Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis.

INTRODUCTION: Adverse events in hospitals are prevented through risk reduction and reliable processes. Highly reliable hospitals are grounded by a robust patient safety culture with effective communication, leadership, teamwork, error reporting, continuous improvement, and organizational learning. Although hospitals regularly measure their patient safety culture for strengths and weaknesses, there have been no systematic reviews with meta-analyses reported from Latin America. PURPOSE: Our systematic review aims to produce evidence about the status of patient safety culture in Latin American hospitals from studies using the Hospital Survey on Patient Safety Culture (HSOPSC). METHODS: This systematic review was guided by the JBI guidelines for evidence synthesis. Four databases were systematically searched for studies from 2011 to 2021 originating in Latin America. Studies identified for inclusion were assessed for methodological quality and risk of bias. Descriptive and inferential statistics, including meta-analysis for professional subgroups and meta-regression for subgroup effect, were calculated. RESULTS: In total, 30 studies from five countries-Argentina (1), Brazil (22), Colombia (3), Mexico (3), and Peru (1)-were included in the review, with 10,915 participants, consisting primarily of nursing staff (93%). The HSOPSC dimensions most positive for patient safety culture were "organizational learning: continuous improvement" and "teamwork within units", while the least positive were "nonpunitive response to error" and "staffing". Overall, there was a low positive perception (48%) of patient safety culture as a global measure (95% CI, 44.53-51.60), and a significant difference was observed for physicians who had a higher positive perception than nurses (59.84; 95% CI, 56.02-63.66). CONCLUSIONS: Patient safety culture is a relatively unknown or unmeasured concept in most Latin American countries. Health professional programs need to build patient safety content into curriculums with an emphasis on developing skills in communication, leadership, and teamwork. Despite international accreditation penetration in the region, there were surprisingly few studies from countries with accredited hospitals. Patient safety culture needs to be a priority for hospitals in Latin America through health policies requiring annual assessments to identify weaknesses for quality improvement initiatives.

Representaciones sociales de salud, enfermedad y cuidado cultural en músicos tradicionales / Social Representations about Health, Disease and Cultural Care in Traditional Musicians

Introducción: Se abordó el estudio de las representaciones sociales para explorar las concepciones que los músicos tienen sobre salud, enfermedad y cuidado, y la manera en que la relacionan con su práctica musical. Objetivo: Comprender las representaciones sociales de la salud, enfermedad y cuidado cultural de músicos tradicionales. Métodos: Estudio descriptivo, cualitativo, fundamentado en el método etnográfico, que combinó observación no participante con entrevista semiestructurada realizada a 15 músicos tradicionales en la ciudad de Santa Marta, Colombia, durante los años 2015 y 2016. Resultados: Las representaciones sociales de los músicos tradicionales permiten generar una aproximación a la manera en que piensan su salud en relación con la práctica musical y su contexto. La conciencia que los músicos tienen de ello reveló que elementos como el trabajo nocturno, consumo de sustancias psicoactivas y situaciones derivadas de la ejecución musical, generan alteraciones de su salud. Se encontró también que desarrollan estrategias de cuidado relacionadas con una actitud preventiva y curativa basada en métodos tradicionales. Conclusiones: Las representaciones sociales constituyen un recurso base para comprender la relación entre la dinámica cultural y los procesos de salud-enfermedad. El contraste con la literatura disponible reveló que a pesar de constituir modalidades y contextos diferentes, existe la posibilidad de encontrar alteraciones similares que puedan afectar la salud de estas personas(AU)

Introduction: The study of social representations was undertaken to explore the conceptions that musicians have about health, illness and care, and the way they relate such aspects to their musical practice. Objective: To understand the social representations of health, illness and cultural care of traditional musicians. Methods: Descriptive, qualitative study, based on the ethnographic method, which combined non-participant observation with a semi-structured interview conducted on 15 traditional musicians in the city of Santa Marta, Colombia, during the years 2015 and 2016. Results: The social representations of traditional musicians allow to generate an approach to how they think about their health in relation to the musical practice and their context. The awareness that musicians have of it revealed that elements such as night work, consumption of psychoactive substances and situations derived from the musical performance generate disorder to their health. They were found to develop care strategies associated to a preventive and curative attitude based on traditional methods. Conclusions: Social representations constitute a basic resource to understand the relationship between cultural dynamics and health-disease processes. The contrast with the available scientific literature revealed that, despite constituting different modalities and contexts, there is the possibility of finding similar alterations that may affect the health of these people(AU)

Historia social de la formación en enfermería en Santa Marta, Colombia / Social history of training in nursing in Santa Marta, Colombia

RESUMEN Introducción: Creada en el año 1994, la Facultad de Enfermería de la Universidad Cooperativa de Colombia de Santa Marta se convirtió en la primera experiencia de formación en enfermería en la ciudad. Inició en el marco de la coyuntura generada por la constitución política de 1991, la ley 100 de 1993, la ley 266 de 1996, en la cual se reglamenta la profesión de la enfermería en Colombia. Desde el punto de vista local, el proceso formativo implicó el reconocimiento y posicionamiento de la enfermería en la ciudad. Objetivo: Analizar el desarrollo histórico del proceso formativo de la enfermería en Santa Marta, Colombia. Métodos: Estudio histórico, combina historia oral con revisión documental. La historia oral se realizó por medio de entrevistas semiestructuradas, realizadas a egresados, profesores y personal administrativo que ha laborado en el programa. Para el análisis de la información se organizó, clasificó y procesó la información y codificó e interpretó de acuerdo a una matriz de análisis. Resultados: En 22 años de existencia, el proceso formativo de enfermería en la ciudad de Santa Marta ha empleado una variedad de estrategias, dirigidas a posicionar la profesión en la ciudad, construyendo un discurso, identidad y performance enfermero. Conclusiones: La historia social de la formación en enfermería permite visibilizar procesos de posicionamiento y reconocimiento de la profesión, así como una serie de iniciativas que permanecen ocultas en las versiones tradicionales de la historia(AU)

ABSTRACT Introduction: Created in 1994, the School of Nursing of the Universidad Cooperativa de Colombia, Santa Marta, became the first experience of nursing education in the city. It started in the framework of the situation created by the 1991 Constitution, Law 100 of 1993, Law 266 of 1996, in which the profession of nursing in Colombia is regulated. From the local perspective, the training process involved the recognition and positioning of nursing in the city. Objective: Analyze the historical development of the learning process of nursing in Santa Marta - Colombia. Methods: Historical study, combines oral history documentary review. Oral history was conducted through semi-structured interviews conducted with alumni, faculty and staff who has worked in the program. For the analysis of information he was organized and processed classified information and codified and interpreted according to an analysis matrix. Results: In its 22 years of existence, the nursing training process in the city of Santa Marta has employed a variety of strategies aimed at positioning the profession in the city, building a speech, identity and performance nurse. Conclusions: The social history of nursing education allows positioning visualize processes and recognition of the profession as well as a number of initiatives that remain hidden in traditional versions of history(AU)

Carga y tipología microbiana relacionada con infecciones asociadas a la asistencia sanitaria en servicios clínicos / The microbial weight and type and its relationship with associated infections in health care

RESUMEN Introducción: Las infecciones asociadas a la asistencia sanitaria repercuten en la calidad de los servicios de salud, causando prolongación en la estancia hospitalaria, aumento en costos de atención, riesgo para la vida de los pacientes. A pesar de los intentos por mejorar esta situación, la problemática aún persiste. Objetivo: Determinar la carga y tipología microbiana relacionada con las infecciones asociadas a la asistencia sanitaria en servicios clínicos. Métodos: Estudio cuantitativo, descriptivo, correlacional, diseño no experimental, realizado en servicios Quirúrgica y Unidad de Cuidados Intensivos de un Hospital de Santa Marta, Colombia, durante abril a septiembre de 2014. De manera intencional se tomaron muestras de laboratorio a pacientes, trabajadores, espacios físicos y equipos. El análisis de la información se realizó mediante frecuencias absolutas y relativas, así como correlación de Pearson. Resultados: Quirúrgica reportó infección de herida quirúrgica (100 por ciento), aislando Pseudomona aeruginosa en 66,66 por ciento de casos; cinco espacios positivos (60,00 por ciento Staphylococcus albus coagulasa negativo y 40,00 por ciento Streptococcus ssp). Dos equipos resultaron positivos para Staphylococcus albus (coagulasa negativo). Unidad de Cuidados Intensivos reportó infecciones urinarias (40,00 por ciento), neumonía (40,00 por ciento) y de herida quirúrgica (20,00 por ciento), siendo Acinetobacter baumannii (40,00 por ciento) el microorganismo más frecuente. En el 100,00 por ciento espacios positivos se aisló Streptococcus ssp; ningún germen fue aislado en instrumental y equipos. Conclusiones: Quirúrgica tuvo mayor carga microbiana que la Unidad de Cuidados Intensivos. El germen predominante fue Acinetobacter baumanii. La correlación entre germen causal de las Infecciones Asociadas a la Asistencia Sanitaria, espacios físicos y equipos biomédicos resultó débil; entre germen causal e instrumental quirúrgico no existió relación(AU)

ABSTRACT Introduction: Health care-associated infections have an impact on the quality of health care services, thus causing longer stay at hospitals, rise in assistance costs and risks for the patient's life. Despite the attempts at improving this situation, the problem still remains. Objective: To determine the microbial burden and typing related to health care-associated infections in the clinical services. Methods: A quantitative, descriptive, correlative and non-experimental design-type study conducted in the Surgery services and in the Intensive Care Unit of a hospital located in Santa Marta, Colombia, from April to September, 2014. The lab samples were intentionally taken from patients, workers, physical spaces and equipment. The information analysis was based on absolute and relative frequencies as well as Pearson's correlation coefficient. Results: The Surgery Services reported surgical wound infection (100 percent), isolation of Pseudomona aeruginosa in 66.66 percent of cases; five bacteria-positive physical spaces (60 percent to coagulase-negative Staphylococcus albus and 40 percent to Streptococcus spp). Two pieces of equipment were positive to coagulase-negative Staphylococcus albus. The Intensive Care Unit reported urinary infections (40 percent), pneumonia (40 percent) and surgical wound (20 percent), being Acinetobacter baumannii (40 percent) the most frequent. In all the positive physical spaces, Streptococcus spp was isolated, but not a single germ was found in the medical instruments or in the equipment. Conclusions: Surgical Service had higher microbial burden than the Intensive Care Unit. The predominant germ was Acinetobacter baumanni. The correlation among the causative germ of health care-associated infections, the physical spaces and the biomedical equipment was poor whereas the correlation of the causative germ and the surgical instruments was non-existent(AU)