Structure and activities of Patient Safety Centers in hospitals: an integrative review

Abstract

Introduction: Since the establishment of the National Patient Safety Program (NPSP) in Brazil, the implementation of Patient Safety Centers (NSP) in health establishments has become mandatory. Although many studies on implementation of the NSP in hospitals have been published, until now, there is not any synthesis of the literature to inform how to improve NSP’s  effectiveness. Objective: To synthesize the knowledge of Brazilian scientifc publications on the structuring and functioning of patient safety centers in Brazilian hospitals. Method: Integrative literature review based on the guiding question: “What does scientifc production present about the structuring and functioning of NSP in hospitals?”. The searches were carried out in June 2020, in the LILACS, MEDLINE and BDENF databases, through services of the following descriptors: Patient Safety; Risk Management, Safety Management and Hospitals. Results: Twelve studies were selected  for inclusion. In general, NSP partially comply with NPSP’s  guidance. Failures related to NSP  material and human resources  structures were identifed, as well as in relation to the NSP activities. Local contextual aspects that represented barriers or facilitators for the effective activity of NSP comprise: material (e.g., stafng and training), symbolic  (e.g., culture of blame), relational (e.g., senior management support) and institutional (e.g., quality improvement tools) issues. Conclusions: NSP  implementation at hospitals have presented some achievements. Improving NSP effectivity requires creating a supportive context for safety improvement efforts.