Impact of COVID-19 on professional nursing practice environments and patient safety culture.

AIM: To analyse the impact of COVID-19 on professional nursing practice environments and patient safety culture. BACKGROUND: The relationship between work environments and patient safety has been internationally recognized. In 2020, the pandemic imposed enormous challenges, yet the impact on these variables remains unknown. METHOD: This is a quantitative observational study, conducted in a Portuguese hospital, with 403 registered nurses. A self-completion questionnaire was used. RESULTS: The impact on the Structure and Outcome components of nursing professional practice environments was positive. Although the Process component remained favourable to quality of care, a negative trend was confirmed in almost all dimensions. The results regarding safety culture showed weaknesses; 'teamwork within units' was the only dimension that maintained a positive culture. CONCLUSION: Positive responses regarding patient safety were significantly associated with the quality of the nursing professional practice environment. The need to invest in all dimensions of safety culture emerges to promote positive professional environments. IMPLICATIONS FOR NURSING MANAGEMENT: Improving professional nursing practice environments can be achieved through managers' investment in the participation and involvement of nurses in the policies and functioning of institutions, as well as promoting an open, fair and participatory safety culture that encourages reporting events and provides adequate support for professionals.

Safety culture in a nephrology service at a university hospital: A mixed method study / Cultura de seguridad en un servicio de nefrología de un hospital universitario: un estudio de método mixto

Objective:To evaluate the safety culture from the perception of the multidisciplinary team of the nephrology service of a university hospital.Method:Mixed methods study with concomitant triangulation of data, with 56 participants. In the adopted approach, data are weighted with QUAN+qual notation. Quantitative data were collected using the Hospital Survey on Patient Safety Culture instrument and analyzed using simple descriptive statistics. Qualitative data were obtained from recorded interviews and analyzed using the content analysis technique proposed by Bardin.Results:The answers obtained in the quantitative instrument pointed out that of the twelve dimensions of the service, three were neutral, nine were fragile, and none was strong. From the qualitative analysis, similarities and divergences were identified in the statements about the quantitative data. The intersection of the data resulted in the category “Safety culture in the work environment of Nephrology”.Conclusion:Knowing the level of safety culture through the perception of nephrology health professionals allowed the identification of a critical and problematic scenario that needs improvements in the dimensions classified as fragile in order to advance in the perspectives of safety and in the polishing of actions aimed at safer care.

Objetivo:Evaluar la cultura de seguridad desde la percepción del equipo multidisciplinar del servicio de nefrología de un hospital universitario.Método:Estudio de un método mixto con triangulación concomitante de datos sobre 56 participantes. En el enfoque adoptado, los datos se ponderan con la notación QUAN+qual. Los datos cuantitativos se recopilaron utilizando el instrumento Hospital Survey on Patient Safety Culture y se analizaron mediante estadísticas descriptivas simples. Los datos cualitativos se obtuvieron de entrevistas grabadas, y se analizaron utilizando la técnica de análisis de contenido de Bardin.Resultados:Las respuestas obtenidas por el instrumento cuantitativo señalaron que, de las 12 dimensiones del servicio, 3 fueron consideradas neutrales, 9 frágiles y ninguna dimensión obtuvo una clasificación fuerte. A partir del análisis cualitativo, se identificaron similitudes y divergencias en las declaraciones de los participantes sobre los datos cuantitativos. Como intersección de los datos, se presentó la categoría «La cultura de la seguridad en el ambiente laboral de nefrología».Conclusión:Conocer el nivel de cultura de seguridad a través de la percepción de los profesionales de la salud en nefrología nos permitió identificar un escenario crítico y problemático que exige estrategias de mejora en dimensiones catalogadas como frágiles para avanzar en las perspectivas de seguridad, y mejorar las acciones orientadas a una atención más segura.

Efeito da cultura organizacional para a segurança do paciente em ambiente hospitalar: revisão sistemática / Efecto de la cultura organizativa para la seguridad del paciente en el entorno hospitalario: revisión sistemática / Effect of the organizational culture for patient safety in the hospital setting: A systematic review

Objective: To identify the effect of the organizational culture on patient safety in the hospital context. Materials and methods: A systematic review, without meta-analysis, registered in PROSPERO with number CRD42020162981. Cross-sectional and observational studies were selected that assessed the safety environment and safety culture published between 2014 and 2020 in journals indexed in the EMBASE, Latin American and Caribbean Literature in Health Sciences (Literatura Latinoamericana e do Caribe em Ciências da Saúde, LILACS) via the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), Medline (International Literature in Health Sciences) via PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Results: The findings show that a positive safety environment exerts a beneficial effect on the safety culture, favors the notification of events, and enables improvements in the quality of health care. Conclusions: The effective interaction between safety culture and organizational culture is still scarce in the literature. Most of the studies carried out investigate the situational diagnosis and little progress is made in terms of deepening the implications for the professional practice and the repercussions for the safety of hospitalized patients.

Objetivo: identificar el efecto de la cultura organizativa para la seguridad del paciente en el entorno hospitalario. Materiales y métodos: revisión sistemática, sin metaanálisis, registrada en el PROSPERO con el número CRD42020162981. Se seleccionaron estudios transversales y observacionales que evaluaron el clima de seguridad y la cultura de seguridad publicados en revistas indexadas en las bases EMBASE, Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), por medio de la Biblioteca Virtual en Salud (BVS), Medline (Literatura Internacional en Ciencias de la Salud), vía PubMed y Cumulative Index to Nursing and Allied Health Literature (CINAHL), entre 2014 y 2020. Resultados: los hallazgos evidencian que el clima de seguridad positivo impacta de forma benéfica en la cultura de seguridad, favorece la notificación de eventos y posibilita la mejoría de la calidad del cuidado a la salud. Conclusiones: la efectiva interacción entre cultura de seguridad y cultura organizativa aun es escasa en la literatura. Gran parte de los estudios realizados investiga el diagnóstico situacional y poco se avanza en el sentido de profundizar las consecuencias para la práctica profesional y la repercusión para la seguridad del paciente hospitalizado.

Objetivo: identificar o efeito da cultura organizacional para a segurança do paciente no contexto hospitalar. Materiais e métodos: revisão sistemática, sem metanálise, registrada no PROSPERO sob o número CRD42020162981. Foram selecionados estudos transversais e observacionais que avaliaram o clima de segurança e a cultura de segurança publicados em periódicos indexados nas bases EMBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), via Biblioteca Virtual em Saúde (BVS), Medline (Literatura Internacional em Ciências da Saúde), via PubMed e Cumulative Index to Nursing and Allied Health Literature (CINAHL), entre 2014 e 2020. Resultados: os achados demostraram que o clima de segurança positivo impacta de forma benéfica na cultura de segurança, favorece a notificação de eventos e possibilita a melhoria da qualidade do cuidado à saúde. Conclusões: a efetiva interação entre cultura de segurança e cultura organizacional ainda é escassa na literatura. A maioria dos estudos realizados investiga o diagnóstico situacional e pouco se avança no sentido de aprofundar a implicação para a prática profissional e para a repercussão para a segurança do paciente hospitalizado.