Cultura de segurança do paciente: atitudes da equipe de enfermagem em hospitais de região de fronteira

• Ano de defesa: 2026
• Autor(a) principal: Cardoso, Flávia Shimeny Soares
• Orientador(a): Zarili, Thais Fernanda Tortorelli
• Banca de defesa: Zarili, Thais Fernanda Tortorelli , Ferreira, Helder , Lima, Silvana Andréa Molina
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual do Oeste do Paraná; Foz do Iguaçu
• Programa de Pós-Graduação: Programa de Pós-Graduação em Saúde Pública em Região de Fronteira
• Departamento: Centro de Ciências da Saúde
• País: Brasil
• Palavras-chave em Português: Segurança do paciente; Cultura organizacional; Equipe de enfermagem; Hospitais; Áreas de fronteira
• Palavras-chave em Inglês: Patient safety; Organizational culture; Nursing; Team; Hospitals; Border areas
• Palavras-chave em Espanhol: Seguridad del paciente; Cultura organizacional; Grupo de enfermería; Hospitales; Áreas fronterizas
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::SAUDE COLETIVA
• Link de acesso: https://tede.unioeste.br/handle/tede/8727

Patient safety is an essential component of healthcare quality, particularly in border regions characterized by intense population mobility and cultural and linguistic diversity. This dissertation aimed to assess patient safety culture among nursing professionals working in two hospital institutions located in the Brazil–Paraguay–Argentina tri-border region. The study was conducted in two complementary stages. The first consisted of an integrative literature review performed in the PubMed and LILACS databases, in which 661 publications were identified and 26 studies were included. The second stage comprised an observational, analytical, cross-sectional, and quantitative study involving 495 nursing professionals. Data were collected using a sociodemographic and professional characterization questionnaire developed by the researchers and the Safety Attitudes Questionnaire. The data were analyzed using descriptive statistics, nonparametric tests, and multiple linear regression, with a significance level of 5%. The review showed that patient safety policies vary in scope and effectiveness and are influenced by organizational culture, leadership, infrastructure, adherence to protocols, team engagement, and continuing education. In the empirical stage, the instrument’s mean total score was 66.47 points, below the cutoff score of 75 points. Only the “Job Satisfaction” domain showed a positive perception, with a mean score of 84.43 points. The “Teamwork Climate”, “Safety Climate”, and “Working Conditions” domains had mean scores of 74.22, 71.98, and 70.64 points, respectively, whereas “Perceptions of Management” and “Stress Recognition” had the lowest scores, with means of 54.64 and 30.15 points. In the multivariable analysis, the total score remained associated with work shift, participation in patient safety training, educational level, and the presence of language barriers. Communication difficulties resulting from these barriers were reported by 64.0% of the professionals, while only 6.1% reported having received training to address cultural or linguistic diversity. The integrative review demonstrated that patient safety policies in hospitals show variable scope and effectiveness, influenced by factors such as organizational culture, leadership, and team engagement. It was also concluded that the institutions investigated have strengths related to job satisfaction, but also present organizational, managerial, and communication-related weaknesses. Strengthening safety culture in these services requires coordinated management actions, continuing education, improved working conditions, and the adoption of formal intercultural communication strategies adapted to the specific characteristics of the border region