Nursing work environment and patient safety in pediatric units

Author(s)

Daniela Fernanda dos Santos Alves

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Enfermagem
• Defense date: 2015-07-30

Examining board members

Edinêis de Brito Guirardello; Daisy Maria Rizatto Tronchin; Regina Aparecida Garcia de Lima; Neusa Maria Costa Alexandre; Sônia Regina Pérez Evangelista Dantas

• Advisor: Edinêis de Brito Guirardello

Abstract

The quality of nursing care provided by health services, especially in hospitals, has been the focus of international studies, with evidence that certain characteristics of the work environment favour the practice of nursing professionals, in addition to providing greater job satisfaction and contributes positively to patient's safety. However, these studies are not directed to paediatric units, which motivates research in this field. This research aimed to evaluate the professional practice environment of the nursing staff and patient safety in paediatric hospitals. This is a cross-sectional study with descriptive and correlational approach, which was conducted in two paediatric hospitals in high-complexity care. One public and the other private, based in São Paulo. The data collection was performed between December 2013 and February-2014, using a record of personal and professional characterization and three instruments: Nursing Work Index - Revised, Maslach Burnout Inventory and Safety Attitudes Questionnaire - Short Form 2006, all previously validated for the Brazilian culture. Correlations between variables were expressed by the Spearman correlation coefficient. The predictive value of the variables emotional exhaustion and job satisfaction on the climate of safety was assessed by multiple logistic regression and the variable emotional exhaustion test mediation through Structural Equation Models. The sample consisted of 267 nurses and included nurses, technicians and nursing assistants who provides direct patient care in inpatient units and paediatric intensive care. The working environment of these hospitals were considered favourable to professional practice, but it was not perceived as a safe environment for the patient. Nurses, technicians and nursing assistants exhibit moderate level of emotional exhaustion; most consider good or very good the quality of care provided by their units; are satisfied with their work and have no intention of leaving their job next year. The variables emotional exhaustion and job satisfaction were considered the safety climate predictors. The structural equation model showed that investments to improve the working environment in pediatric units can reduce emotional exhaustion levels, improve the satisfaction of nursing staff, decrease the intention to leave the job and make the climate of security more positive (AU)

• FAPESP's process: 13/09441-0 - Nursing Work Environment and Safety Patient in Pediatric Units
• Grantee: Daniela Fernanda dos Santos Alves
• Support Opportunities: Scholarships in Brazil - Doctorate