Safety climate in Intensive Care Units: Integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i7.16702

Keywords:

Attitude of Health Personnel; Health Personnel; Patient Safety; Safety Management; Critical Care; Review.

Abstract

Objective: To identify evidence in the literature about the patient safety climate in intensive care units. Method: Integrative literature review, carried out in the CINAHL, LILACS, Medline / PubMed, Scopus, Web of Science and Cochrane library databases, to answer the guiding question: “What is the patient safety climate in intensive care units?”. The search takes place in the months of June 2021, where the following steps were taken: base of the problem; search in the literature of primary studies; evaluation of studies included in the review; data analysis; Results presentation. Publications were published at any time, in Portuguese, English and Spanish. Results: 225 references were identified, of which 25 were included in the review, considering the inclusion and exclusion criteria. In most of the sample, scores below 75% were observed regarding the perception of the safety climate by the health professionals obtained. Conclusion: The identification of low scores in the assessment of the patient's safety climate and the weakness in reporting adverse events, point to the need for greater investment in the safety culture in intensive care units.

References

Abdi Z., Delgoshaei B., Ravaghi H., Abbasi M. & Heyrani A. (2015). The culture of patient safety in an Iranian intensive care unit. J Nurs Manag. 23(3):333–45. DOI: 10.1111/jonm.12135

Abu-El-Noor N. I., Hamdan M. A., Abu-El-Noor M. K., Radwan A-K. S. & Alshaer A. A. (2017). Safety Culture in Neonatal Intensive Care Units in the Gaza Strip, Palestine: A Need for Policy Change. J Pediatr Nurs. 33:76–82. DOI: 10.1016/j.pedn.2016.12.016

Alayed A. S. , Lööf H. & Johansson U-B. (2014). Saudi Arabian ICU safety culture and nurses’ attitudes. Int J Health Care Qual Assur. ;27(7):581–93. DOI: 10.1108/IJHCQA-04-2013-0042

Agency for Healthcare Research and Quality (AHRQ). (2016). Quality Improvement and monitoring at your fingertips. Rockville. Available from: https://qualityindicators.ahrq.gov/

Al Malki A., Endacott R. & Innes K. (2018). Health professional perspectives of patient safety issues in intensive care units in Saudi Arabia. J Nurs Manag. 26(2):209–18. DOI: 10.1111/jonm.12536

Al-Mugheed K. & Bayraktar N. (2020). Patient safety attitudes among critical care nurses: A case study in North Cyprus. Int J Health Plann Manage. DOI: 10.1002/hpm.2976

Amiri M., Khademian Z. & Nikandish R. (2018). The effect of nurse empowerment educational program on patient safety culture: a randomized controlled trial. BMC Med Educ. 18(1):158. DOI: 10.1186/s12909-018-1255-6

Armellino D., Quinn Griffin M. T. & Fitzpatrick JJ. (2010). Structural empowerment and patient safety culture among registered nurses working in adult critical care units. J Nurs Manag. 18(7):796–803. DOI: 10.1111/j.1365-2834.2010.01130.x

Ballangrud R, Hedelin B & Hall-Lord M. L.(2012). Nurses’ perceptions of patient safety climate in intensive care units: A cross-sectional study. Intensive Crit Care Nurs. 28(6):344–54. DOI: 10.1016/j.iccn.2012.01.001

Carvalho P. A., Albina C., Laundos S., Ventura J. & Juliano S. (2019). Assessment of safety culture in a public hospital in the Federal District, Brazil. Heal Serv Assess [Internet]. 72(Suppl 1):263–9. Available from: http://dx.doi.org/10.1590/0034-7167-2017-0716

Duarte S. da C. M., Stipp M. A. C., Cardoso M. M. V. N. & Büscher A. (2018). Patient safety: understanding human error in intensive nursing care. Rev da Esc Enferm da USP [Internet].52(e03406):1–8. Available from: http://dx.doi.org/10.1590/S1980-220X2017042203406

Dunstan E. & Coyer F. (2020). Safety culture in two metropolitan Australian tertiary hospital intensive care units: A cross-sectional survey. Aust Crit Care. 33(1):4–11. DOI: 10.1016/j.aucc.2018.11.069

Gutiérrez-Cía I., De Cos P. M., Juan A. Y., Obón-Azuara B., Alonso-Ovies A., Martin-Delgado M. C., Álvarez-Rodríguez J., Aibar-Remón C. (2010). Perception of safety culture in Spanish intensive care units | Percepción de la cultura de seguridad en los servicios de medicina intensiva españoles. Med Clin (Barc). 135(SUPPL.):37–44. DOI: 10.1016/S0025-7753(10)70019-1

Hamdan M. (2013). Measuring safety culture in Palestinian neonatal intensive care units using the Safety Attitudes Questionnaire. J Crit Care. 28(5):886.e7-886.e14. DOI: 10.1016/j.jcrc.2013.06.002

Huang D. T., Clermont G., Sexton J. B., Karlo C. A., Miller R. G., Weissfeld L. A., Rowan K. M., Angus D. C. (2007). Perceptions of safety culture vary across the intensive care units of a single institution. Crit Care Med. 35(1):165–76. DOI: 10.1097/01.CCM.0000251505.76026.CF

Huang C-H., Wu H- & Lee Y-C. (2018). The perceptions of patient safety culture: A difference between physicians and nurses in Taiwan. Appl Nurs Res [Internet]. 40:39–44. DOI: 10.1016/j.apnr.2017.12.010. Available from: http://www.sciencedirect.com/science/article/pii/S0897189716300775

Jha A. K. (2018). Presentation at the “Patient Safety – A Grand Challenge for Healthcare Professionals and Policymakers Alike” a Roundtable at the Grand Challenges Meeting of the Bill & Melinda Gates Foundation. Available from: https://globalhealth.harvard.edu/qualitypowerpoin

Livorsi D., Knobloch M. J., Blue L. A., Swafford K., Maze L., Riggins K., Hayward T., Safdar N. (2016). A rapid assessment of barriers and facilitators to safety culture in an intensive care unit. Int Nurs Rev. 63(3):372–6. DOI: 10.1111/inr.12254

Mendes K. D. S., Silveira R. C. C. P. & Galvão C. M. (2019). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 17(4): 758-64. Available from: https://www.scielo.br/j/tce/a/XzFkq6tjWs4wHNqNjKJLkXQ/?lang=pt&format=pdf.

Meurling L., Hedman L., Sandahl C., Fellander-Tsai L .& Wallin C-J. (2013). Systematic simulation-based team training in a Swedish intensive care unit: a diverse response among critical care professions. BMJ Qual Saf. 22(6):485–94. DOI: 10.1136/bmjqs-2012-000994

Milton J., Chaboyer W., Åberg N. D., Erichsen Andersson A. & Oxelmark L. (2020). Safety attitudes and working climate after organizational change in a major emergency department in Sweden. Int Emerg Nurs [Internet]. 100830. DOI: 10.1016/j.ienj.2020.100830. Available from: http://www.sciencedirect.com/science/article/pii/S1755599X2030001X

Moreno M. C. & Andreoli P. de A. (2019). Segurança do paciente: não é uma intenção, é uma ação. In: Bopsin P dos S, Ribas EO, Silva DM, editors. Guia Prático para Segurança do Paciente. Porto Alegre: Moriá; p. 255.

Murphy T., Laptook A. & Bender J. (2018). Sustained Improvement in Neonatal Intensive Care Unit Safety Attitudes After Teamwork Training. J Patient Saf. 14(3):174–80.

Notaro K. A. M., Corrêa A. R., Tomazoni A., Rocha P. K. & Manzo B. F. (2019). Safety culture of multidisciplinary teams from neonatal intensive care units of public hospitals. Rev Lat Am Enfermagem. 27. DOI: 10.1590/1518-8345.2849-3167

Okuyama J. H. H., Galvão T. F., Crozatti M. T. L., Silva M. T. (2019). Health professionals’ perception of patient safety culture in a university hospital in São Paulo: A cross-sectional study applying the Hospital Survey on Patient Safety Culture. Sao Paulo Med J [Internet]. May [cited 2020 Jul 22];137(3):216–22. DOI: 10.1590/1516-3180.2018.0430140319. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000300216&tlng=en

Pavan N. F. P., Magalhães A. L. P., Poncio D. F. , Ascari R. A., Zanini P. D. , Knihs N. da S, Silva O. M. (2019). Patient safety culture in kidney transplant patients in western Santa Catarina. Acta Paul Enferm [Internet]. Aug [cited 2020 Jun 8];32(4):398–405. DOI: 10.1590/1982-0194201900055. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-21002019000400398&tlng=pt

Poley M. J., van der Starre C., van den Bos A., van Dijk M. & Tibboel D. (2011). Patient safety culture in a Dutch pediatric surgical intensive care unit: an evaluation using the Safety Attitudes Questionnaire. Pediatr Crit Care Med. 12(6):e310-6. DOI: 10.1097/PCC.0b013e318220afca

Profit J., Etchegaray J., Petersen L.A. , Sexton J. B., Hysong S. J., Mei M., Thomas E. J. (2012). Neonatal intensive care unit safety culture varies widely. Arch Dis Child Fetal Neonatal Ed. 97(2). DOI: 10.1136/archdischild-2011-300635

Raftopoulos V. & Pavlakis A. (2013). Safety climate in 5 intensive care units: a nationwide hospital survey using the Greek-Cypriot version of the safety attitudes questionnaire. J Crit Care. Feb;28(1):51–61. DOI: 10.1016/j.jcrc.2012.04.013

Rojas F. L. L., Kehrig R. T., Biato E. C. L. & Santos N. C. dos. (2019). Permanent education in health: the rethinking about the construction of heath practices. J Heal NPEPS [Internet].4(2):310–30. DOI: 10.30681/252610103730. Available from: https://periodicos.unemat.br/index.php/jhnpeps/article/view/3730/3362

Sexton J. B., Berenholtz S. M., Goeschel C. A., Watson S. R., Holzmueller C. G., Thompson D. A., Hyzy R. C., Marsteller J. A., Schumacher K., Pronovost P. J. (2011). Assessing and improving safety climate in a large cohort of intensive care units. Crit Care Med [Internet]. 39(5):934–9. DOI: 10.1097/CCM.0b013e318206d26c. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104710839&lang=pt-br&site=ehost-live&authtype=ip,cookie,uid

Sexton J. B., Helmreich R. L., Neilands T. B., Rowan K., Vella K., Boyden J., Roberts P. R., Thomas, E. J. (2006). The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 6:44.DOI: 10.1186/1472-6963-6-44

Sorra J. S. & Nieva V. F. (2004). Hospital Survey on Patient Safety Culture. (Prepared by Westat, under Contract No 290-96-0004) AHRQ Publication no 04-0041 [Internet]. 2004; Available from: https://proqualis.net/sites/proqualis.net/files/User guide HSOPSC.pdf .

Sousa P. & Mendes W. (2019). Segurança do paciente: criando organizações de saúde seguras. 2 edição. FIOCRUZ, editor. Rio de Janeiro: CDEAD; 268 p.

Souza C. S. de, Tomaschewski-Barlem J. G., Rocha L. P., Barlem E. L. D., Silva T. L. & Neutzling B. R. da S. (2019). Patient safety culture in intensive care units: perspective of health professionals. Rev Gauch Enferm. 40(spe):e20180294. DOI: 10.1590/1983-1447.2019.20180294

Thomas A. & Lomas J-P. (2018). Establishing the use of a safety attitudes questionnaire to assess the safety climate across a critical care network. J Intensive Care Soc. Aug;19(3):219–25. DOI: 10.1177/1751143717750788

Thomas, E. J. M. D, MPH; Sexton, J. Bryan PhD & Helmreich R. L. P. (2003). Discrepant attitudes about teamwork among critical care nurses and physicians. Crit Care Med [Internet]. 31(3):956–9. DOI: 0.1097/01.CCM.0000056183.89175.76

Tlili M. A., Aouicha W., Ben Rejeb M., Sahli J., Ben Dhiab M., Chelbi S., Mtiraoui A., Laatiri H. S., Ajmi T., Zedini C., Mallouli M. (2020). Assessing patient safety culture in 18 Tunisian adult intensive care units and determination of its associated factors: A multi-center study. J Crit Care. 56:208–14. DOI: 10.1016/j.jcrc.2020.01.001

Tomazoni A., Rocha P. K., de Souza S., Anders J. C. & de Malfussi H. F. C. (2014). Patient safety culture at neonatal intensive care units: Perspectives of the nursing and medical team. Rev Lat Am Enfermagem. 22(5):755–63. DOI: 10.1590/0104-1169.3624.2477

Tomazoni A., Rocha P. K., Ribeiro M. B., Serapião L. S., Souza S. & Manzo B. F. (2017). Perception of nursing and medical professionals on patient safety in neonatal intensive care units | Segurança do paciente na percepção da enfermagem e medicina em unidades de terapia intensiva neonatal. Rev Gauch Enferm. 38(1):e64996. DOI: 10.1590/1983-1447.2017.01.64996

World Health Organization. (2019). Global action on patient safety Report by the Director-General. A72/26 [Internet]. Genebra. Available from: https://apps.who.int/iris/bitstream/handle/10665/328696/A72_26-en.pdf?sequence=1&isAllowed=y

Published

23/06/2021

How to Cite

SOUSA NETO, A. L. de .; MARQUES, L. de A. .; SADOYAMA, A. dos S. P.; LEAL, G. S.; RÖDER, D. V. D. de B. Safety climate in Intensive Care Units: Integrative review. Research, Society and Development, [S. l.], v. 10, n. 7, p. e33910716702, 2021. DOI: 10.33448/rsd-v10i7.16702. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/16702. Acesso em: 12 nov. 2024.

Issue

Section

Review Article