nurses: an online cross-sectional study. BMJ Open Qual. 2024;13(1):e002182. Doi: https://doi.org/10.1136/bmjoq-2022-002182
22. Ferreira JESM, Cavalcante TF, Jansen RC, Damasceno DFO, Oliveira LR, Silva MJN, et al. Challenges for maintaining surgical care practices in the COVID-19 pandemic: an integrative review. Invest Educ Enferm. 2023;40(1). Doi: https://doi.org/10.17533/udea.iee.v40n1e16
23. Ribeiro OMPL, Cardoso MF, Trindade LL, Rocha KG, Teles PJFC, Pereira S, et al. From the first to the fourth critical period of COVID-19: what has changed in nursing practice environments in hospital settings? BMC Nurs. 2023;22(1):1–12. Doi: https://doi.org/10.1186/s12912-023-01207-x
24. Dal’Bosco EB, Floriano LSM, Skupien SV, Arcaro G, Martins AR, Anselmo ACC. Mental health of nursing in coping with COVID-19 at a regional university hospital. Rev Bras Enferm. 2020;73:e20200434. Doi: https://doi.org/10.1590/0034-7167-2020-0434
25. Santos JLGD, Menegon FHA, Andrade GB, Freitas EO, Camponogara S, Balsanelli AP, et al. Changes implemented in the work environment of nurses in the COVID-19 pandemic. Rev Bras Enferm. 2022;75(suppl 1):1–6. Doi: https://doi.org/10.1590/0034-7167-2020-1381
26. Klemenc-Ketiš Z, Poplas SA. Safety culture at primary healthcare level: a cross-sectional study among employees with a leadership role. Zdr Varst. 2020;59(1):42-6. Doi: https://doi.org/10.2478/sjph-2020-0006
27. Spolverato G, Capelli G, Restivo A, Bao QC, Pucciarelli S, Pawlik TM, et al. The management of surgical patients during the coronavirus dieases 2019 (COVID-19) pandemic. Surgery. 2020;168(1):4-10. Doi: https://doi.org/10.1016/j.surg.2020.04.036
28. Berdida DJE, Grande RAN. Nurses' safety climate, quality of care, and standard precautions adherence and compliance: A cross-sectional study.
J Nurs Scholarsh. 2024;29. Doi: https://doi.org/10.1111/jnu.12960
29. Passos EM, Santos RB, Ribeiro R, Nogueira BVS. Teaching patient safety in undergraduate nursing in the state of Bahia. Ciênc. cuid. saúde. 2022;210. Doi: https://doi.org/10.4025/ciencuidsaude.v21i0.57704
30. Faridah I, Setyowati S, Lestari F, Hariyati RTS. The correlation between work environment and patient safety in a general hospital in Indonesia. Enferm Clin. 2021;31(2):S220–S224. Doi: https://doi.org/10.1016/j.enfcli.2020.12.026.
2. Lourenção DCA, Tronchin DMR. Safety climate in the surgical center: validation of a questionnaire for the Brazilian scenario. Rev. Eletr. Enf. 2018;20:1–11. Doi: https://doi.org/10.5216/ree.v20.47570
3. Souza SS, Farias MTD, Bandeira AKC, Magalhães MSSP, Sales MGS, Rodrigues AS, et al. Nurses conduct in the surgical center in the Covid-19 pandemic scenario. Nursing (Ed. brasileira. Online). 2022;25(291):8394-403. Doi: https://doi.org/10.36489/nursing.2022v25i291p8394-8403
4. Oliveira Junior NJ, Lourenção DCA, Poveda VB, Riboldi CO, Martins FZ, Magalhães AMM. Safety culture in surgical centers from the perspective of the multiprofessional team. Rev Rene. 2022;23:e78412. Doi: https://doi.org/10.15253/2175-6783.20222378412
5. United Nations. Transforming Our World: The 2030 Agenda for Sustainable Development [on-line]. 2015.[citado em 09 fev 2025]. Disponível em: URL: https://documents.un.org/doc/undoc/gen/n15/291/89/pdf/n1529189.pdf
6. World Health Organization. Global patient safety action plan 2021–2030: towards eliminating avoidable harm in health care [online]. 2021. [citado em 09 fev 2025]. Disponível em: URL: https://www.who.int/teams/integrated-health-services/patient-safety/policy/global-patient-safety-action-plan
7. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357. Doi: https://doi.org/10.1093/intqhc/mzm042
8. Souza MAR de, Wall ML, Thuler AC de MC, Lowen IMV, Peres AM. O uso do software IRAMUTEQ na análise de dados em pesquisas qualitativas. Rev Esc Enferm USP. 2018;52:e03353. Doi: https://doi.org/10.1590/S1980-220X2017015003353
9. Costa CJND, D’Artibale EF, Duarte ÊRM, Ribeiro MRR, Martins ETJ, Ferreira GE. Clima de segurança em saúde no contexto de pandemia da covid-19 em um hospital universitário. renome. 2022;10(2):47–56. Doi: https://doi.org/10.46551/rnm23173092202100206
10. Macedo LL, Silva AMR, Silva JFM, Haddad MCFL, Girotto E. A cultura em torno da segurança do paciente na atenção primária à saúde: distinções entre categorias profissionais. Trab educ saúde. 2020;18(1):e0023368. Doi: https://doi.org/10.1590/1981-7746-sol00233
11. Seo JK, Lee SE. Mediating roles of patient safety knowledge and motivation in the relationship between safety climate and nurses’ patient safety behaviors: a structural equation modeling analysis. BMC Nurs. 2022;21(1):335. Doi: https://doi.org/10.1186/s12912-022-01123-6
12. Gurková E, Zeleníková R, Friganovic A, Uchmanowicz I, JaroÅ¡ová D, Papastavrou E, et al. Hospital safety climate from nurses’ perspective in four European countries. Int Nurs Ver. 2020;67(2):208-217. Doi: https://doi.org/10.1111/inr.12561
13. Burlakov N, Rozani V, Bluvstein I, Kagan I. The association between quality and safety climate of a hospital ward, family members’ empowerment, and satisfaction with provided care. J Nurs Scholarsh. 2021;53:727-736. Doi: https://doi.org/https://doi.org/10.1111/jnu.12682
14. Martins KN, Bueno A de A, Mazoni SR, Machado VB, Evangelista RA, Bolina AF. Management process in surgicenters from the perspective of nurses. Acta Paul Enferm. 2021;34:eAPE00753. Doi: https://doi.org/10.37689/acta-ape/2021AO00753
15. Hoffmann M, Schwarz CM, Schwappach D, Banfi C, Palli C, Sendlhofer G. Speaking up about patient safety concerns: view of nursing students. BMC Health Serv Res. 2022;22:1547. Doi: https://doi.org/10.1186/s12913-022-08935-x
16. Ribeiro OMPL, Trindade LL, Fassarella CS, Pereira SCA, Teles PJFC, Rocha CG, et al. Impact of COVID-19 on professional nursing practice environments and patient safety culture J Nurs Manag. 2022;30(5):1105–1114. Doi: https://doi.org/10.1111/jonm.13617
17. Skegg E, McElroy C, Mudgway M, Hamill J. Debriefing to improve interprofessional teamwork in the operating room: A systematic review. J Nurs Scholarsh. 2023;55(6):1179–88. Doi: https://doi.org/10.1111/jnu.12924
18. Diaz-Navarro C, Enjo-Perez I, Leon-Castelao E, Hadfield A, Nicolas-Arfelis JM, Castro-Rebollo P. Implementation of the TALK© clinical self-debriefing tool in operating theatres: a single-centre interventional study. Br J Anaesth. 2024;133(4):853-861. Doi: https://doi.org/10.1016/j.bja.2024.05.044
19. Van Dalen ASH, Swinkels JA, Coolen S, Hackett R, Schijven MP. Improving teamwork and communication in the operating room by introducing the theatre cap challenge. J Perioper Pract. 2022;32(1–2):4–9. Doi: https://doi.org/10.1177/17504589211046723
20. Silva LC, Caldas CP, Fassarella CS, Souza PS. Effect of the organizational culture for patient safety in the hospital setting: A systematic review. Aquichan. 2021;21(2):e2123. Doi: https://doi.org/10.5294/aqui.2021.21.2.3
21. Nyberg A, Olofsson B, Fagerdahl A, Haney M, Otten V. Longer work experience and age associated with safety attitudes in operating room nurses: an online cross-sectional study. BMJ Open Qual. 2024;13(1):e002182. Doi: https://doi.org/10.1136/bmjoq-2022-002182
22. Ferreira JESM, Cavalcante TF, Jansen RC, Damasceno DFO, Oliveira LR, Silva MJN, et al. Challenges for maintaining surgical care practices in the COVID-19 pandemic: an integrative review. Invest Educ Enferm. 2023;40(1). Doi: https://doi.org/10.17533/udea.iee.v40n1e16
23. Ribeiro OMPL, Cardoso MF, Trindade LL, Rocha KG, Teles PJFC, Pereira S, et al. From the first to the fourth critical period of COVID-19: what has changed in nursing practice environments in hospital settings? BMC Nurs. 2023;22(1):1–12. Doi: https://doi.org/10.1186/s12912-023-01207-x
24. Dal’Bosco EB, Floriano LSM, Skupien SV, Arcaro G, Martins AR, Anselmo ACC. Mental health of nursing in coping with COVID-19 at a regional university hospital. Rev Bras Enferm. 2020;73:e20200434. Doi: https://doi.org/10.1590/0034-7167-2020-0434
25. Santos JLGD, Menegon FHA, Andrade GB, Freitas EO, Camponogara S, Balsanelli AP, et al. Changes implemented in the work environment of nurses in the COVID-19 pandemic. Rev Bras Enferm. 2022;75(suppl 1):1–6. Doi: https://doi.org/10.1590/0034-7167-2020-1381
26. Klemenc-Ketiš Z, Poplas SA. Safety culture at primary healthcare level: a cross-sectional study among employees with a leadership role. Zdr Varst. 2020;59(1):42-6. Doi: https://doi.org/10.2478/sjph-2020-0006
27. Spolverato G, Capelli G, Restivo A, Bao QC, Pucciarelli S, Pawlik TM, et al. The management of surgical patients during the coronavirus dieases 2019 (COVID-19) pandemic. Surgery. 2020;168(1):4-10. Doi: https://doi.org/10.1016/j.surg.2020.04.036
28. Berdida DJE, Grande RAN. Nurses' safety climate, quality of care, and standard precautions adherence and compliance: A cross-sectional study.
J Nurs Scholarsh. 2024;29. Doi: https://doi.org/10.1111/jnu.12960
29. Passos EM, Santos RB, Ribeiro R, Nogueira BVS. Teaching patient safety in undergraduate nursing in the state of Bahia. Ciênc. cuid. saúde. 2022;210. Doi: https://doi.org/10.4025/ciencuidsaude.v21i0.57704
30. Faridah I, Setyowati S, Lestari F, Hariyati RTS. The correlation between work environment and patient safety in a general hospital in Indonesia. Enferm Clin. 2021;31(2):S220–S224. Doi: https://doi.org/10.1016/j.enfcli.2020.12.026.
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2025-04-22
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Clima de segurança no ambiente cirúrgico: estudo qualitativo. (2025). Ciência, Cuidado E Saúde, 24(1). https://doi.org/10.4025/ciencuidsaude.v24i1.73451
