Organizational climate, job satisfaction and burnout in the administrative staff at the Daniel Alcides Carrión National University / Clima organizacional, satisfacción laboral y burnout en el personal administrativo en la universidad nacional daniel alcides carrión

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ABSTRACT Objective: To determine the correlation between the organizational climate, job satisfaction and burnout in the administrative staff of the Daniel Alcides Carrión National University. Methodology: The research was designed as a quantitative study applied with a correlational approach. A cross-sectional non-experimental design was used, since the measurements of the variables were made at a single time. The study population corresponded to a total of430 employees of the Daniel Alcides Carrión National University, which is why a simple random sampling was applied, with a confidence level of 95 % and a margin of error of 5 %, which allowed to determine a sample of 157 employees. For data collection, the survey technique was applied, therefore, three questionnaires were designed as instruments, one for each variable, with a Likert-type response scale. In the case of the Organizational Climate variable, this was based on three dimensions, namely: a) Recognition, b) Teamwork and c) Innovation, which helped to configure a total of 15 items to be evaluated. For the Job Satisfaction variable, it was based on three dimensions, which were: a) Job satisfaction, b) Satisfaction with remuneration and c) Satisfaction with the physical environment, constituting in turn 15 items to be evaluated, while for the Burnout variable, three dimensions were considered: a) Personal exhaustion, b) Depersonalization and c) Demotivation, for a total of 15 items to be evaluated. The questionnaires were subjected to a validity process according to the opinion of experts, who considered that they were suitable in their construction for application, in addition a pilot test was applied with a sample of 85participants, who were not part of the one included in the study, which allowed to determine that these instruments had an internal consistency of Cronbachs Alpha of0.97, 0.95 and 0.89 for the organizational climate, job satisfaction and burnout variables respectively. The data were systematized in an Excel spreadsheet to perform the descriptive statistical analysis, using measures of central tendency to check the frequency and behavior of the variables. Then, the SPSS version 22 program was used to perform inferential statistical calculations. the distribution of the normality of the data was statistically verified using the Kolmogorov-Smirnov test, since the number of the sample was greater than fifty. For the determination of the correlation between the variables, the Spearman rank correlation coefficient was used, because the sample presented a non-normal distribution. The significance of the correlation was established by a level of p<0.05 for hypothesis testing. Results: The results showed that between the Organizational climate variable and the Recognition dimension there is an average level of satisfaction (61.14 %), 35.67 % showed a high level of satisfaction and 3.19 % a very high level of satisfaction. Between the Organizational climate and the Teamwork dimension, a result of 2.23 was obtained, which indicates a perception that there is good teamwork. Regarding the Organizational climate and Innovation, it was found that 52.23 % of employees almost alwaysfeel stimulated to innovate, 33.12 % always feel motivated to innovate and 14.6 5 % sometimes feel that motivation. With respect to the variable Job Satisfaction and the dimension satisfaction with work, it was obtained that 60.5 % feel indifferent with respect to job satisfaction and 39.5 % are satisfied. For the Satisfaction with Remuneration dimension, 36.4 % of employees feel indifferent about their remuneration, 39.8 % feel satisfied and 13.1 % feel very satisfied with their remuneration. Regarding the dimension Satisfaction with the physical environment, 38.8 % declared themselves indifferent with respect to this dimension, 23.2 %o feel satisfied and 0.8 % of the samplefeel very satisfied with the physical environment. With respect to the Burnout variable and the Personal exhaustion dimension, 47.13 % of the employees presented a high level of personal burnout, 33.12 % revealed to have an average level of burnout and 19.75% showed a very high level of burnout. As for the aspect of Depersonalization, the results showed that the majority represented by 85.35% has a very high level of depersonalization, only 0.64 % presented a high level of depersonalization and 14.01 % presented an average level of depersonalization. As for the Demotivation dimension, it was obtained that 30.57 % of employees showed an average level of demotivation, while 69.43 % of workers showed a high level. Finally, the results revealed a positive and significant correlation (Spearman's Rho = 0.299) between organizational climate and job satisfaction. Likewise, a weak negative correlation (-0.153) was observed between organizational climate and burnout. In relation to the organizational climate and burnout variables, a weak negative correlation was observed with a coefficient of-0.153. While for the variables job satisfaction and burnout, a correlation coefficient of-0.024 was observed very close to zero. Conclusion: There is a positive and significant correlation between organizational climate and job satisfaction, and a negative and significant correlation between organizational climate and burnout, suggesting that a better organizational climate is associated with higher satisfaction and lower burnout in workers. This relationship highlights the importance of promoting a positive and conducive work environment to improve the job satisfaction of administrative staff. The need to focus on recognition as an essential component to promote greater job satisfaction is highlighted, it is also observed that teamwork and innovation are key aspects that contribute to the favorable organizational climate at the university. These conclusions emphasize the importance of implementing policies and practices that promote recognition, teamwork and the promotion of innovation as strategies to improve job satisfaction and prevent burnout in administrative staff. It is also highlighted that at higher levels of organizational climate, lower levels of administrative staff are observed, which is why it is important to create a healthy work environment and support the emotional well-being of employees to prevent job burnout. Ultimately, the relationship between organizational climate, job satisfaction and burnout are a multidimensional dynamic that requires a holistic approach. By continuing to research and apply effective approaches to improving the work climate, organizations can cultivate an environment where employees feel valued, motivated, and able to contribute meaningfully. Doingso will not only benefit the workers and the organization, but also set a higher standardfor well-being in the overall work environment.

Estructura organizativa para el Club de Boxeo Mas Holding, Sri Lanka

En el Club de Boxeo MAS Holding, en Sri Lanka, se constatan insuficiencias en las relaciones entre las áreas organizativas de la estructura actual y con ello, poca coherencia de acciones estratégicas para el logro de los objetivos de la institución deportiva; ello se manifiesta en la poca estabilidad de los resultados competitivos nacional e internacionalmente, lo anterior asociado a que la estructura organizativa responde a criterios muy pragmáticos y utilitarios, resulta insuficiente y se ha convertido en una barrera que impide asumir, creadoramente, los cambios del entorno. La investigación tiene como objetivo determinar los componentes de una estructura para la gestión deportiva del Club de Boxeo MAS Holding, Sri Lanka. El resultado está en la concepción teórica de la estructura organizacional para el Club de Boxeo Mas Holding que responde a los fundamentos jurídicos, políticos y administrativos del país, y da respuesta a las exigencias de cambios para el desarrollo de la actividad deportiva. Se sostiene dicha estructura en principios como la eficiencia, el carácter dinámico, flexible e innovador y sujeta a cambios, según los escenarios que se presenten al boxeo.

No MAS Holding Boxing Club, Sri Lanka, existem insuficiências nas relações entre as áreas organizacionais da estrutura atual e, com isso, pouca coerência de ações estratégicas para a consecução dos objetivos da instituição esportiva; isso se manifesta na pouca estabilidade dos resultados competitivos nacionais e internacionais, isso associado ao fato de que a estrutura organizacional responde a critérios muito pragmáticos e utilitários, é insuficiente e se tornou uma barreira que a impede de assumir, criativamente, as mudanças do ambiente. A pesquisa tem como objetivo determinar os componentes de uma estrutura para a gestão esportiva do MAS Holding Boxing Club, Sri Lanka. O resultado é a concepção teórica da estrutura organizacional do Mas Holding Boxing Club que atende aos fundamentos legais, políticos e administrativos do país e responde às demandas de mudança para o desenvolvimento da atividade esportiva. Essa estrutura se baseia em princípios como eficiência, caráter dinâmico, flexível e inovador e está sujeita a mudanças, de acordo com os cenários que surgem no boxe.

In the MAS Holding Boxing Club, in Sri Lanka, there are insufficiencies in the relationships between the organizational areas of the current structure and with it, little coherence of strategic actions to achieve the objectives of the sports institution; this is manifested in the poor stability of competitive results nationally and internationally, the above, associated with the fact that the organizational structure responds to very pragmatic and utilitarian criteria, is insufficient and has become a barrier that prevents creatively assuming the changes in the environment. The research aims to determine the components of a structure for the sports management of the MAS Holding Boxing Club, Sri Lanka. The result is in the theoretical conception of the organizational structure for the Mas Holding Boxing Club that responds to the legal, political and administrative foundations of the country, and responds to the demands for changes for the development of sporting activity. This structure is supported by principles such as efficiency, dynamic, flexible and innovative character and subject to change, depending on the scenarios presented to boxing.

Cultura de segurança em unidades de terapia intensiva na perspectiva da equipe multiprofissional: Estudo multicêntrico / Cultura de seguridad en unidades de terapia intensiva en la perspectiva del equipo multiprofesional: Estudio multicéntrico / Safety Culture in intensive care units from multiprofessional team perspective: A multicenter study

Resumo Introdução: A Cultura de Segurança do Paciente é considerada um importante componente estrutural dos serviços, que favorece a implantação de práticas seguras e a diminuição da ocorrência de eventos adversos. Objetivo: Identificar os fatores associados à cultura de segurança do paciente nas unidades de terapia intensiva adulto em hospitais de grande porte da região Sudeste do Brasil. Método: Estudo transversal do tipo survey e multicêntrico. Participaram 168 profissionais de saúde de quatro unidades (A, B, C e D) de terapia intensiva adulto. Foi utilizado o questionário "Hospital Survey on Patient Safety Culture". Considerou-se como variável dependente o nível de cultura de segurança do paciente e variáveis independentes aspectos sociodemográficos e laborais. Foram usadas estatísticas descritivas e para a análise dos fatores associados foi elaborado um modelo de regressão logística múltipla. Resultados: Identificou-se associação entre tipo de hospital com onze dimensões da cultura de segurança, quanto à função a categoria profissional médico, técnico de enfermagem e enfermeiro foram relacionadas com três dimensões; o gênero com duas dimensões e tempo de atuação no setor com uma dimensão. Conclusão: Evidenciou-se que o tipo de hospital, categoria profissional, tempo de atuação no setor e gênero foram associados às dimensões de cultura de segurança do paciente.

Resumen Introducción: La cultura de seguridad del paciente se considera un componente estructural importante de los servicios, que favorece la aplicación de prácticas seguras y la reducción de la aparición de acontecimientos adversos. Objetivo: Identificar los factores asociados a la cultura de seguridad del paciente en unidades de terapia intensiva adulto en hospitales de la región Sudeste del Brasil. Metodología: Estudio transversal de tipo encuesta y multicéntrico. Participaron 168 profesionales de salud de cuatro unidades (A, B, C y D) de terapia intensiva adulto. Se utilizó el cuestionario "Hospital Survey on Patient Safety Culture". Se consideró como variable dependiente el nivel de cultura de seguridad del paciente y variables independientes los aspectos sociodemográficos y laborales. Fueron usadas estadísticas descriptivas y, para analizar los factores asociados, fue elaborado un modelo de regresión logística múltiple. Resultados: Se identificó asociación entre tipo de hospital con once dimensiones de cultura de seguridad del paciente. En relación a la función, personal médico, técnicos de enfermería y personal de enfermería fueron asociados con tres dimensiones, el género con dos dimensiones y tiempo de actuación con una dimensión en el modelo de regresión. Conclusión: Se evidenció que el tipo de hospital, función, tiempo de actuación en el sector y género fueron asociados a las dimensiones de la cultura de seguridad del paciente.

Abstract Introduction: Patient safety culture is considered an important structural component of the services, which promotes the implementation of safe practices and the reduction of adverse events. Objective: To identify the factors associated with patient safety culture in adult intensive care units in large hospitals in Belo Horizonte. Method: Cross-sectional survey and multicenter study. A total of 168 health professionals from four units (A, B, C and D) of adult intensive care participated. The questionnaire "Hospital Survey on Patient Safety Culture" was used. The patient's level of safety culture was considered as a dependent variable, and sociodemographic and labor aspects were the independent variables. Descriptive statistics were used and a multiple logistic regression model was developed to analyze the associated factors. Results: An association was identified between the type of hospital and eleven dimensions of the safety culture. In terms of function, the doctors, nursing technicians, and nurse were related to three dimensions; gender with two dimensions, and time working in the sector with one dimension. Conclusion: It was evidenced that the type of hospital, function, time working in the sector, and gender were associated with the dimensions of patient safety culture.

Clima organizacional y gestión de la calidad en la Universidad Mayor de San Andrés Caso: División de títulos y diplomas / Organizational climate and quality management at the Major University of San Andrés Case: Division of degrees and diplomas / Gestão do clima organizacional e da qualidade na principal Universidade de San Andrés Caso: Divisão de graus e diplomas

El propósito del trabajo fue determinar la relación existente entre el clima organizacional y la gestión de la calidad en la División de Títulos y Diplomas (DTD), unidad administrativa de la Universidad Mayor de San Andrés (UMSA), institución pública y autónoma, responsable de la formación académica profesional, investigativa y social en la ciudad de La Paz. Para ello se empleó una metodología cuantitativa y un diseño correlacional transaccional; se elaboraron tres escalas que fueron validadas y confiabilizadas para luego ser aplicadas a funcionarios y usuarios de la DTD (seleccionados a través de muestras probabilísticas simples y censal); se contó también con una guía de entrevistas. Los resultados arrojan que en la DTD se cuenta con un clima organizacional participativo en el que resaltan el liderazgo, el trabajo en equipo y una visión positiva sobre sueldos y prestaciones recibidas; como debilidades resaltan el ambiente físico de trabajo, el diseño de puestos de trabajo y el desarrollo de carrera. La certificación en gestión de calidad es la mayor fortaleza a lo que se suma la orientación al cliente; la debilidad en gestión de calidad está centrada en la planificación. Finalmente se determinó que, si bien ambas variables están conectadas, el comportamiento de una no obedece exclusivamente al comportamiento de la otra, por lo que se infiere que existen otras variables que inciden en ellas, entre estas el compromiso, la normativa general institucional y el trato mismo que dispensa el usuario al funcionario.

The purpose of the work was to determine the relationship between the organizational climate and quality management in the Degrees and Diplomas Division (DTD), an administrative unit of the Universidad Mayor de San Andrés (UMSA), a public and autonomous institution, responsible for professional, investigative and social academic training in the city of La Paz. For this, a quantitative methodology and a transactional correlational design were used; Three scales were developed that were validated and made reliable and then applied to officials and users of the DTD (selected through simple probabilistic samples and census); There was also an interview guide. The results show that the DTD has a participatory organizational climate in which leadership, teamwork and a positive vision of salaries and benefits received stand out; as weaknesses they highlight the physical work environment, job design and career development. Certification in quality management is the greatest strength to which customer orientation is added; the weakness in quality management is focused on planning. Finally, it will be concluded that, although both variables are connected, the behavior of one does not obey exclusively to the behavior of the other, so it is inferred that there are other variables that affect them, among them the commitment, the general institutional regulations and the same treatment that dispenses the user to the officer.

O objetivo do trabalho foi determinar a relação entre o clima organizacional e a gestão da qualidade na Divisão de Graus e Diplomas (DTD), unidade administrativa da Universidade Mayor de San Andrés (UMSA), instituição pública e autônoma, responsável pela gestão profissional, formação acadêmica investigativa e social na cidade de La Paz. Para tanto, utilizou-se uma metodologia quantitativa e um desenho correlacional transacional; foram desenvolvidas três escalas que foram validadas e tornadas confiáveis ​​e depois aplicadas a funcionários e usuários da DTD (selecionados através de amostras probabilísticas simples e censo); havia também um guia de entrevista. Os resultados mostram que o DTD possui um clima organizacional participativo em que se destacam a liderança, o trabalho em equipe e uma visão positiva dos salários e benefícios recebidos; os pontos fracos incluem o ambiente físico de trabalho, a concepção do trabalho e o desenvolvimento da carreira. A certificação em gestão da qualidade é o maior ponto forte ao qual se soma a orientação para o cliente; A fraqueza na gestão da qualidade está focada no planejamento. Por fim, determinou-se que, embora ambos ases variáveis estejam conectadas, o comportamento de uma não obedece exclusivamente ao comportamento da outra, pelo que se infere que existem outras variáveis que as afetam, incluindo o comprometimento, as regulamentações institucionais gerais e o mesmo tratamento que o usuário dá ao funcionário.

El papel del clima organizacional como mediador entre la disposición al cambio y el bienestar eudaimónico / The role of organizational climate as a mediator between the will to change and eudaimonic well-being

Resumen Introducción: la gestión eficiente del cambio y el bienestar de los empleados se han convertido en factores determinantes para el éxito organizacional. Este estudio se centró en analizar el papel mediador del clima organizacional en la relación entre la disposición al cambio y el bienestar eudaimónico de los colaboradores. Método: se contó con una muestra de 510 participantes de tres países (Colombia: n = 158, 31 %; España: n = 201, 39.4 %; Ecuador: n = 151, 29.6 %), con una edad media de 36.47 años (DE = 12.61), quienes respondieron el Test de Clima Organizacional (Focus-93), un Test de Disposición al Cambio Organizacional (CEDCO ) y un Índice de Bienestar Eudaimónico (EWB). Resultados: los análisis multivariados y de regresión con ecuaciones estructurales indicaron una capacidad predictiva limitada del cambio organizacional en el bienestar, y la influencia positiva de aquel en el clima organizacional, además de una relación moderada entre el bienestar y el clima organizacional. No obstante, la relación entre el cambio organizacional y el clima subraya la importancia de la gestión efectiva del cambio para incidir en el bienestar de los empleados. Conclusiones: estos hallazgos enfatizan la necesidad de diseñar estrategias que fomenten el bienestar de los empleados a través de la gestión del cambio y la promoción del clima organizacional positivo en entornos organizacionales específicos.

Abstract Introduction: Efficient change management and employee well-being have become determining factors for organizational success. This study focused on analyzing the mediating role of organizational climate in the relationship between willingness to change and eudaimonic well-being of employees. Method: There was a sample of 510 participants from three countries (Colombia: n = 158, 31%; Spain: n = 201, 39.4%; Ecuador: n = 151, 29.6%), with an average age of 36.47 years (SD = 12.61), who responded to the Organizational Climate Test (Focus-93), a Test of Readiness for Organizational Change (Cedco ) and an Index of Eudaimonic Well-being (EWB). Results: The multivariate and regression analyzes with structural equations indicated a limited predictive capacity of organizational change in well-being and the positive influence on the organizational climate, in addition to a moderate evaluation between well-being and organizational climate. However, the evaluation between organizational change and climate highlights the importance of effective change management to influence employee well-being. Conclusions: These findings emphasize the need to design strategies that foster employee well-being through change management and the promotion of a positive organizational climate in specific organizational settings.

Cultura de segurança do paciente sob a visão de profissionais de uma instituição filantrópica / Patient safety culture under the view of professionals from a philanthropic institution / Cultura de seguridad del paciente en la perspectiva de profesionales de una institución filantrópica

Objetivo: Avaliar a percepção da Cultura de Segurança dos profissionais de saúde de um hospital filantrópico. Métodos: Estudo quantitativo do tipo survey com amostra retrospectiva, a partir da análise de respostas ao questionário Pesquisa sobre Segurança do Paciente em Hospitais em um hospital filantrópico de alta complexidade cardiovascular. Para análise dos dados foi empregada a análise descritiva e a estatística inferencial através do teste de Kruskal-Wallis. Resultados: A amostra é composta por 288 profissionais, dos quais 70,49% são mulheres. A equipe de enfermagem mostrou maior expressividade totalizando 58,33% dos entrevistados. A avaliação da cultura de segurança de acordo com a unidade de atuação foi considerada como muito boa por 138 dos 288 participantes (47,92%). Conclusão: A cultura de segurança foi classificada como muito boa, entretanto, ainda é um ponto a se fortalecer na instituição. Os resultados podem servir para o planejamento das ações com intervenções expressivas, fortalecendo o clima de segurança e a adoção de boas práticas institucionais. (AU)

Objective: To evaluate the belief of the Safety Culture of health professionals in a philanthropic hospital. Methods: Quantitative survey-type study with a retrospective sample, based on the analysis of responses to the questionnaire Research on Patient Safety in Hospitals in a philanthropic hospital of high cardiovascular complexity. Descriptive analysis and inferential statistics were used for data analysis using the Kruskal-Wallis' test. Results: The sample is composed of 288 professionals, of which 70.49% are women. The nursing team showed greater expressiveness, totaling 58.33% of respondents. The evaluation of the safety culture according to the unit of operation was considered very good by 138 of the 288 participants (47.92%). Conclusion: The safety culture was classified as very good; however, it is still a point to be strengthened in the institution. The results can be used to plan actions with significant interventions, strengthening the security climate and the adoption of good institutional practices. (AU)

Objetivo: Evaluar la percepción de la Cultura de Seguridad de los profesionales de la salud en un hospital filantrópico. Métodos: Estudio cuantitativo tipo encuesta con muestra retrospectiva, basado en el análisis de las respuestas al cuestionario Investigación sobre Seguridad del Paciente en Hospitales en un hospital filantrópico de alta complejidad cardiovascular. El análisis descriptivo y la estadística inferencial se utilizaron para el análisis de datos mediante la prueba de Kruskal-Wallis. Resultados: La muestra está compuesta por 288 profesionales, de los cuales el 70,49% son mujeres. El equipo de enfermería mostró mayor expresividad, totalizando el 58,33% de los encuestados. La evaluación de la cultura de seguridad según la unidad de operación fue considerada muy buena por 138 de los 288 participantes (47,92%). Conclusión: La cultura de seguridad fue catalogada como muy buena, sin embargo, aún es un punto por fortalecer en la institución. Los resultados pueden ser utilizados para planificar acciones con intervenciones significativas, fortaleciendo el clima de seguridad y la adopción de buenas prácticas institucionales. (AU)

Percepción del clima organizacional y cultura de seguridad en el servicio de cirugía de un hospital de emergencias nivel III-1 / Perception of the organizational climate and safety culture in the surgery service of a level III-1 emergency hospital

RESUMEN Para determinar la correlación entre la percepción del clima organizacional y la cultura de seguridad en el servicio de cirugía del Hospital de Emergencias José Casimiro Ulloa (HEJCU), se realizó un estudio descriptivo y correlacional con 100 profesionales de salud, utilizando los cuestionarios ECO-S y MOSPS, respectivamente. La correlación se analizó con el coeficiente de correlación de Spearman, siendo p<0,05 estadísticamente significativo. Del total, 57% fueron hombres y 43% mujeres; 62% médicos y 38% enfermeros. El clima organizacional fue adecuado (43%), en riesgo (40%) e inadecuado (17%); la cultura de seguridad fue alta (14%), media (82%) y baja (4%). Se encontró una correlación positiva significativa entre la cultura de seguridad y el clima organizacional (rho=0,501), comportamiento organizacional (rho=0,477), estructura organizacional (rho=0,494) y estilo de dirección (rho=0,474) (p<0,001). En conclusión, existe una correlación positiva entre el clima organizacional y la cultura de seguridad en el servicio de cirugía del HEJCU.

ABSTRACT To determine the correlation between the perception of organizational climate and the safety culture in the surgery department of the José Casimiro Ulloa Emergency Hospital (HEJCU), a descriptive and correlational study was conducted with 100 healthcare professionals, using the ECO-S and MOSPS questionnaires, respectively. The correlation was analyzed using Spearman's correlation coefficient, with p<0.05 considered statistically significant. Of the total, 57% were men and 43% women; 62% were physicians and 38% nurses. The organizational climate was adequate (43%), at risk (40%), and inadequate (17%); the safety culture was high (14%), medium (82%), and low (4%). A significant positive correlation was found between safety culture and organizational climate (rho=0.501), organizational behavior (rho=0.477), organizational structure (rho=0.494), and management style (rho=0.474) (p<0.001). In conclusion, there is a positive correlation between organizational climate and safety culture in the surgery department of HEJCU.

Patient safety climate in Primary Health Care in Brazil: an integrative review / Clima de Segurança do Paciente na Atenção Primária à Saúde no Brasil: revisão integrativa / Clima de seguridad del paciente en la Atención Primaria de Salud en Brasil: una revisión integradora

Justification and Objectives: although Primary Health Care plays a central role in Brazil, much of the research that assesses safety culture and climate focuses on hospitals and few studies on this subject have explored this reality, thus justifying this study. The aim was therefore to identify the patient safety climate characteristics in Primary Health Care services in Brazil. Methods: an integrative review study. The MEDLINE via PubMed, LILACS, CINAHL and SciELO databases were used to search for studies. Results: nine articles were selected which reported on the negative safety climate in Primary Health Care. The five classes generated in the dendrogram are divided into two main categories: (1) Safe healthcare in Primary Health Care; and (2) Patient safety climate assessment in Primary Health Care services. Communication, organizational learning and teamwork were cited as enhancers of safe healthcare. Community health workers had a more negative safety climate perception. Working conditions and management support were rated negatively. Conclusion: strengthening the safety climate in Primary Health Care services favors quality of care and safe healthcare.(AU)

Justificativa e Objetivos: embora a Atenção Primária à Saúde tenha papel central no contexto brasileiro, grande parte das pesquisas que avaliam a cultura e o clima de segurança tem enfoque no âmbito hospitalar e poucas investigações sobre essa temática exploram essa realidade, justificando a elaboração deste estudo. Dessa forma, objetivou-se identificar as características do clima de segurança do paciente em serviços de Atenção Primária à Saúde no Brasil. Métodos: estudo de revisão integrativa. As bases de dados MEDLINE via PubMed, LILACS, CINAHL e SciELO foram utilizadas para busca das publicações. Resultados: foram selecionados nove artigos, que relataram sobre o clima de segurança negativo na Atenção Primária à Saúde. As cinco classes geradas no dendrograma se dividem em duas categorias principais: (1) Cuidado à saúde seguro na Atenção Primária à Saúde; e (2) Avaliação do clima de segurança do paciente nos serviços de Atenção Primária à Saúde. Comunicação, aprendizagem organizacional e trabalho em equipe foram citados como potencializadores do cuidado à saúde seguro. Os Agentes Comunitários de Saúde apresentaram percepção mais negativa do clima de segurança. As condições de trabalho e o suporte da gerência foram avaliados negativamente. Conclusão: o fortalecimento do clima de segurança nos serviços primários de saúde favorece a qualidade da assistência e o cuidado à saúde seguro.(AU)

Justificación y Objetivos: a pesar de que la Atención Primaria de Salud desempeña un papel central en Brasil, gran parte de las investigaciones que evalúan la cultura y el clima de seguridad se centran en los hospitales y pocos estudios sobre este tema han explorado esta realidad, lo que justifica el desarrollo de este estudio. Por lo tanto, el objetivo fue identificar las características del clima de seguridad del paciente en los servicios de Atención Primaria de Salud en Brasil. Métodos: estudio de revisión integradora. Se utilizaron las bases de datos MEDLINE vía PubMed, LILACS, CINAHL y SciELO para la búsqueda de publicaciones. Resultados: fueron seleccionados nueve artículos que informaban sobre el clima de seguridad negativo en los servicios de Atención Primaria de Salud. Las cinco clases generadas en el dendrograma se dividen en dos categorías principales: (1) Atención de salud segura en la Atención Primaria de Salud; y (2) Evaluación del clima de seguridad del paciente en los servicios de Atención Primaria de Salud. La comunicación, el aprendizaje organizativo y el trabajo en equipo se citaron como potenciadores de una asistencia sanitaria segura. Los trabajadores sanitarios comunitarios tenían una percepción más negativa del clima de seguridad. Las condiciones de trabajo y el apoyo de la dirección se valoraron negativamente. Conclusión: reforzar el clima de seguridad en la Atención Primaria de Salud favorece la calidad de la atención y la seguridad de la asistencia sanitaria.(AU)

Cultura de segurança do paciente: percepção de profissionais atuantes no centro cirúrgico / Patient safety culture: perception of professionals working in the surgical center

Objetivo: Avaliar a cultura de segurança do paciente em um centro cirúrgico de um hospitalpúblico federal. Método: Trata-se de um estudo descritivo exploratório, com corte transversal e abordagem quantitativa. A coleta de dados ocorreu entre dezembro de 2019 e fevereiro de 2020, por meio do questionário Hospital Survey on Patient Safety Culture, que reúne o maior número de critérios psicométricos específicos sobre a cultura de segurança do paciente. Resultados: Participaram da pesquisa 55 profissionais, a maioria técnicos de Enfermagem em contato direto com o paciente. As dimensões "aprendizagem organizacional/melhoria continuada" e "apoio da gerência do hospital para a segurança do paciente" obtiveram maiores taxas de respostas positivas, consideradas dimensões de fortaleza para a cultura de segurança. Entretanto, dez dimensões não atingiram o nível de fortaleza da cultura de segurança do paciente. Conclusão: Mediante a análise das dimensões, evidenciou-se uma cultura de segurança do paciente ainda frágil na instituição, com destaque importante para o apoio da gerência hospitalar e a aprendizagem organizacional, que impactam diretamente na percepção dos profissionais sobre esse tema. (AU)

Objective: To evaluate the patient safety culture in a surgical center of a federal public hospital. Method: This is an exploratory descriptive study, with a cross-section and a quantitative approach. Data collection took place between December 2019 and February 2020, using the Hospital Survey on Patient Safety Culture questionnaire, which gathers the largest number of specific psychometric criteria on patient safety culture. Results: A total of 55 professionals participated in the research, most of them nursing technicians in direct contact with the patient. The dimensions "organizational learning/continuous improvement" and "hospital management support for patient safety" obtained higher rates of positive responses, considered dimensions of strength for the safety culture. However, ten dimensions did not reach the strength level of patient safety culture. Conclusions: Through the analysis of the dimensions, we evidenced a still fragile patient safety culture in the institution, with particular emphasis on hospital management support and orga-nizational learning, which directly impact the professionals' perception of this topic. (AU)

Objetivo: Evaluar la cultura de seguridad del paciente en un centro quirúrgico de un hospital público federal. Método: Se trata de un estudio descriptivo exploratorio, de enfoque transversal y cuantitativo. La recogida de datos se realizó entre diciembre de 2019 y febrero de 2020, mediante el cues-tionario Hospital Survey on Patient Safety Culture, que reúne el mayor número de criterios psicométricos específicos sobre cultura de seguridad del paciente. Resultados: Participaron de la investigación 55 profesionales, la mayoría técnicos de enfermería en contacto directo con el paciente. Las dimensiones "apren-dizaje organizacional/mejora continua" y "apoyo de la gestión hospitalaria a la seguridad del paciente" obtuvieron mayores índices de respuestas positivas, consideradas dimensiones de fortaleza para la cultura de seguridad. Sin embargo, diez dimensiones no alcanzaron el nivel de fortaleza de la cultura de segu-ridad del paciente. Conclusión: A través del análisis de las dimensiones, la cultura de seguridad del paciente aún era frágil en la institución, con importante énfasis en el apoyo a la gestión hospitalaria y al aprendizaje organizacional, que impactan directamente en la percepción de los profesionales sobre este tema. (AU)

The Influence of Organizational Support on Doctors'Career Satisfaction in Public Hospitals:An Analysis of Mediating Effects Based on Role Stress / 中国医院管理

Objective To explore the influence of organizational support on the career satisfaction of doctors in public hospitals and the mediating effect of role stress.Methods Using the survey data of 523 public hospital doctors from 9 medical institutions in 4 places in 2022,OLS linear regression model was used to analyze the influence of organizational support on career satisfaction,and Bootstrap test was used to explore the mediating effect of role stress.Results Organizational support had a positive effect on the career satisfaction of doctors in public hospitals,and for every unit increase in organizational support score,career satisfaction score will increase by 0.528 points.And role stress had a negative effect on the career satisfaction of doctors in public hospitals.Conclusion Organizational managers should take measures to promote the positive impact of organizational support on doctors'career satisfaction in public hospitals,reduce doctors'role stress,and continuously improve their career satisfaction.

Research on the Digital Transformation Path of Primary Health Care Institutions Based on Organizational Change Theory:Take Tianjin's Digital Health Service Consortium as an Example / 中国医院管理

Objective To explore the digital transformation path of primary medical and health institutions in China,and provide reference for the research and follow-up policy formulation in the field.Methods The experience and practice of Tianjin digital health service consortium were collected by semi-structured interview,and the external and internal data were continuously collected as supplements.Finally,the data were coded and analyzed by programmatic grounded method.Results After coding,39 first-level categories and 13 second-level categories were obtained.Finally,guided by the theoretical analysis framework of organizational change,five core categories were obtained,namely,driving factors,structural change,technological change,person change and task change,so as to establish the digital transformation of primary health care institutions.Conclusion The four dimensions of structure,technology,person and task change influence and complement each other.The digital transformation of regional medical institutions should ensure the coordinated development of multiple dimensions at the organizational level.Finally,suggestions are put forward in three aspects:attaching importance to top-level design driving,applying digital technology to empower business scenarios,and actively promoting practical experience in relevant regions.

Ergonomic Risk Factors and Job Performance of Electronic Employee in Malaysia

@#Introduction: Ergonomics is the scientific study of the interactions between humans and other elements of a system to improve human well-being and overall system performance. In larger scope ergonomics examines human behavioral, psychological, and physiological capabilities and limitations. It has given a huge impact on the workers comfort which directly affects the work efficiency and productivity. In Malaysia, the electronics industry is the leading industry in the manufacturing sector and one of the largest employers. This study was conducted to examine the relationship between ergonomics factors and job performance among employees in electronics industry. Material and Method: A total of 155 employees in electronic industry were involved as respondents in this study. A cross-sectional study was conducted using self-administered questionnaires consisting of sections on physical ergonomics, cognitive ergonomics, and organizational ergonomics and job performance. The data were analysed using SPSS version 25, and descriptive statistics, person correlation and multiple liner regressions were used to identify the factors associated with job performance. Results: The findings showed that there is a significant relationship between ergonomics factors (physical ergonomics, cognitive ergonomics, and organizational ergonomics) and employee performance with p<0.05. While the multiple linear regression analysis found that the most contributing ergonomics factors was physical ergonomics that significantly affects job performance in the electronics industry in Malaysia. Conclusion: Ergonomics factors can be used to promote improved performance and productivity from the employees in the organization such as awareness training and education.

Psychological and organizational factors impacting job satisfaction during the COVID-19 Pandemic: A study on similar exposure groups in Indonesia

Introduction@#The COVID-19 pandemic has impacted technical workers who work more often in the field (e.g., engineering, mechanical, health safety environment (HSE), quality control, and production workers) with increasingly complex workloads and work pressures. Few studies have yet to examine the job satisfaction of such workers using a combination of psychological and organizational factors during difficult times, such as the current COVID-19 pandemic. @*Objective@#This study aims to explain whether psychological and organizational factors affect employee job satisfaction as a result of the COVID-19 pandemic. @*Methods@#This quantitative research uses Partial Least Square-Structural Equation Modeling. A survey with a questionnaire was used to collect data in this study. Using the non-probability sampling technique, data from 103 respondents spread throughout four Similar Exposure Groups (SEGs) in Indonesia were collected. Data analysis in this study used SmartPLS 3.0. @*Results@#Male workers in this study constituted more than 90% of the respondents, the majority with a long working period (more than five years). Worker experience was directly proportional to worker age; most workers were between 41 and 56 years old. The results, with a majority of SEGs from engineering, found that out of five hypotheses (H1–H5), four are accepted while one is rejected. Employee job satisfaction during this pandemic is influenced by the feeling of safety (H1) and work pressure (H3). Work pressure is further influenced by the feeling of safety at work (H2). Moreover, work pressure acts as a mediator on the feeling of safety and job satisfaction (H4). However, job satisfaction is not influenced by management commitment (H5). @*Conclusion@#Management commitment to work safety during pandemic situations must be adjusted, especially regarding policies to ensure the availability of additional standards on health protocols to prevent the spread of COVID-19 in the workplace. In addition, the guarantee that the company is committed to ensuring that workers feel safe will be covered if exposed to COVID-19. Occupational safety and health standards are no longer fully focused on work equipment or facilities. The feeling of safety and work pressure during a pandemic require attention from companies in accordance with their existing limitations and capabilities.

Study on the relationship between multidisciplinary teamwork behavior and organizational factors in tertiary public hospitals in Hangzhou:Based on moderated mediation model / 中国卫生政策研究

Objective:Analyze the impact of organizational factors on multidisciplinary teamwork behavior in tertiary public hospitals in Hangzhou,as well as the role mechanism of team atmosphere and team leadership.Provide suggestions for fully mobilizing their teamwork enthusiasm and improving teamwork efficiency.Methods:From January 2022 to March 2022,a questionnaire survey was conducted on multidisciplinary team members in tertiary public hospitals in Hangzhou using purposive sampling,and a total of 452 valid questionnaires were collected;Use the Process plugin in SPSS 26.0 software to test the moderated mediation model.Results:Positive organizational factors have a positive promoting impact on multidisciplinary teamwork behavior(β = 0.128,P<0.001),team atmosphere plays a mediating role between organizational factors and multidisciplinary teamwork behavior(β =0.063,P<0.001),and team leadership plays a negative moderating role between organizational factors and team atmosphere(β =-0.011,P<0.001).Conclusions:The behavior of multidisciplinary teamwork is influenced by multiple factors such as organizational factors,team atmosphere,and team leadership.Therefore,the hospital should actively explore a long-term operation mechanism for multidisciplinary teamwork that conforms to the characteristics of the hospital,improve top-level design,strengthen organizational investment,create a harmonious cooperation atmosphere within the team,enhance team cohesion,use shared leadership for team decision-making,and grant team members sufficient autonomy and decision-making power.

Success of sports organizations and correlation with efficiency and leadership style / éxito de las organizaciones deportivas y correlación con eficiencia y estilo de liderazgo / Sucesso de organizações esportivas e correlação com eficiência e estilo de liderança

ABSTRACT Objective: The objective of this research is to determine how managers evaluate the success of sports organizations. Methods: A system of a total of 119 variables (9 variables of the structure of sports organizations, 7 variables of the management structure of sports organizations, 3 variables of the performance of sports organizations, 45 variables of leadership styles and 55 variables of organizational effectiveness) was applied to a sample of 175 respondents aged 19-66. In the research, we used multiple regression analysis. Results: It was found that there is a statistically significant influence of the management of sports organizations on predicting the success of sports organizations, while organizational effectiveness and leadership styles do not have a significant impact. Conclusion: The success of sports organizations can be predicted based on the characteristics of the management of sports organizations. Level of Evidence II; Therapeutic Studies - Examination of Results.

Resumen Objetivo: El objetivo de esta investigación es determinar cómo los directivos evalúan el éxito de las organizaciones deportivas. Métodos: Sistema de un total de 119 variables (9 variables de estructura de organizaciones deportivas, 7 variables de estructura de gestión de organizaciones deportivas, 3 variables de desempeño de organizaciones deportivas, 45 variables de estilos de liderazgo y 55 variables de eficacia organizacional) se aplicó a una muestra de 175 encuestados de entre 19 y 66 años. En la investigación, utilizamos análisis de regresión múltiple. Resultados: Se encontró que existe una influencia estadísticamente significativa de la gestión de las organizaciones deportivas en la predicción del éxito de las organizaciones deportivas, mientras que la eficacia organizacional y los estilos de liderazgo no tienen una influencia significativa. Conclusiõn: El éxito de las organizaciones deportivas se puede predecir en base a las características de la gestión de las Organizaciones deportivas. Nivel de Evidencia II; Estudios Terapéuticos - Examen de los Resultados.

RESUMO Objetivo: O objetivo desta pesquisa é determinar como os gerentes avaliam o sucesso das organizações esportivas. Métodos: Um sistema com um total de 119 variáveis (9 variáveis da estrutura das organizações desportivas, 7 variáveis da estrutura de gestão das organizações desportivas, 3 variáveis do desempenho das organizações desportivas, 45 variáveis dos estilos de liderança e 55 variáveis da eficácia organizacional) foi aplicado a uma amostra de 175 entrevistados com idades entre 19 e 66 anos. Na pesquisa, utilizamos a análise de regressão múltipla. Resultados: Verificou-se que existe uma influência estatisticamente significativa da gestão das organizações desportivas na previsão do sucesso das organizações desportivas, enquanto a eficácia organizacional e os estilos de liderança não têm influência significativa. Conclusão: O sucesso das organizações esportivas pode ser previsto com base nas características da gestão das organizações esportivas. Nível de Evidencia II; Estudios Terapêuticos - Investigação dos Resultados.

Factors influencing data quality in routine health information systems in Maridi county, South Sudan

Background: Health system planning and monitoring rely on routine data collection, analysis and utilisation. However, underdeveloped countries need more data for decision-making. South Sudan's data management framework only partially functions, with delayed data collection and inaccurate data. The study examined the factors affecting data quality in Maridi County, South Sudan, aiming to improve resource forecasting and equitable health service delivery. Objective: The study sought to identify the obstacles and opportunities for improving data quality in health information systems (HIS) in Maridi County, Western Equatoria State, South Sudan. Methods: A cross-sectional study involving 106 respondents was conducted on 12 healthcare facilities in Maridi County. Statistical Package for the Social Sciences (SPSS) version 25 was used for descriptive, factor and thematic analysis to understand data quality, focussing on behavioural, organisational and technical aspects. Result: The study revealed that insufficient motivation, negative staff attitudes, excessive workloads, a lack of cooperation, personnel insufficiency, inadequate supervision, feedback and training influenced data quality. These factors were interrelated, with over 50% of variables showing weak to strong correlations. Set of standard indicators correlated with the presence of standard data collection tools (r = 0.51). Regular feedback from the County Health Department linked with completeness (r = 0.63) and the training of personnel on health management information systems (HMIS) and completeness resulted in moderate association (r = 0.488). Conclusion: Staff motivation, optimal staffing, training, regular feedback, and continuous supervision are crucial for maintaining the appropriate skill set for data quality. Contribution: Data quality can be achieved when standard tools and human resources are maintained and are evenly distributed.

Nurses' perceptions about the patient safety climate in Primary Health Care / Percepción de los enfermeros sobre el clima de seguridad del paciente en la atención primaria de la salud / Percepção dos enfermeiros sobre o clima de segurança do paciente na atenção primária à saúde

Objective: to evaluate the patient safety climate in Primary Health Care from the perspective of nurses working in the services. Method: a quantitative and cross-sectional study conducted with 148 nurses from a municipality in the state of São Paulo. The Brazilian version of the Primary Care Safety Questionnaire Survey and personal, professional, and organizational performance variables (intention to stay at work, job satisfaction, care quality, and frequency of incidents) were used. Parametric and non-parametric comparison tests and Spearman's correlation coefficient were performed, considering a 5% significance level. Results: the safety climate was positive, varying from 4.52 to 5.33 and differing across districts for workload (p=0.0214) and leadership (p=0.0129). The safety climate professional variables and dimensions differed in relation to the frequency of incidents. Teamwork and safety and learning system were strongly correlated with job satisfaction and moderately with perceived care quality. Conclusion: teamwork and safety and learning system stood out for their positive correlations with job satisfaction and care quality. A positive safety climate favors the involvement of Primary Care nurses to develop improvement plans aligned with the National Patient Safety Program.

Objetivo: evaluar el clima de seguridad del paciente en la Atención Primaria de la Salud, desde la perspectiva de los enfermeros de los servicios. Método: estudio cuantitativo y transversal, con 148 enfermeros de un municipio del Estado de São Paulo. Se utilizó la versión brasileña del Primary Care Safety Questionnaire Survey y variables personales, profesionales y de desempeño organizacional (intención de permanecer en el empleo, satisfacción laboral, calidad de la atención y frecuencia de incidentes). Se realizaron pruebas de comparación paramétricas y no paramétricas y coeficiente de correlación de Spearman, considerando un nivel de significación del 5%. Resultados: el clima de seguridad fue positivo, osciló entre 4,52 y 5,33; difirió entre distritos en carga de trabajo (p=0,0214) y liderazgo (p=0,0129). Las variables profesionales y dimensiones del clima de seguridad difirieron en la frecuencia de incidentes. El trabajo en equipo, el sistema de seguridad y el aprendizaje tuvieron una correlación alta con la satisfacción laboral y una moderada con la percepción de la calidad de la atención. Conclusión: el trabajo en equipo y el sistema de seguridad y aprendizaje se destacaron por su correlación positiva con la satisfacción laboral y la calidad de la atención. Un clima de seguridad positivo favorece la participación de los enfermeros de la atención primaria en el desarrollo de planes de mejora que sigan las indicaciones del Programa Nacional de Seguridad del Paciente.

Objetivo: avaliar o clima de segurança do paciente na Atenção Primária à Saúde, sob a perspectiva dos enfermeiros dos serviços. Método: estudo quantitativo e transversal, com 148 enfermeiros de um município do Estado de São Paulo. Foram utilizadas a versão brasileira do Primary Care Safety Questionnaire Survey e variáveis pessoais, profissionais e desempenho organizacional (intenção permanecer no trabalho, satisfação no trabalho, qualidade do cuidado e frequência de incidentes). Realizaram-se testes de comparação paramétricos, não paramétricos e coeficiente de correlação de Resultados: o clima de segurança foi positivo, com variação de 4,52 a 5,33; diferiu entre distritos para carga de trabalho (p=0,0214) e liderança (p=0,0129). As variáveis profissionais e dimensões do clima de segurança diferiram em relação à frequência de incidentes. Trabalho em equipe, sistema de segurança e aprendizagem foram fortemente correlacionados à satisfação no trabalho e moderadamente com percepção da qualidade do cuidado. Conclusão: trabalho em equipe e sistema de segurança e aprendizagem se destacaram pela correlação positiva com satisfação no trabalho e qualidade do cuidado. O clima de segurança positivo favorece o envolvimento dos enfermeiros da atenção primária para desenvolver planos de melhorias alinhados ao Programa Nacional de Segurança do Paciente.

O enfermeiro recém-formado na condição de segunda vítima / El enfermero recién graduado en condición de segunda víctima / The newly graduated nurse as a second victim

Resumo Objetivo Descrever a prevalência de enfermeiros recém-formados como segundas vítimas de eventos adversos e conhecer as condições de apoio recebidas nas instituições de saúde. Métodos Estudo transversal, descritivo e de abordagem quantitativa, cuja população foi constituída por enfermeiros recém-formados, que aceitaram responder ao questionário online, com perguntas relacionadas à admissão na instituição, envolvimento em eventos adversos e gerenciamento da condição de segunda vítima, contatados por e-mail, intermediado pelo Conselho Regional de Enfermagem de São Paulo. Foi realizada a análise descritiva dos dados e teste de igualdade de proporções. Resultados A amostra final foi de 138 enfermeiros, 54,3% desconheciam o termo segunda vítima, 44,9% desconheciam a existência de protocolos institucionais para apoio emocional aos profissionais e 26,8% estiveram envolvidos em eventos adversos. Destes, 94,6% apresentaram como desfecho diante do evento o sofrimento emocional, frustração, culpa, tristeza, estresse, incapacidade, constrangimento e insegurança para realizar suas funções no trabalho; 59,5% receberam algum tipo de apoio e 21,6% receberam punição institucional. Conclusão A prevalência de enfermeiros recém-formados envolvidos em eventos adversos foi de 26,8%, e, entre os que vivenciaram esse incidente, a maioria apresentou como desfecho, sentimentos negativos e de insegurança na condução do trabalho. Após o evento, o apoio recebido partiu, na maioria das vezes, de colegas de trabalho e pessoas significativas, e, quanto ao apoio institucional, destaca-se ainda a necessidade de programas para suporte emocional, a fim de que esses profissionais superem quando se encontram na condição de segunda vítima.

Resumen Objetivo Describir la prevalencia de enfermeros recién graduados como segundas víctimas de eventos adversos y conocer las condiciones de apoyo recibidas en las instituciones de salud. Métodos Estudio transversal, descriptivo y de enfoque cuantitativo, cuya población estuvo compuesta por enfermeros recién graduados, que aceptaron responder un cuestionario digital con preguntas relacionadas con la admisión en la institución, la participación en eventos adversos y la gestión de la condición de segunda víctima, contactados por correo electrónico e intermediado por el Consejo Regional de Enfermería de São Paulo. Se realizó el análisis descriptivo de los datos y prueba de igualdad de proporciones. Resultados La muestra final fue de 138 enfermeros. El 54,3 % desconocía el término segunda víctima, el 44,9 % desconocía la existencia de protocolos institucionales para apoyo emocional a profesionales y el 26,8 % estuvo involucrado en eventos adversos. De estos, el 94,6 % presentó, como consecuencia del evento, sufrimiento emocional, frustración, culpa, tristeza, estrés, incapacidad, vergüenza e inseguridad para realizar sus funciones en el trabajo; el 59,5 % recibió algún tipo de apoyo, y el 21,6 % recibió sanción institucional. Conclusión La prevalencia de enfermeros recién graduados involucrados en eventos adversos fue del 26,8 % y, de los que pasaron por estos incidentes, la mayoría presentó, como consecuencia, sentimientos negativos y de inseguridad en la conducción de su trabajo. Después del evento, el apoyo recibido, la mayoría de las veces, surgió de compañeros de trabajo y personas importantes. Respecto al apoyo institucional, también se observa la necesidad de programas para apoyo emocional para que estos profesionales se sobrepongan cuando se encuentren en condición de segunda víctima.

Abstract Objective To describe the prevalence of newly graduated nurses as second victims of adverse events and to know the conditions of support received in health institutions. Methods Cross-sectional, descriptive, quantitative study. The population consisted of newly graduated nurses who agreed to answer the online questionnaire with questions related to being hired at the institution, involvement in adverse events and management of the second victim condition. Contacted was by email, intermediated by the Regional Nursing Council of São Paulo. Descriptive data analysis and the test of equality of proportions were performed. Results The final sample consisted of 138 nurses, 54.3% were unaware of the term 'second victim', 44.9% were unaware of the existence of institutional protocols for emotional support to professionals and 26.8% were involved in adverse events. Of these, 94.6% presented emotional distress, frustration, guilt, sadness, stress, inability, embarrassment and insecurity to perform their duties at work as an outcome of the event; 59.5% received some type of support and 21.6% received institutional punishment. Conclusion The prevalence of newly graduated nurses involved in adverse events was 26.8%, and among those who experienced this incident, the majority presented negative feelings and insecurity in performing their work as an outcome. After the event, most of the time, the support received came from work colleagues and significant others. Regarding institutional support, the need for programs for emotional support is also highlighted, so that these professionals can overcome when finding themselves in the place of the second victim.

Asimetrías entre la coordinación nacional y la autonomía de los gobiernos estatales en la adopción de tecnologías sanitarias frente a la COVID-19 en Argentina / Asymmetries between national articulation and the autonomy of state governments in implementing health technologies to fight COVID-19 in Argentina / Assimetrias entre a articulação nacional e a autonomia de governos estaduais na implementação de tecnologias de saúde em combate à COVID-19 na Argentina

Resumen: En pandemia, en Argentina y en otros países se observó variabilidad en las políticas públicas implementadas sobre tecnologías sanitarias para prevención y tratamiento de la COVID-19. El objetivo fue analizar cómo se procesaron en Argentina los movimientos de coordinación vs. cooperación, y de autonomía vs. reparto de autoridad entre entidades, explorando asimetrías entre diferentes entidades en la implementación de políticas públicas sobre tecnologías sanitarias en pandemia y las influencias de otros actores. Se realizó una revisión documental del período 2020-2021 (informes técnicos publicados por la Organización Mundial de la Salud, organismos nacionales y sociedades científicas, leyes, fallos judiciales, prensa, encuestas y entrevistas en profundidad a miembros de los Ministerios de Salud de Argentina). Se indagó sobre procesos y resultados de la toma de decisiones en los Ministerios de Salud, mapeando la cobertura y recomendación de cada tecnología y el partido político provincial gobernante. Hubo heterogeneidad en resultados y procesos entre los Ministerios, y disputas en el interior de los mismos. La adherencia a recomendaciones oficiales fue baja, influyendo distintos criterios técnico-políticos (relaciones de poder, presión social, de los medios, académicos, poder Judicial y Legislativo). En algunos casos se observó una fuerte tensión entre oficialismo y oposición al partido gobernante a partir de la discusión sobre tecnologías. Cada provincia argentina definió sus políticas sobre tecnologías sanitarias para COVID-19 con autonomía, y la toma de decisiones en la administración pública en pandemia fue desordenada, compleja y no lineal.

Abstract: Argentina, as other countries, showed several public policies related to the health technologies implemented to fight and treat the COVID-19 pandemic. This study sought to analyze how articulation vs. cooperation and autonomy vs. division of powers between entities occurred in Argentina, exploring asymmetries between several entities in implementing public policies related to health technologies during the pandemic and the influences of other actors. For this, a documentary research was carried out related to 2020-2021 (technical reports published by the World Health Organization, national agencies and scientific societies, laws, court decisions, press, and research and in-depth interviews with members of the Argentine Ministries of Health). The processes and results of decision-making in the Ministries of Health were analyzed, outlining the coverage and orientations of each technology and the political party in power in the province. This study found heterogeneous results and processes between Ministries and disputes within them. It also observed the poor adherence to official guidelines due to technical-political criteria (power relations, social, media, academic, judiciary, and legislative pressure). Some cases showed a strong tension between the government and its opposition over the discussion of technologies. Each province in Argentina has autonomously defined its policies on health technologies for COVID-19, and decision-making in public administration was disorderly, complex, and non-linear during the pandemic.

Resumo: Na Argentina, assim como em outros países, houve uma variabilidade de políticas públicas relacionadas às tecnologias de saúde implementadas no combate e tratamento da COVID-19 durante a pandemia. Este estudo buscou analisar como ocorreram a articulação vs. cooperação, e a autonomia vs. divisão de poderes entre as entidades na Argentina, explorando assimetrias entre diferentes entidades na implementação de políticas públicas relacionadas a tecnologias de saúde na pandemia, bem como as influências de outros atores. Para tanto, realizou-se uma pesquisa documental para o período de 2020-2021 (relatórios técnicos publicados pela Organização Mundial da Saúde, agências nacionais e sociedades científicas, leis, decisões judiciais, imprensa, pesquisas e entrevistas em profundidade com membros dos Ministérios da Saúde da Argentina). Os processos e os resultados da tomada de decisão nos Ministérios da Saúde foram analisados, traçando a cobertura e orientações de cada tecnologia e o partido político no poder na província. Observou-se uma heterogeneidade nos resultados e processos entre os Ministérios, e disputas em seu interior. Houve uma baixa adesão às orientações oficiais, influenciada por diferentes critérios técnico-políticos (relações de poder, pressão social, midiática, acadêmica, do poder Judiciário e do Legislativo). Em alguns casos, observou-se uma forte tensão entre governo e oposição a partir da discussão das tecnologias. Cada província da Argentina definiu suas políticas sobre tecnologias de saúde para a COVID-19 de forma autônoma, e a tomada de decisões na administração pública foi desordenada, complexa e não linear durante a pandemia.

Lean methodology: contributions to improving work processes in health and nursing / Metodología Lean: aportes a la mejora de los procesos de trabajo en salud y enfermería / Metodologia Lean: contribuições para melhoria dos processos de trabalho em saúde e enfermagem

ABSTRACT Objective: to investigate the contributions of applying the Lean methodology to improve work processes in health and nursing and its impact on associated financial aspects. Method: an integrative review, carried out in six databases, whose sample of ten (100.0%) studies was analyzed and summarized descriptively. Results: the outcomes obtained were stratified into: benefits/barriers to Lean Healthcare implementation; economic aspects involving Lean Healthcare implementation; and process improvements through Lean Healthcare implementation. The majority of studies (60.0%) were carried out in university hospitals, contexts that need to continually improve the quality of services provided, generally with scarce and limited resources, which support the viability of maintaining the teaching, research and extension tripod. Conclusion: three (30.0%) studies highlighted the financial aspects associated with Lean methodology application. The others only mentioned the possibility of financial gains through improving processes and reducing waste.

RESUMEN Objetivo: investigar las contribuciones de la aplicación de la metodología Lean a la mejora de los procesos de trabajo en salud y enfermería y su impacto en los aspectos financieros asociados. Método: revisión integradora, realizada en seis bases de datos, cuya muestra de diez (100,0%) estudios fue analizada y resumida de forma descriptiva. Resultados: los resultados obtenidos se estratificaron en: beneficios/barreras para la implementación de Lean Healthcare; aspectos económicos que implican la implementación de Lean Healthcare; y mejoras de procesos mediante la implementación de Lean Healthcare. La mayoría de los estudios (60,0%) se realizaron en hospitales universitarios, contextos que necesitan mejorar continuamente la calidad de los servicios prestados, generalmente con recursos escasos y limitados, que sustentan la viabilidad de mantener el trípode de docencia, investigación y extensión. Conclusión: tres (30,0%) estudios destacaron los aspectos financieros asociados a la aplicación de la metodología Lean. Los demás solo mencionaron la posibilidad de obtener ganancias financieras mejorando los procesos y reduciendo el desperdicio.

RESUMO Objetivo: investigar as contribuições da aplicação da metodologia Lean para melhoria dos processos de trabalho em saúde e enfermagem e sua repercussão nos aspectos financeiros associados. Método: revisão integrativa, realizada em seis bases de dados, cuja amostra de dez (100,0%) estudos foi analisada e sintetizada descritivamente. Resultados: os desfechos obtidos foram estratificados em: benefícios/barreiras para implantação do Lean Healthcare; aspectos econômicos envolvendo a implantação do Lean Healthcare; e melhorias em processos por meio da implantação do Lean Healthcare. A maioria dos estudos (60,0%) foi realizada em hospitais universitários, contextos que precisam melhorar, continuamente, a qualidade dos serviços prestados, geralmente com recursos escassos e limitados, os quais sustentam a viabilidade da manutenção do tripé ensino, pesquisa e extensão. Conclusão: três (30,0%) estudos evidenciaram os aspectos financeiros associados à aplicação da metodologia Lean. Os demais apenas mencionaram a possibilidade de ganhos financeiros por meio da melhoria de processos e redução de desperdícios.