Clima de segurança e acidentes de trabalho entre trabalhadores de enfermagem atuantes em terapia intensiva

Abstract

The complexity of the intensive care environment contributes to the daily and prolonged exposure of nursing professionals to occupational risks and accidents/diseases. Therefore, the objective of this study was to analyze the relationship between the perception of a climate of safety at work and the occurrence of occupational accidents/diseases among nursing professionals working in intensive care units. This is a cross-sectional, correlational study with a quantitative approach and linked to the matrix project entitled “Climate of safety and accidents at work among nursing professionals working in a hospital environment.” The study consisted of nursing professionals in the intensive care units of a university hospital, which is located in Rio Grande do Sul State, Brazil, who had worked in the units for at least three months. The participants who were on leave of any kind were excluded from the study. Data collection took place between April and May 2019. The data were acquired from a research protocol consisting of a questionnaire of socio-demographic, labor, and occupational accidents/diseases data and the Climate of Safety in Hospital Work Scale. The statistical, descriptive, and inferential analysis of the data was performed using SPSS (Statistical Package For Social Sciences) software version 15.0. Qualitative variables were described using absolute and relative frequencies. Quantitative variables were described using measures of central tendency (mean and median) and dispersion (standard deviation, minimum, and maximum values). Data normality was verified using the Kolmogorov-Smirnov test. The Student's t test, analysis of variance (ANOVA) with post-hoc Tukey test, and Pearson's correlation coefficient were used for the variables that followed normal distribution. For the data that did not meet normal distribution, the Mann-Whitney test, Kruskal-Wallis test, and Spearman’s correlation coefficient were used. The ethical principles of Resolution No. 466/2012 of the National Health Council were considered in order to carry out the study. This study comprised 131 nursing professionals, 84.7% of whom were female, 80.2% had a partner, and 71.8% had children. The mean age was 40.1 years (sd±8.1), of which 39.7% were nurses, 57.3% were nursing technicians, and 3.1% were nursing assistants. As for employment, 63.4% of the participants had a weekly workload of 36 hours and were employed according to Brazilian labor regulations, and 49.6% worked the night shift. Moreover, 46.6% reported the occurrence of occupational accidents/diseases, being the majority (59.0%) of the physical type, and 49.2% required time off of work. The results also showed that that 57.3% of the occupational accidents/diseases were classified as work-related. Regarding the climate of safety at work, nursing professionals showed better perception of a climate of safety in the Safety Equipment and Environment Organization domain (4.06 sd±0.55) and a worse perception of a climate of safety in the Program and Safety domain (3.02 sd±0.66). In addition, there was an inversely proportional association between the occurrence of occupational accidents/diseases, the perception of a general climate of safety (p=0.004), and the domains: Program and Safety Standards (p=0.007), Safety Equipment and Environment Organization (p=0.004), and Support for Work and Safety Practices (p=0.003). It was possible to conclude that a better perception of the climate of safety at work is related to the lower occurrence of occupational accidents/diseases. Therefore, strategies related to health and safety at work are recommended to be prioritized by management as well as by the nursing professionals themselves in order to strengthen behaviors and attitudes that minimize risks and occupational accidents/diseases in the work environment of intensive therapy.