Providing safe care means changes in attitude and practice of all professionals involved in patient care. This requires, in the workplace, a safety culture that strengthens the commitment and performance of the multidisciplinary team, as well as specific competences in terms of care, in order to ensure patient safety1.
According to the World Health Organization (WHO), patient safety is the reduction, to an acceptable minimum, of the risk of unnecessary harm associated with health care. To ensure patient safety in Brazil, the National Patient Safety Program (PNSP) stands out with one of the strategies, promoting the safety culture, emphasizing learning and organizational improvement and the adherence of professionals and patients in incident prevention, using systems safe and avoiding individual accountability 2.
To establish a culture of safety, it is necessary to understand that it is the product of a set of values, attitudes, perceptions, competences and abilities, whether group or individual, that integrate into a behavior of commitment to the safety and safe care of the service and/or institution. This commitment behavior should involve management and professionals in actions to improve health care, through collective learning and correction of errors3.
However, it is observed that the strategies developed for the implementation of safety culture in the Primary Care and Home Care Service have not been the target of these actions 4,5.
Patient safety in Primary Care and Home Care Service is sometimes neglected, because the development of actions and research with this theme are still focused on hospital services and institutions, since a culture of safety and safety of the patient outside the hospital is still a challenge to be faced 6,7.
Home care services are part of a federal program that seeks to expand and qualify care within the Brazilian Unified Health System. It is composed of services and actions that come not to replace, but to complement other levels of care, especially the tertiary and outpatient, ensuring an objective continuity in care and integration with the other services of the network8.
It also enables a full knowledge of the user, where the professional is qualified and familiar with the routine, culture and family, which favors the execution and articulation of actions of rehabilitation, prevention, education and health promotion, configuring itself as a space in which a greater force of patient safety movements and recognition for an established safety culture9,10.
In this context, due to the prioritization of patient safety in high complexity services, today we have a shortage of studies on the subject in primary and home care, presenting gaps in research and actions that turn to practices such as this 11,12. In order to elucidate possible needs for change or implementation in care practice, it is necessary, initially, to evaluate the safety actions that are practiced, based on the perception of the professionals who work there.
Among the strategies, the application of instruments that assess patient safety are important tools that can measure aspects such as organizational conditions that lead to damage during the care provided, contributing to awareness of safety issues, identification of risk factors to be objective works and interventions. This type of assessment also helps diagnose safety culture, possible harm risks, evolution of these patient safety interventions, and monitoring the safety culture over time13,14.
The Safety Attitudes Questionnaire (SAQ) is one of these tools to provide this situational diagnosis of a service and/or institution, which enables an accurate assessment of the factors that have been identified as those that need to be worked on by the professionals involved and that influence the safety culture, such as teamwork, professional satisfaction and working conditions15.
Thus, the objective of this study was to evaluate the safety culture in Primary and Home Care Services through the Safety Attitudes Questionnaire (SAQ).