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 of risk of unnecessary harm associated to health care to an acceptable minimum. 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 safe systems and avoiding individual accountability 2.
To establish a safety culture, it is necessary to understand that it is the product of a set of values, attitudes, perceptions, competences, and abilities, from whether a group or a individual, that integrate into a behavior of commitment to the safety and safe care of a service and/or institution. This commitment behavior should involve managers and professionals through actions to improve health care, 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 services have not been the target of these actions 4,5.
Patient safety in Primary Care and Home Care Service is sometimes neglected. The development of actions and research within this theme are still focused on hospitals and clinics since a culture of safety and patient safety outside the hospital is still a challenge to be faced 6,7.
In Brazil, primary care is recognized as the gateway to the health system. Services provided in Brazilian primary health facilities directly affect the well-being of Brazilian families and the use of other resources. Consequently, insecure, inadequate, or ineffective primary care can increase preventable morbidity and mortality or lead to unnecessary use of hospital resources8.
Home care services are part of a federal program that seeks to expand and qualify care within the Brazilian Unified Health System (SUS). It is composed of services and actions that come not to replace, but to complement other levels of care, especially the tertiary and outpatient levels, ensuring an objective continuity of care and integration with the other services of the network9.
It also enables a full knowledge of the patient, where the professional is qualified and familiar with the routine, culture, and families, which favors the execution and articulation of actions such as rehabilitation, prevention, education and health promotion. Thus, the Brazilian SUS is recognized as a system that favors patient safety movements and the implementation of a safety culture10,11.
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 practices12,13. 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 perceptions of health workers.
Instruments that assess patient safety are important tools to measure aspects such as organizational conditions that lead to damage during health care, contributing to awareness of safety issues. This type of assessment helps to diagnose factors that influence the safety culture and the interventions that can be adopted to improve patient safety14,15.
The Safety Attitudes Questionnaire (SAQ) is one of these tools to provide a situational diagnosis of a service and/or institution, which enables an accurate assessment of factors that need to be improved and that influence the safety culture, such as teamwork, professional satisfaction and working conditions16.
Thus, the objective of this study was to evaluate the safety culture in Primary and Home Care Services through the Safety Attitudes Questionnaire (SAQ) and to verify if there are relationships between the SAQ domains and the variables gender, type of service (primary care and home care), and years of professional experience.