Avaliação da cultura de segurança do paciente na atenção primária

Abstract

Introduction: Primary Health Care (PHC), the gateway to the Unified Health System (SUS), is essential for coordinating care and promoting safety. Despite national policies, errors and adverse events still occur, requiring a safety culture based on prevention, open communication, and learning from incidents. Inspired by Florence Nightingale and consolidated globally by studies such as To Err is Human, patient safety is still slow to advance in PHC. Assessing this culture through instruments such as the MOSPSC allows for the identification of weaknesses and the strengthening of safe practices. Objective: This study aimed to analyze the patient safety culture in Primary Health Care and identify risk factors in care from the perspective of professionals. Methodology: A cross-sectional study with a quantitative approach was conducted in Family Health Units in the municipality of São Cristóvão, Sergipe, with the participation of 30 higher-educated health professionals selected by convenience. Data were collected through an online questionnaire based on the Medical Office Survey on Patient Safety Culture, adapted for PHC in Brazil, covering dimensions such as teamwork, open communication, and management support. The statistical analysis performed in this study was based on a variety of descriptive measures. Descriptive measures such as mean, median, standard deviation, interquartile range, absolute frequency, and percentages were used to describe the characteristics of the variables and provide summary information about the collected data. In this study, all statistical analyses were performed using the R programming environment (version 4.3.2). Results and Discussion: The study in the Primary Care of São Cristóvão included 33 professionals, predominantly women (76%), with a mean age of 37 years, higher education (45%), and an average experience of 8.4 years. Patient safety culture presented the highest scores in "Follow-up of Care" (mean = 86) and "Communication about Errors" (mean = 76), while "Exchange of Information" (mean = 44) and "Overall Perception of Safety" (mean = 42) revealed weaknesses. Aspects such as rapid access to appointments, medication review, and team cooperation were well-evaluated, but patient identification, record availability, test follow-up, and workload showed limitations. Intersectoral communication was heterogeneous, and management support was moderate (mean = 56). The overall assessment indicated a positive perception of patient-centered care, effectiveness, and impartiality, but punctuality, operational efficiency, and safety barriers still require improvement, reinforcing the need for protocols, ongoing training, and monitoring of service quality and safety. Conclusion: It is concluded that, although the patient safety culture in Primary Care and scientific health units presents advances, there are still weaknesses related to communication and institutional support. The need to strengthen collaborative practices, invest in continuing education and consolidate a culture focused on prevention and continuous improvement in the quality of care is reinforced.