Análise do ambiente da prática, clima de segurança e omissão de cuidados entre profissionais de enfermagem de um hospital de ensino

Abstract

The nursing team is considered an essential component of a quality and safe care practice, as it is available at all times during the hospitalization period and provides direct care to patients. The quality of care is influenced by the adequacy of Patient Safety actions, the adequacy of material resources, staff dimensioning, being associated with the nursing practice environment, safety climate and nursing omission rates. The objective of this study is to evaluate the perception of nursing professionals about the environment of nursing practice, safety climate and omission of care in a hospital in Minas Gerais. It is a study with a quantitative approach, of the descriptive and correlational type. The following instruments were used: PES-NWI, SAQ and MISCARE-Brasil to identify the perception of nursing professionals. A total of 143 nursing professionals participated in the study, being 35% nurses and 65% nursing technicians. Among the results, an environment of nursing practice was observed, with a score higher than 2.5 indicating a favorable environment for professional practice, a safety climate with an overall average of less than 75 points, a value of 72, 54, considered unfavorable. Regarding the omission of nursing care, the most omitted were: "participation in interdisciplinary team discussions" (52.45%), “walking three times a day” (47.55%), “sitting the patient out of bed” (34.26%); and “hand hygiene” (0.70%) was the care considered most carried out in the perception of the institution's professionals. Regarding the reasons for omission of care, was mentioned: “unexpected increase in the volume/severity of patients” (74.82%), “inadequate number of personnel for assistance or administrative tasks” (70.63%), “patient emergency situation” (67.83%). There was a difference in the perception related to “working conditions” (p=0.04), “labor resources” (p=0.01) of the SAQ and “ethical dimension” (p=0.03) of the MISSCARE among nursing technicians when compared to nurses. Positive correlations were observed between the PES-NWI and SAQ subscales and a negative correlation was observed between the MISCARE-BRASIL subscales and the subscale “Adequacy of staff and resources”. The present study showed a relationship between the nursing practice environment, safety climate and the omission of nursing care. A negative correlation was evidenced between the environment of nursing practice, safety climate and the omission of care, demonstrating that favorable practice environments and positive safety climate are factors for reducing the rates of omission of nursing care.