CULTURA DE SEGURANÇA E CARGA DE TRABALHO DE PROFISSIONAIS DA ATENÇÃO PRIMÁRIA À SAÚDE

Abstract

Ensuring patient safety in the Health Care Network involves establishing a culture that values safety and the recognition that workload can interfere with professionals’ perception and attitudes. Faced with a scenario in which Primary Health Care is little covered by official documents and scientific literature on patient safety, this research aimed to analyze the relationship between safety culture and the workload of Primary Health Care professionals. This was an exploratory study, typified as Survey, with a quantitative approach, carried out from January to July 2023, with 355 Primary Care professionals from a capital in the Center- West of Brazil. Three instruments were used: the worker’s sociodemographic characterization questionnaire; the National Aeronautics and Space Administration – Task Load Index method and the Medical Office Survey on Patient Safety Culture instrument, the latter two having been validated and adapted to the Brazilian reality. The data were subjected to descriptive and inferential statistical analysis. Data collection initially took place electronically; however, from May onwards, it was conducted in person until the sample was obtained. A total of 355 professionals from different categories took part, including nurses (n=112, 31.5%), community health and endemic disease control agents (n=62, 17.8%) and dentists (n=40, 11.3%) who had been working in the network for less than five years (44.8%, n=159). The workload was considered high by most professionals (73.8%), and the 12 dimensions of the Medical Office Survey on Patient Safety Culture instrument were evaluated with scores lower than 75%, being considered fragile dimensions of safety culture. The best rated dimension was ‘Patient care follow-up’, with 63.7% (n=214), followed by ‘Teamwork’, with 60.3% (n=214). It was observed that ‘Open communication’ and ‘Communication about errors’ were more positive among administrative professionals compared to health care professionals (54.10% x 45.50%; 55.90% x 42.90%, respectively). The worst rated dimension was ‘Pressure and pace of work’, with 18.6% (n=66). There was a significant statistical association between a higher prevalence of positive answers and a weekly workload of up to 40 hours in the dimensions ‘Support from managers in patient safety’ (p<0.0001) and ‘Issues related to patient safety and quality’ (p<0.0001) p<0.0001). Furthermore, an association was found between a lower workload and a better evaluation of safety culture in the dimensions ‘Work process and standardization’ (p-value=0.01) and ‘Support from managers in patient safety' (p value=0.03), as well as in the General safety and quality evaluation. It is concluded that there was an association between high workload and a worse perception of patient safety culture among primary care professionals. In this way, explaining the unfavorable conditions for the perception of safety culture in primary care can support the planning of actions focused on reviewing work processes and, consequently, advance in terms of safety culture in primary care, a scenario that has been little explored in this area, thus enhancing the scientific dissemination of the challenges faced by primary health care workers.