PATIENT SAFETY CULTURE IN HEALTHCARE ORGANIZATIONS

Abstract

Patient safety is defined as the reduction, to a minimum acceptable level, of the risk of unnecessary harm associated with healthcare delivery, constituting a central element of care quality. In this context, patient safety culture refers to the set of values, attitudes, competencies, and behavioral patterns shared by professionals, which directly influence how risks are recognized and managed within healthcare organizations. Despite normative and institutional advances, adverse events remain frequent in hospital settings, highlighting persistent challenges to the consolidation of safe practices. This study aimed to identify, in the scientific literature, how patient safety culture is configured in healthcare organizations. This is an integrative literature review conducted between February and April 2022. The search was carried out in the PubMed, Scopus, LILACS, Embase, Web of Science, and Google Scholar databases, using descriptors related to patient safety, safety culture, and healthcare institutions. Articles published in the last ten years, in Portuguese and English, and directly related to the topic were included. Study selection was performed independently by two reviewers, with reference management using the Zotero software and presentation of the selection process according to PRISMA recommendations. Twelve studies were included, all conducted in Brazil and published between 2013 and 2021. Weaknesses in patient safety culture predominated, particularly in dimensions related to adverse event reporting, perception of safety, feedback and communication about errors, and non-punitive response to errors. Teamwork within units emerged as a relatively strengthened dimension in some contexts. Patient safety culture was found to be predominantly fragile, indicating the need to strengthen management models, encourage non-punitive practices, adopt evaluative instruments, and expand continuing education strategies.