Challenges of safety culture in Surgical Center: mixed methods study.

OBJECTIVE: to analyze the safety attitudes of health and support areas professionals working in Surgical Center. METHOD: sequential explanatory mixed methods study. The quantitative stage covered 172 health and support professionals in eight Surgical Centers of a hospital complex. The Safety Attitudes Questionnaire/Surgical Center was applied. In the subsequent qualitative stage, 16 professionals participated in the Focus Group. Photographic methods were used from the perspective of ecological and restorative thinking, and data analysis occurred in an integrated manner, through connection. RESULTS: the general score, by group of Surgical Centers, based on the domains of the Safety Attitudes Questionnaire/Surgical Center, reveals a favorable perception of the safety climate, with emphasis on the domains Stress Perception, Communication in the Surgical Environment, Safety Climate and Perception of Professional Performance. The overall analysis of the domain Communication and Collaboration between Teams appears positive and is corroborated by data from the qualitative stage, which highlights the importance of interaction and communication between healthcare teams as fundamental for daily work. CONCLUSION: the perception of safety attitudes among health and support professionals was positive. The perception of the nursing team stands out as closer or more favorable to attitudes consistent with the safety culture.

Effectiveness of Educational Interventions to Develop Patient Safety Competencies in Undergraduate Nursing Students: A Systematic Review.

BACKGROUND: Nursing professionals are key to providing safe care that improves patient outcomes. Hence, it is essential to focus on developing nurses' patient safety competencies and principles. PURPOSE: This review examined the effectiveness of educational interventions in developing patient safety knowledge, skills, behaviors, and attitudes in undergraduate nursing students. METHODS: The search strategy aimed to identify published and unpublished studies in databases and grey literature. Studies were assessed using the Joanna Briggs Institute critical appraisal tools. RESULTS: A total of 36 studies met the inclusion criteria. The teaching methods employed single or combined interventions and the educational interventions suggested either improvements in outcomes or no impact. CONCLUSION: The effectiveness of educational interventions to develop patient safety competencies in undergraduate nursing students, either as a single or combined strategy, was mixed. Further research is needed to provide more robust evidence on which teaching method for patient safety is most effective.

[Patient identification in healthcare organizations: an emerging debate]. / Identificação do paciente nas organizações de saúde: uma reflexão emergente.

The patient identification process is essential to ensure safety and quality of assistance in healthcare institutions. The use of a wristband for identification is common practice, although cultural organization, material and human factors cause non-conformity resulting in errors or adverse events. The aim of this article is to highlight constituent elements of the patient identification process by means of wristbands and discuss topics related to the implementation of this process in hospitals. This study was based on theoretic references and standardizations of accrediting organizations and bodies that debate security in the hospital environment and incentives for safe patient identification. It was concluded that patient identification by means of wristbands is recommended internationally although there are loopholes in relation to protocol, effective execution and evaluation of the process to support management and healthcare actions.

COVID-19 Pandemic: Analysis of Health Effects on Emergency Service Nursing Workers via a Qualitative Approach.

During the COVID-19 pandemic, longstanding issues involving nursing work, which has always involved significant risks of illness and infection, were intensified. It is necessary to acknowledge the risks and nurses' perceptions about the risks qualitatively during the period of the health crisis. The aim of this study was to examine the health repercussions perceived by nursing workers in emergency services during the outbreak of the COVID-19 pandemic in Brazil. This was a qualitative, descriptive, cross-sectional study. The settings of the study were emergency services with a national scope; the participants were nursing workers. Data were collected via face-to-face virtual calling interviews and analyzed via a content analysis technique, which was supported by IRAMUTEQ software. The formation of textual classes pointed in three thematic directions, from which three categories emerged: nursing workers' exposure, due to a lack of protective equipment, to the risk of being contaminated with, falling ill from, and transmitting the COVID-19 virus; changes in work environments, processes, and relations in response to the pandemic; and physical, mental, and psychosocial alterations perceived by emergency service nursing workers. The exposure to the virus, risk of contamination, and changes in the work environment and relations all resulted in health repercussions, which were perceived as physical, mental, and psychosocial alterations that were described as dietary disturbances, physical fatigue, burnout, increased smoking, anxiety, sleep alterations, fear, exhaustion, stress, social isolation, loneliness, distancing from relatives, and social stigma.

The second victim experience: cross-cultural adaptation of an instrument for the Brazilian context.

OBJECTIVE: To cross-culturally adapt and analyze the evidence of content validity of the Second Victim Experience and Support Tool for the Portuguese language spoken in Brazil. METHOD: Psychometric study of cross-cultural adaptation following the steps of the Patient-Reported Outcome Measurement Information System. Semantic, idiomatic, experimental, and conceptual equivalences were evaluated. The content validity was verified using the Content Validity Ratio. 31 health professionals from the city of São Paulo participated in the pre-test. RESULTS: The equivalence analysis showed an agreement rate was 88.7%. The content validity presented 86% of the items with Content Validity Ratio values ​​above the stipulated. In the pre-test, the participants reported that they understood the items of the instrument and only 10% of the participants reported difficulty in understanding any item. CONCLUSION: The Brazilian version of the Second Victim Experience and Support Tool presented a good translation quality and good evidence of content validity.

Distress and pleasure indicators in health care workers on the COVID-19 front line. / Indicadores de sofrimento e prazer em trabalhadores de saúde na linha de frente da COVID-19.

OBJECTIVE: to evaluate distress and pleasure indicators in health care workers on the front line of care for suspected or confirmed COVID-19 cases. METHOD: an exploratory, analytical and cross-sectional study with a quantitative approach. The studied sample consisted of 437 health professionals invited by electronic means, who answered the questionnaire on sociodemographic information, occupational aspects and clinical conditions. Distress and pleasure at work were considered as outcomes, which were analyzed with multinomial logistic regression regarding the associated independent variables. RESULTS: Most of the participants were female (71.0%), nurses (55.6%), with a weekly working shift of 40 hours or more (75.8%); 61.6% of the participants suffered from mental distress. The psychosocial characteristics of high-strain work and low social support were reported by 23.8% and 52.9% of the participants, respectively. In the multiple analysis, distress and lack of pleasure at work were associated with high job strain, low support from co-workers and mental distress. The profession is also associated with distress at work. CONCLUSION: distress and lack of pleasure at work are associated with occupational characteristics and mental strain among health care workers in the COVID-19 scenario.

Recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic: a scoping review.

OBJECTIVE: To map the recommendations for hospitalised patient safety in the context of the COVID-19 pandemic. DESIGN: Scoping review using the method recommended by the Joanna Briggs Institute. DATA SOURCES: Databases: Medline, SCOPUS, EMBASE, ScienceDirect, LILACS, CINAHL and IBECS; grey literature platform: Google Scholar; and 11 official websites of leading healthcare institutions were searched on 27 April 2021 and updated on 11 April 2022. ELIGIBILITY CRITERIA: We included documents that present recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic, published in any language, from 2020 onwards. DATA EXTRACTION AND SYNTHESIS: Data extraction was performed in pairs with consensus rounds. A descriptive analysis was carried out to present the main characteristics of the articles. Qualitative data from the extraction of recommendations were analysed through content analysis. RESULTS: One hundred and twenty-five documents were included. Most papers were identified as expert consensus (n=56, 44.8%). Forty-six recommendations were identified for the safety of hospitalised patients: 17 relating to the reorganisation of health services related to the flow of patients, the management of human and material resources and the reorganisation of the hospital environment; 11 on the approach to the airways and the prevention of the spread of aerosols; 11 related to sanitary and hygiene issues; 4 about proper use of personal protective equipment and 3 for effective communication. CONCLUSIONS: The recommendations mapped in this scoping review present the best practices produced so far and serve as a basis for planning and implementing good practices to ensure safe hospital care, during and after COVID-19. The engagement of everyone involved in the care of hospitalised patients is essential to consolidate the mapped recommendations and provide dignified, safe and quality care.

Effectiveness of educational interventions to develop patient safety knowledge, skills, behaviours and attitudes in undergraduate nursing students: a systematic review protocol.

INTRODUCTION: Patient safety is a healthcare discipline that aims to prevent and reduce patient harm, risks and errors during the provision of healthcare. Given the size of the nursing workforce in the healthcare system the inclusion of patient safety in the undergraduate nursing curriculum is necessary to enhance a safe culture in the daily work of their future careers. To this end, it is essential to apply effective teaching strategies to develop patient safety competencies. This review will aim to evaluate the effectiveness of educational interventions in developing patient safety knowledge, skills, behaviours and attitudes in undergraduate nursing students within the existing topic areas of the WHO Multi-professional Patient Safety Curriculum Guide. METHODS AND ANALYSIS: The databases Medline, CINAHL, Scopus, Education Research Complete, The Cochrane Central Register of Controlled Trials, LILACS, Medes and Grey literature such as ClinicalTrials.gov, Google Scholar, DART-Europe, ProQuest Dissertations, CAPES thesis and dissertations, The Virginia Henderson Global e-Repository, Mednar and Thesis Canada will be searched from July 2011 to January 2022. Two independent reviewers will conduct the search, extract the data and assess the risk of bias for the included studies, using standardised critical appraisal instruments from the Joanna Briggs Institute. The quality of the evidence will be assessed using the Grading of Recommendations, Assessment Development and Evaluation methodology. Studies will be pooled in the meta-analysis. Alternatively, the findings will be presented in narrative form, including tables and figures, to aid in data presentation. ETHICS AND DISSEMINATION: This study raises no ethical issues. The findings will be disseminated through presentations at professional conferences and publications in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021254965.

Occupational psychosocial stressors and mental distress among healthcare workers during COVID-19 pandemic.

OBJECTIVE: To analyze the factors associated with mental distress among health workers who cared for patients with a suspected or confirmed diagnosis of coronavirus disease 2019 (COVID-19). METHODS: A cross-sectional analytical study of national scope, carried out between in the second quarter of 2020. A total of 437 health professionals, who filled out an electronic form about sociodemographic data, occupational aspects, psychosocial characteristics of work and mental distress. Multiple logistic regression was performed to analyze the covariables associated with mental distress. RESULTS: There was a predominance of workers on the nursing team (65.0%), female (71.0%), from Southeastern region of the country (68.6%) and with no morbidities (36.2%). The prevalence of mental distress was 61.6%. Job strain was reported by 24% of participants, and the perception of low support from coworkers was described by 52.9%. The final multiple regression model showed that mental distress was associated with females (odds ratio - OR: 1.93; 95%CI: 1.22-3.07), age up to 40 years (OR: 1.64; 95%CI: 1.07-2.52), weekly working hours equal or over 60 hours (OR: 1.87; 95%CI: 1.15-3.11), job strain (OR: 2.45; 95%CI: 1.41-4.40) and low support from co-workers (OR: 3.47; 95%CI: 2.26-5.38). CONCLUSION: Six out of ten participants presented mental distress, which was associated to both individual characteristics and factors related to the work carried out during the pandemic. There is an urgent need to map services that have such characteristics, to outline actions to promote mental health and prevent emotional distress at different levels of health care.

Prevalence of COVID-19 testing among health workers providing care for suspected and confirmed cases.

OBJECTIVES: To describe the prevalence of testing among health workers providing care for suspected and confirmed cases of COVID-19. METHODS: This quantitative, cross-sectional study was conducted from April to June 2020, using a convenience sample. An online questionnaire was used for collecting sociodemographic, occupational, and clinical data, which were analyzed descriptively. RESULTS: In total, 437 health workers participated in the study, with a predominance of nursing workers (58.68%), women (70.3%), age between 30 and 49 years (54.2%), individuals living in the Southeast region of Brazil (60.54%), working in the public care system (69.11%), and focused on primary care (30.89%). Among the participants, 36% reported comorbidities, 21.1% had symptoms suggestive of COVID-19, and only 27% had undergone some type of COVID-19 testing. CONCLUSIONS: Despite the existence of risk comorbidities and symptoms suggestive of contamination, the frequency of testing was below one third among respondents. The lack of action compromises health surveillance and protection strategies for workers providing care for the population and may favor the contamination of new patients and the community.

[Management competences in the formation of nurses]. / Competências gerenciais na formação do enfermeiro.

This study had as purpose to identify the insertion of the management competences in the formation of nurses. That was a study of qualitative approach, that used the analysis of content of the pedagogic documents of the course of nursing of an institution of higher education of the South Region of the country. In the thematic documental analysis developed in this study, the evidence of the meaning items corroborated the insert of the managerial competence in the dimensions: knowledge, abilities and attitudes. The study demonstrated that they are contemplated in the nurse formation the managerial competences in the researched course. It important to say that from the analysis of the data emerged the enrolled gaps as contribution of the study.

Challenges of safety culture in Surgical Center: mixed methods study / Desafíos de la cultura de seguridad en Centro Quirúrgico: estudio de métodos mixtos / Desafios da cultura de segurança em Centro Cirúrgico: estudo de métodos mistos

Objective: to analyze the safety attitudes of health and support areas professionals working in Surgical Center. Method: sequential explanatory mixed methods study. The quantitative stage covered 172 health and support professionals in eight Surgical Centers of a hospital complex. The Safety Attitudes Questionnaire/Surgical Center was applied. In the subsequent qualitative stage, 16 professionals participated in the Focus Group. Photographic methods were used from the perspective of ecological and restorative thinking, and data analysis occurred in an integrated manner, through connection. Results: the general score, by group of Surgical Centers, based on the domains of the Safety Attitudes Questionnaire/Surgical Center, reveals a favorable perception of the safety climate, with emphasis on the domains Stress Perception, Communication in the Surgical Environment, Safety Climate and Perception of Professional Performance. The overall analysis of the domain Communication and Collaboration between Teams appears positive and is corroborated by data from the qualitative stage, which highlights the importance of interaction and communication between healthcare teams as fundamental for daily work. Conclusion: the perception of safety attitudes among health and support professionals was positive. The perception of the nursing team stands out as closer or more favorable to attitudes consistent with the safety culture.

Objetivo: analizar las actitudes de seguridad de los profesionales de la salud y de áreas de apoyo que trabajan en el Centro Quirúrgico. Método: estudio explicativo secuencial de métodos mixtos. La etapa cuantitativa abarcó a 172 profesionales de la salud y de apoyo en ocho Centros Quirúrgicos de un complejo hospitalario. Se aplicó el Cuestionario de Actitudes de Seguridad/Centro Quirúrgico. En la etapa cualitativa posterior, participaron del Grupo Focal 16 profesionales. Se utilizaron métodos fotográficos desde la perspectiva del pensamiento ecológico y restaurativo, y el análisis de datos se produjo de manera integrada, por medio de conexión. Resultados: el puntaje general, por grupo de Centros Quirúrgicos, con base en los dominios del Cuestionario de Actitudes de Seguridad/Centro Quirúrgico, revela una percepción favorable del clima de seguridad, con énfasis en los dominios Percepción del Estrés, Comunicación en el Ambiente Quirúrgico, Clima de Seguridad y Percepción del Desempeño Profesional. El análisis global del dominio Comunicación y Colaboración entre Equipos parece positivo y está corroborado por datos de la etapa cualitativa, que resalta la importancia de la interacción y de la comunicación entre los equipos de salud como fundamentales para el trabajo diario. Conclusión: la percepción de las actitudes de seguridad entre los profesionales de la salud y de apoyo fue positiva. Se destaca la percepción del equipo de enfermería como más cercana o favorable a actitudes coherentes con la cultura de seguridad.

Objetivo: analisar as atitudes de segurança de profissionais da saúde e de áreas de apoio atuantes em Centro Cirúrgico. Método: estudo explanatório sequencial de métodos mistos. A etapa quantitativa abrangeu 172 profissionais da saúde e de apoio em oito Centros Cirúrgicos de um complexo hospitalar. Aplicou-se o Questionário de Atitudes de Segurança/Centro Cirúrgico . Na etapa qualitativa subsequente, 16 profissionais participaram do Grupo Focal. Utilizaram-se métodos fotográficos na perspectiva do pensamento ecológico e restaurativo, e a análise dos dados ocorreu de maneira integrada, por conexão. Resultados: o escore geral, por agrupamento de Centros Cirúrgicos, com base nos domínios do Questionário de Atitudes de Segurança/Centro Cirúrgico, revela percepção favorável do clima de segurança, com destaque para os domínios Percepção do Estresse, Comunicação no Ambiente Cirúrgico, Clima de Segurança e Percepção do Desempenho Profissional. A análise global do domínio Comunicação e Colaboração entre as Equipes mostra-se positiva e é corroborada pelos dados da etapa qualitativa, na qual destaca-se a importância da interação e da comunicação entre as equipes de saúde como fundamentais para o trabalho diário. Conclusão: a percepção das atitudes de segurança entre os profissionais da saúde e de apoio foi positiva. A percepção da equipe de enfermagem se destaca como mais próxima ou favorável a atitudes condizentes com a cultura de segurança.

Engajamento profissional e qualidade de vida entre trabalhadores de enfermagem de uma unidade hospitalar, São Paulo - Brasil / Professional engagement and quality of life among nursing professionals at a hospital, São Paulo - Brazil

Analisar a associação entre engajamento e o programa de qualidade de vida da equipe de enfermagem. Estudo exploratório, transversal, participaram 334 trabalhadores da equipe de enfermagem de um hospital privado do município de São Paulo. Utilizou-se os instrumentos: Questionário de Caracterização do Trabalhador, Escala de Engajamento no Trabalho, Percepção dos Trabalhadores sobre o programa de qualidade de vida e Planilha de Pontuação da Adesão do programa de qualidade de vida. O escore global de engajamento no trabalho apresentou média de 4,62 pontos (dp=0,98 pontos), o maior nível foi observado na dimensão Dedicação (média=4,93 pontos; dp=1,04 pontos), e a menor na dimensão Concentração (média=4,33; dp=1,06). Quanto ao programa de qualidade de vida, foi possível verificar a adesão de 152 trabalhadores de enfermagem (45,5%). Em relação à percepção sobre o programa de qualidade de vida da instituição, 83,92% têm percepção positiva. Quanto as circunstâncias que dificultam a adesão, 52,95% relaciona-se a fatores intrínsecos do trabalhador, falta de tempo, dificuldade em conciliar as responsabilidades fora da instituição, duplo vinculo e a disponibilidade pessoal. Este estudo mostra uma percepção positiva do mesmo, inclusive identificando-o como estímulo para o autocuidado e prevenção de doenças, que são pilares para a manutenção da saúde no trabalho, sentem-se acolhidos, cuidados e valorizados, percebendo a preocupação da instituição com o trabalhador, compreendem ser um diferencial em relação a outras instituições, apresentando níveis elevados de engajamento com o trabalho.

This study aimed to analyze the association between engagement and the quality-of-life program of the nursing team. This was an exploratory, cross-sectional study, and 334 workers from the nursing team of a private hospital in the city of São Paulo participated. The following instruments were used: Worker Characterization Questionnaire, Work Engagement Scale, Workers' Perception of the quality-of-life program, and Score Sheet for Participation in the quality-of-life program. The global score of engagement at work presented an average of 4.62 points (SD=0.98 points), the highest level was observed in the dimension Dedication (average=4.93 points; SD=1.04 points), and the lowest in the Focus dimension (mean=4.33; SD=1.06). As for the quality-of-life program, it was possible to verify the adhesion of 152 nursing workers (45.5%). Regarding the perception of the institution's quality-of-life program, 83.92% have a positive perception. As for the circumstances that hinder participation, 52.95% are related to intrinsic factors of the worker, lack of time, difficulty in reconciling responsibilities outside the institution, simultaneous employment, and personal availability. This study group expressed a positive perception of the quality-of-life program, even identifying it as a stimulus for self-care and disease prevention, which are pillars for maintaining good health at work, and participants understand that it is a provided benefit in relation to other institutions, showing high levels of engagement with work.

The second victim experience: cross-cultural adaptation of an instrument for the Brazilian context / La experiencia de la segunda víctima: adaptación transcultural de un instrumento para el contexto brasileño / A experiência da segunda vítima: adaptação transcultural de um instrumento para o contexto brasileiro

ABSTRACT Objective To cross-culturally adapt and analyze the evidence of content validity of the Second Victim Experience and Support Tool for the Portuguese language spoken in Brazil. Method Psychometric study of cross-cultural adaptation following the steps of the Patient-Reported Outcome Measurement Information System. Semantic, idiomatic, experimental, and conceptual equivalences were evaluated. The content validity was verified using the Content Validity Ratio. 31 health professionals from the city of São Paulo participated in the pre-test. Results The equivalence analysis showed an agreement rate was 88.7%. The content validity presented 86% of the items with Content Validity Ratio values ​​above the stipulated. In the pre-test, the participants reported that they understood the items of the instrument and only 10% of the participants reported difficulty in understanding any item. Conclusion The Brazilian version of the Second Victim Experience and Support Tool presented a good translation quality and good evidence of content validity.

RESUMEN Objetivo Adaptar y analizar transculturalmente la evidencia de validez de contenido de la Second Victim Experience and Support Tool para el idioma portugués hablado en Brasil. Método Estudio psicométrico de adaptación transcultural siguiendo los pasos del Patient-Reported Outcome Measurement Information System. Se evaluaron equivalencias semánticas, idiomáticas, experimentales y conceptuales. La validez de contenido se verificó mediante el índice de validez de contenido. 31 profesionales de la salud de la ciudad de São Paulo participaron en la prueba preliminar. Resultados El análisis de equivalencias mostró una tasa de acuerdo del 88,7%. La validez de contenido presentó 86% de los ítems con valores de Tasa de Validez de Contenido por encima de lo estipulado. En la prueba previa, los participantes informaron que entendieron los ítems del instrumento y solo el 10% de los participantes dijeron que tenían dificultades para entender algún ítem. Conclusión La versión brasileña del Cuestionario de Experiencia y Apoyo a Segundas Víctimas mostró una buena calidad de traducción y buena evidencia de validez de contenido.

RESUMO Objetivo Adaptar transculturalmente e analisar as evidências de validade de conteúdo do Second Victim Experience and Support Tool para a língua portuguesa falada no Brasil. Método Estudo psicométrico de adaptação transcultural, seguindo as etapas do Patient-Reported Outcome Measurement Information System. Foram avaliadas as equivalências semântica, idiomática, experimental e conceitual. A validade de conteúdo foi verificada, com base no Content Validity Ratio. Participaram do pré-teste 31 profissionais de saúde da cidade de São Paulo. Resultados A análise das equivalências apresentou uma taxa de concordância de 88,7%. A validade de conteúdo apresentou 86% dos itens com valores de Content Validity Ratio acima do estipulado. No pré-teste, os participantes reportaram terem entendido os itens do instrumento e apenas 10% dos participantes relataram dificuldade para entender algum item. Conclusão A versão brasileira do Questionário de Experiência e Apoio à Segunda Vítima apresentou boa qualidade de tradução e boas evidências de validade de conteúdo.

Cultura de segurança em centros cirúrgicos na perspectiva da equipe multiprofissional / Safety culture in surgical centers from the perspective of the multiprofessional team

RESUMO Objetivo avaliar a cultura de segurança a partir da percepção do clima de segurança dos profissionais de saúde que atuam em Centro Cirúrgico. Métodos estudo transversal realizado em oito centros cirúrgicos de um complexo hospitalar. Aplicou-se a versão brasileira validada do Safety Attitudes Questionnaire/Operating Room para uma amostra de conveniência de 172 profissionais de saúde (médicos e de enfermagem) e de apoio. Para a análise empregou-se os testes Qui-quadrado, t de Student e Mann-Whitney. Resultados na avaliação geral, o clima de segurança foi avaliado como positivo. Apenas os profissionais de enfermagem atingiram a mínima pontuação necessária para indicar um resultado positivo no domínio Qualidade da comunicação e colaboração. Os domínios Clima de segurança, Percepção do estresse, Comunicação no ambiente cirúrgico e Percepção do desempenho profissional mostraram-se positivos, enquanto Percepção da gerência e Condição de trabalho apresentaram piores escores. Conclusão a percepção do clima de segurança foi positiva. No entanto, a comunicação apresentou fragilidades apontadas pelos profissionais. Contribuições para a prática: a identificação de domínios que necessitam ser fortalecidos contribui para fomentar uma cultura de segurança nos centros cirúrgicos, repercutindo em melhores resultados assistenciais e ambientes de trabalho para os profissionais.

ABSTRACT Objective to evaluate the safety culture through an observation of the safety climate of health workers from a Surgical Center. Methods cross-sectional study in eight surgical centers from a hospital complex. A validated Brazilian version of the Safety Attitudes Questionnaire/Operating Room was applied to a convenience sample of 172 health and support workers (physicians and nurses). The Chi-squared, Student's t, and Mann-Whitney's tests were used. Results the general evaluation showed a positive safety climate. Only the nursing professionals reached the minimum score that indicates a positive result in the domain Quality of communication and collaboration. The domains Safety climate, Stress recognition, Communication in the surgical environment, and Perception of professional performance showed positive results, while Perception of management and Work conditions had the worst scores. Conclusion the safety climate was positive. Nonetheless, communication showed shortcomings pointed out by the workers. Contributions to practice: identifying domains that need to be improved helps fomenting safety culture in surgical centers, leading to better care outcomes and work environments.

Indicadores de sofrimento e prazer em trabalhadores de saúde na linha de frente da COVID-19 / Distress and pleasure indicators in health care workers on the COVID-19 front line / Indicadores de sufrimiento y placer en trabajadores de la salud en la primera línea del COVID-19

Resumo Objetivo avaliar indicadores de sofrimento e prazer em trabalhadores de saúde na linha de frente do cuidado aos casos suspeitos ou confirmados de COVID-19. Método estudo exploratório, analítico, transversal, com abordagem quantitativa. A amostra estudada foi constituída por 437 profissionais da saúde convidados por meio eletrônico, que responderam ao questionário sobre informações sociodemográfica, aspectos ocupacionais e condições clínicas. Foram considerados como desfechos o sofrimento e o prazer no trabalho, os quais foram analisados com regressão logística multinomial quanto às variáveis independentes associadas. Resultados a maioria dos participantes era do sexo feminino (71,0%), enfermeira (55,6%), com jornada de trabalho semanal de 40 horas ou mais (75,8%); 61,6% dos participantes estavam em sofrimento mental. As características psicossociais do trabalho de alta exigência e de baixo apoio social foram informadas, respectivamente, por 23,8% e 52,9% dos participantes. Na análise múltipla, o sofrimento e a falta de prazer no trabalho estiveram associados com a alta exigência no trabalho, baixo apoio dos colegas de trabalho e sofrimento mental. A profissão também está associada ao sofrimento no trabalho. Conclusão o sofrimento e a falta de prazer no trabalho estão associados às características ocupacionais e ao desgaste mental entre trabalhadores da saúde no cenário da COVID-19.

Abstract Objective to evaluate distress and pleasure indicators in health care workers on the front line of care for suspected or confirmed COVID-19 cases. Method an exploratory, analytical and cross-sectional study with a quantitative approach. The studied sample consisted of 437 health professionals invited by electronic means, who answered the questionnaire on sociodemographic information, occupational aspects and clinical conditions. Distress and pleasure at work were considered as outcomes, which were analyzed with multinomial logistic regression regarding the associated independent variables. Results Most of the participants were female (71.0%), nurses (55.6%), with a weekly working shift of 40 hours or more (75.8%); 61.6% of the participants suffered from mental distress. The psychosocial characteristics of high-strain work and low social support were reported by 23.8% and 52.9% of the participants, respectively. In the multiple analysis, distress and lack of pleasure at work were associated with high job strain, low support from co-workers and mental distress. The profession is also associated with distress at work. Conclusion distress and lack of pleasure at work are associated with occupational characteristics and mental strain among health care workers in the COVID-19 scenario.

Resumen Objetivo evaluar indicadores de sufrimiento y placer en trabajadores de la salud en la primera línea de atención de casos sospechosos o confirmados de COVID-19. Método estudio exploratorio, analítico, transversal con enfoque cuantitativo. La muestra estudiada estuvo conformada por 437 profesionales de la salud invitados por medios electrónicos, que respondieron el cuestionario sobre información sociodemográfica, aspectos ocupacionales y condiciones clínicas. Se consideraron como resultados el sufrimiento y el placer en el trabajo, que fueron analizados con regresión logística multinomial en cuanto a las variables independientes asociadas. Resultados la mayoría de los participantes era de sexo femenino (71,0%), enfermera (55,6%), tenía una jornada laboral semanal de 40 horas o más (75,8%); el 61,6% de los participantes presentaban sufrimiento mental. En cuanto a las características psicosociales del trabajo, los participantes lo consideraron de alta exigencia y bajo apoyo social, 23,8% y 52,9% respectivamente. En el análisis múltiple, la angustia y la falta de placer en el trabajo se asociaron con una alta exigencia laboral, poco apoyo de los compañeros de trabajo y sufrimiento mental. La profesión también está asociada al sufrimiento en el trabajo. Conclusión el sufrimiento y la falta de placer en el trabajo se asocian con características ocupacionales y el agotamiento mental en los trabajadores de la salud en el escenario del COVID-19.

Occupational psychosocial stressors and mental distress among healthcare workers during COVID-19 pandemic / Estressores psicossociais ocupacionais e sofrimento mental em trabalhadores de saúde na pandemia de COVID-19

ABSTRACT Objective To analyze the factors associated with mental distress among health workers who cared for patients with a suspected or confirmed diagnosis of coronavirus disease 2019 (COVID-19). Methods A cross-sectional analytical study of national scope, carried out between in the second quarter of 2020. A total of 437 health professionals, who filled out an electronic form about sociodemographic data, occupational aspects, psychosocial characteristics of work and mental distress. Multiple logistic regression was performed to analyze the covariables associated with mental distress. Results There was a predominance of workers on the nursing team (65.0%), female (71.0%), from Southeastern region of the country (68.6%) and with no morbidities (36.2%). The prevalence of mental distress was 61.6%. Job strain was reported by 24% of participants, and the perception of low support from coworkers was described by 52.9%. The final multiple regression model showed that mental distress was associated with females (odds ratio - OR: 1.93; 95%CI: 1.22-3.07), age up to 40 years (OR: 1.64; 95%CI: 1.07-2.52), weekly working hours equal or over 60 hours (OR: 1.87; 95%CI: 1.15-3.11), job strain (OR: 2.45; 95%CI: 1.41-4.40) and low support from co-workers (OR: 3.47; 95%CI: 2.26-5.38). Conclusion Six out of ten participants presented mental distress, which was associated to both individual characteristics and factors related to the work carried out during the pandemic. There is an urgent need to map services that have such characteristics, to outline actions to promote mental health and prevent emotional distress at different levels of health care.

RESUMO Objetivo Analisar os fatores associados ao sofrimento mental de trabalhadores de saúde que atuavam na assistência a pacientes com diagnóstico suspeito ou confirmado de doença pelo coronavírus 2019 (COVID-19). Métodos Estudo transversal analítico de abrangência nacional, realizado no segundo trimestre de 2020. Participaram 437 profissionais de saúde que preencheram formulário eletrônico sobre dados sociodemográficos, aspectos ocupacionais, características psicossociais do trabalho e sofrimento mental. Foi realizada regressão logística múltipla para analisar as covariáveis associadas ao sofrimento mental. Resultados Predominaram trabalhadores da equipe de enfermagem (65,0%), do sexo feminino (71,0%), da região Sudeste do país (68,6%) e sem morbidades (36,2%). A prevalência de sofrimento mental foi de 61,6%. O trabalho de alta exigência psicossocial foi informado por 24% dos participantes e a percepção de baixo apoio dos colegas de trabalho foi relatada por 52,9%. O modelo de regressão múltiplo final demonstrou que o sofrimento mental estava associado a: sexo feminino (razão de chance - RC: 1,93; IC95%: 1,22-3,07), idade até 40 anos (RC: 1,64; IC95%: 1,07-2,52), jornada semanal de trabalho igual ou superior a 60 horas (RC: 1,87; IC95%: 1,15-3,11), trabalho de alta exigência (RC: 2,45; IC95%: 1,41-4,40) e baixo apoio dos colegas (RC: 3,47; IC95%: 2,26-5,38). Conclusão Seis em cada dez participantes apresentavam quadro de sofrimento mental associado tanto a características individuais, quanto a fatores relacionados ao trabalho realizado durante a pandemia. É urgente a necessidade de mapear os serviços que tenham tais características, para delinear ações de promoção da saúde mental e prevenção do desgaste emocional nos diversos níveis de atenção em saúde.

Análisis factorial confirmatorio del cuestionario de actitudes de seguridad/centro quirúrgico / Análise das notificações de eventos adversos em um hospital privado / Confirmatory factor analysis of the safety attitudes questionnaire/operating room

Objetivo: analizar la estructura factorial de la versión traducida y adaptada culturalmente del Safety Attitudes Questionnaire / Operating Room Version para el contexto brasileño. Método: fue desarrollado un estudio metodológico acerca del cuestionario. El cuestionario fue aplicado a 412 profesionales de salud trabajadores en centros quirúrgicos. La evaluación del cuestionario fue realizada con base en Análisis Factorial Confirmatorio (AFC) y en el alfa de Cronbach. Resultados: el valor total del alfa de Cronbach fue 0,912; en los dominios los valores variaron de 0,56 a 0,85. El peor dominio fue Comunicación en el Ambiente Quirúrgico. Los hallazgos de la AFC mostraron que el valor de SRMR fue de 0,052; el RMSEA de 0,031 y el de CFI de 0,95. Estos valores demuestran la confiabilidad y un ajuste de modelo acepTable de la versión brasileña del SAQ / OR. Conclusión: la estructura factorial mostró que la versión brasileña del cuestionario es válida y confiable para medir el clima de seguridad del paciente en la percepción de los profesionales de salud que trabajan en el ambiente quirúrgico

Introdução: a segurança do paciente, no contexto atual, passou a ser investigada nos diversos campos da saúde, com o objetivo de reduzir a incidência de danos e eventos adversos aos pacientes. Objetivo: identificar e analisar os eventos adversos que comprometem a segurança do paciente durante a assistência de enfermagem em um hospital privado. Métodos: pesquisa exploratória, documental e retrospectiva. O instrumento de coleta de dados foi o relatório de notificação de eventos adversos utilizado pelo hospital composto por questões abertas e fechadas. Resultados: analisaram-se 262 relatórios de notificação de eventos adversos/incidentes que ocorreram no período de 2015 a 2016. Demonstra-se que o fatores contribuintes para a ocorrência dos eventos adversos foram causados por falha humana. Do total de formulários analisados, 161 (61,83%) apontaram descuido e distração. A omissão se destacou com 11 (4,20%) casos. A falta de atenção com o paciente propiciou 116 (44,27%) erros na administração de medicamentos, 46 (17,56%) falhas durante a digitação e transcrição da prescrição médica e 35 (13,36%) falhas na assistência. Conclusão: percebe-se que os incidentes são causados por fatores humanos e de possível reversão. Quando investigados, podem ser minimizados, o que contribui para a qualidade e segurança no cuidado ao paciente

Objective: to analyze the factor structure of the version of the Safety Attitudes Questionnaire/Operating Room Version that has been translated and culturally adapted to the Brazilian context. Method: this was a methodological study about a questionnaire. The questionnaire was administered to 412 health professionals who worked in operating rooms. The factor structure was tested with confirmatory factor analysis (CFA) and Cronbach's alpha. Results: The total score for Cronbach's alpha was 0.912; and the scores for the domains ranged from 0.56 and 0.85. The domain with the worst performance was communication in the surgical setting. The results of CFA showed that the score for SRMR was 0.052, RMSEA, 0.031, and CFI, 0.95. These scores indicate the reliability and acceptability of the Brazilian adaptation of the questionnaire. Conclusion: the factor structure demonstrated the validity and reliability of the Brazilian version of the questionnaire for measuring the patient safety climate as perceived by healthcare professionals who worked in surgical settings

Clima de segurança em centro cirúrgico: validação de um questionário para o cenário brasileiro / Safety climate in the surgical center: validation of a questionnaire for the Brazilian scenario

Validar a versão traduzida e adaptada culturalmente do Safety Attitudes Questionnaire/Operating Room Version para o contexto brasileiro. Estudo metodológico de validação das propriedades psicométricas do questionário adaptado para o contexto brasileiro. A amostra correspondeu a 590 profissionais de saúde atuantes em centro cirúrgico, de quatro hospitais brasileiros, coletando-se os dados de maio a agosto de 2014. A validação de constructo ocorreu pela análise fatorial exploratória e a confiabilidade pelo alpha de Cronbach. A análise originou um questionário com 40 assertivas alocadas em seis domínios: clima de segurança, percepção da gerência, percepção do estresse, condição do trabalho, comunicação no ambiente cirúrgico e percepção do desempenho profissional. A versão adaptada mostrou-se confiável, obtendo o valor geral do alpha de Cronbach de 0,87 e entre os domínios, o alpha variou de 0,59 a 0,87. Esta pesquisa permitiu validar um instrumento passível de avaliar o clima de segurança em centro cirúrgico.

To validate the translated and culturally adapted version of the Safety Attitudes Questionnaire/Operating Room Version to the Brazilian context. A methodological study to validate the psychometric properties of the questionnaire adapted to the Brazilian context. The sample corresponded to 590 health professionals acting in the surgical center, of four Brazilian hospitals, collecting the data from May to August 2014. The construct validation was performed by the exploratory factorial analysis and the reliability using the Cronbach's alpha. The analysis generated a questionnaire with 40 affirmations divided into six domains: clima de segurança, percepção da gerência, percepção do estresse, condição do trabalho, comunicação no ambiente cirúrgico e percepção do desempenho profissional. The adapted version was reliable, obtained a general Cronbach's alpha value of 0.87, and between domains, the alpha varied from 0.59 to 0.87. This study allowed to validate an instrument capable of assessing the safety environment in a surgical center.

Segurança do paciente no ambiente cirúrgico: tradução e adaptação cultural de instrumento validado / Patient safety in the surgical environment: translation and cross-cultural adaptation of validated instrument

Resumo Objetivo Traduzir e adaptar o Safety Attitudes Questionnaire/Operating Room Version para a língua portuguesa. Métodos Pesquisa metodológica de adaptação transcultural que empregou as etapas: tradução, síntese, retrotradução, avaliação por comitê de juízes, pré-teste, submissão e avaliação dos relatórios pelos autores do instrumento original. A validação de conteúdo foi realizada mediante as equivalências semântica, idiomática, conceitual, experiencial e de conteúdo. Participaram 12 juízes e o índice de concordância correspondeu a ≥ 80%. Resultados As etapas de tradução e retrotradução foram consideradas adequadas e na avaliação da síntese pelos juízes foi indicada alteração em 41 itens, do total de 137. Em relação ao processo de validação das equivalencias realizado pelos juízes, o consenso geral do instrumento obteve 84,1% de equivalência, 9,3% de não equivalência e 6,6% de indecisos. No pré-teste, o tempo médio de preenchimento correspondeu a 16,5 minutos. Conclusão O processo de tradução e adaptação apresentou adequação quanto à validade de conteúdo mediante os índices obtidos nas equivalências e compreensão pelos sujeitos, e foi aprovado pelos autores.

Abstract Objective To translate and adapt the Safety Attitudes Questionnaire/Operating Room Version into Portuguese. Methods Methodological research of cross-cultural adaptation which applied the stages: translation, synthesis, back-translation, expert panel evaluation, pretest, submission and evaluation of the reports by the authors of the original instrument. The content validation was performed using the semantic, idiomatic, conceptual, experiential and content equivalence. A total of 12 experts participated and the agreement index corresponded to ≥ 80%. Results The stages of translation and back-translation were considered adequate and in the synthesis evaluation by the experts, changes were indicated in 41 items from the total of 137. Regarding the equivalence of the validation process carried out by the experts, the general consensus of the instrument obtained 84.1% equivalence, 9.3% of non-equivalence and 6.6% undecided. In the pretest, the mean time to fill in the questionnaire corresponded to 16.5 minutes. Conclusion The process of translation and adaptation presented adequacy as to the validity of content through the indices obtained in equivalences and understanding for the subjects, and it was approved by the authors.