Encuesta Nacional de Comportamientos Disruptivos en el Equipo de Salud: Identificación del problema y diagnóstico situacional

Mario Godino; Marcelo Barbato; Laura Ramos; María Otero; Leonel Briozzo

Authors

Mario Godino Ministerio de Salud Pública, Departamento de Calidad y Seguridad de la Atención, Política de comportamientos y factores humanos en equipo de salud. Coordinador
Marcelo Barbato Ministerio de Salud Pública. Departamento de Calidad y Seguridad de la Atención. Director. ASSE, Hospital Maciel. Director de CTI
Laura Ramos Sociedad Uruguaya de Psicología Médica. Presidenta
María Otero Sociedad Uruguaya de Psicología Médica. Secretaria
Leonel Briozzo Ministerio de Salud Pública. Subsecretario. Universidad de la República, Facultad de Medicina, Cátedra A de Ginecotocología. Profesor Titular

Keywords:

WORKPLACE VIOLENCE, WORKING CONDITIONS, HEALTH PERSONNEL, ATTITUDE OF HEALTH PERSONNEL, QUALITY OF HEALTH CARE, HEALTH SURVEYS

Abstract

Disruptive behaviors in the healthcare setting may risk the patient’s safety as well as the safety of the healthcare team itself.
Both the health system and professionals are responsible for diagnosing and managing this situation that has a negative impact on the health team, the staff’s health and the results achieved by the healthcare team.
Objective: to conduct the first national survey on disruptive behaviors in the health team. To determine prevalence, triggers and consequences.
Method: The Ministry of Public Health, through the National Strategy for the Patient’s Safety called for all health professionals (public and private) who would volunteer to participate in the survey with the purpose of developing a public policy. The survey was anonymous and voluntary. It was carried out during four months (June 2013 through September 2013) and included distribution, filling in the forms and providing feedback.
Results: thirty eight health professionals took part in the survey, 4,782 surveys were completed by 1,713 (36%) certified nurse assistants, 1,040 (22%) medical doctors and 662 (14%) licensed practitioner nurses. Eighty per cent of them worked over 30 hours a week.
Eighty eight point five percent of them witnessed disruptive behaviors and 60% of them suffered it. Derogatory comments about colleagues prevailed (75%) and aggressive screams and anger outbreaks followed (45%). These were seen frequently once a week in at least 20 % of cases.
Seventy one % of participants think the triggers are found in the work environments, being the great work load (47,5%) more significant than salary concerns (33%). Sixty three percent stated they have to do with personal issues; 53% noticed these behaviors in colleagues, 42% thought about changing job and 6% changed job.
Discussion and conclusions: it was the first national survey on disruptive behaviors at the international level (SIC), the only one encouraged from the health authorities.
This problem is rather frequent; it reduces safety and has a negative influence on the passing of information and the ability to work in a team. There is a low perception of risk. Economic compensation is not the main trigger identified, and disruptive behaviors usually arise among peers. It has a negative impact on retaining staff and on job security.

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