Weaknesses in safety culture in Brazilian hospitals: integrative review
Keywords:
Patient Care Team, Patient Safety, HospitalsAbstract
Objective: To identify weaknesses in the safety culture of national hospitals in the literature. Method: Integrative literature review, organized in six stages, conducted from June to December 2024. Data were searched online in the MEDLINE via PubMed, in the LILACS, in the BDENF and in the SciELO, considering the period from 2014 to 2024. The studies retrieved from the data sources were exported to the EndNote online software to detect and exclude duplicates, and later to Rayyan to maintain the blind evaluation. Results: The sample consisted of 24 publications, 21 articles and three academic papers. Most of the publications were published in 2018. It was observed that 11 (46%) studies presented weaknesses in all dimensions of the scales. On the other hand, job satisfaction was scored as a strong point in most of the studies and one study measured weakness in only one item of the assessment instrument. Final considerations: Although the topic of safety culture is not something new in the national scenario, this study demonstrated that there are many weaknesses and that patients and professionals are exposed to risks, compromising the quality of care and their health.
References
Brownrigg JRW, Schaper NC, Hinchliffe RJ. Diagnosis and Assessment of Peripheral Arterial Disease in the Diabetic Foot. Diabetic Medicine. 2015 Apr 15;32(6):738–47.
Mackay K, Thompson R, Parker M, Pedersen J, Kelly H, Loynd M, et al. The Role of Hyperbaric Oxygen Therapy in the Treatment of Diabetic Foot Ulcers - a Literature Review. Journal of Diabetes and its Complications [Internet]. 2025 Feb 13;39(3):108973. Available from: https://www.sciencedirect.com/science/article/pii/S1056872725000261?via%3Dihub
Kwee E, Borgdorff M, Schepers T, Halm JA, Winters HAH, Weenink RP, et al. Adjunctive Hyperbaric Oxygen Therapy in the Management of Severe Lower Limb Soft Tissue injuries: a Systematic Review. European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society [Internet]. 2024 Feb 22 [cited 2024 Feb 28];50(3). Available from: https://pubmed.ncbi.nlm.nih.gov/38386077/
Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global Epidemiology of Diabetic Foot ulceration: a Systematic Review and meta-analysis. Annals of Medicine. 2016 Nov 3;49(2):106–16.
Vicente RS, Costa DA, Castelo Branco M. Oxigenoterapia Hiperbárica Enquanto Terapêutica Complementar da Úlcera do Pé Diabético: Útil ou Inútil? – Uma Revisão da Literatura. Gazeta Médica. 2020 Mar 31;7(1).
Chen HR, Lu SJ, Wang Q, Li ML, Chen XC, Pan BY. Application of Hyperbaric Oxygen Therapy in Diabetic Foot ulcers: a meta-analysis. Int Wound J [Internet]. 2024 [cited 2025 Aug 11];21(4):e14621–1. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/mdl-38531355
Tao L, Yuan X. Efficacy and Safety of Hyperbaric Oxygen Therapy in the Management of Diabetic Foot ulcers: a Systematic Review and meta-analysis. Int Wound J [Internet]. 2024 [cited 2025 Aug 11];21(3):e14507–7. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/mdl-37990756
Jiang F, Zhang Y, Cheng S, Yang X, Bai M, Zhang M. Quality of Evidence Supporting the Role of Hyperbaric Oxygen Therapy for Diabetic Foot ulcers. Int Wound J [Internet]. 2024 [cited 2025 Aug 11];21(4):e14530–0. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/mdl-38053520
Zhang Z, Zhang W, Xu Y, Liu D. Efficacy of Hyperbaric Oxygen Therapy for Diabetic Foot ulcers: an Updated Systematic Review and meta-analysis. Asian J Surg [Internet]. 2022;45(1):68–78. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/mdl-34376365
Wenhui L, Changgeng F, Lei X, Baozhong Y, Guobin L, Weijing F. Hyperbaric Oxygen Therapy for Chronic Diabetic Foot ulcers: an Overview of Systematic Reviews. Diabetes Research and Clinical Practice. 2021 Jun;176:108862.
Sharma R, Sharma SK, Kumar MS, Jelly P, Thakur K. Efficacy of Hyperbaric Oxygen Therapy for Diabetic Foot ulcer, a Systematic Review and meta-analysis of Controlled Clinical trials. Sci Rep [Internet]. 2021 [cited 2025 Aug 11];11(1):2189–9. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/mdl-33500533
Lalieu, Rutger C, Brouwer RJ, Ubbink DT, Hoencamp R, Raap B, Hulst van. Hyperbaric Oxygen Therapy for Nonischemic Diabetic ulcers: a Systematic review. Wound Repair Regen [Internet]. 2020 [cited 2025 Aug 11];28(2):266–75. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/mdl-31667898
Brouwer RJ, Lalieu RC, Hoencamp R, van Hulst RA, Ubbink DT. A Systematic Review and meta-analysis of Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers with Arterial Insufficiency. Journal of Vascular Surgery. 2020 Feb;71(2):682-692.e1.
Golledge J, Singh TP. Systematic Review and Meta‐analysis of Clinical Trials Examining the Effect of Hyperbaric Oxygen Therapy in People with Diabetes‐related Lower Limb Ulcers. Diabetic Medicine. 2019 May 26;36(7).
Salama SE, Eldeeb AE, Elbarbary AH, Abdelghany SE. Adjuvant Hyperbaric Oxygen Therapy Enhances Healing of Nonischemic Diabetic Foot Ulcers Compared with Standard Wound Care Alone. The International Journal of Lower Extremity Wounds. 2019 Mar;18(1):75–80.
Zhao D, Luo S, Xu W, Hu J, Lin S, Wang N. Efficacy and Safety of Hyperbaric Oxygen Therapy Used in Patients With Diabetic Foot: A Meta-analysis of Randomized Clinical Trials. Clinical Therapeutics [Internet]. 2017 Oct [cited 2020 Jan 6];39(10):2088-2094.e2. Available from: https://www.sciencedirect.com/science/article/pii/S0149291817309037
Li G, Hopkins RB, Levine MAH, Jin X, Bowen JM, Thabane L, et al. Relationship between hyperbaric oxygen therapy and quality of life in participants with chronic diabetic foot ulcers: data from a randomized controlled trial. Acta Diabetologica. 2017 Jun 12;54(9):823–31.
Chen CY, Wu RW, Hsu MC, Hsieh CJ, Chou MC. Adjunctive Hyperbaric Oxygen Therapy for Healing of Chronic Diabetic Foot Ulcers. Journal of Wound, Ostomy and Continence Nursing. 2017;44(6):536–45.
Fedorko L, Bowen JM, Jones W, Oreopoulos G, Goeree R, Hopkins RB, et al. Hyperbaric Oxygen Therapy Does Not Reduce Indications for Amputation in Patients With Diabetes With Nonhealing Ulcers of the Lower Limb: A Prospective, Double-Blind, Randomized Controlled Clinical Trial. Diabetes Care. 2016 Jan 6;39(3):392–9.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Revista de Divulgação Científica Sena Aires
This work is licensed under a Creative Commons Attribution 4.0 International License.
-
Atribuição — Você deve dar o crédito apropriado, prover um link para a licença e indicar se mudanças foram feitas. Você deve fazê-lo em qualquer circunstância razoável, mas de nenhuma maneira que sugira que o licenciante apoia você ou o seu uso.
- Sem restrições adicionais — Você não pode aplicar termos jurídicos ou medidas de caráter tecnológico que restrinjam legalmente outros de fazerem algo que a licença permita.
