Introdução: A segurança do paciente tornou-se uma preocupação formal em diversos sistemas de saúde no mundo nas últimas décadas. Em 2004 a Organização Mundial da Saúde (OMS) propõe a Aliança para segurança do paciente e aponta a avaliação da cultura de segurança nas instituições de saúde como um dos aspectos chave para esse processo. Método: pesquisa transversal de abordagem quantitativa, realizada em um hospital de ensino no interior do estado de são Paulo entre os meses de março e abril de 2014. A população de estudo foi composta por todos os profissionais que faziam parte da escala de trabalho das unidades de terapia intensiva (UTI) adulto, pediátrica e neonatal e não se enquadravam no critério de exclusão (menos de 6 meses na unidade). Foram aplicados dois instrumentos para avaliação da cultura e clima de segurança do paciente, o Hospital Survey on Patient Safety (HSOPSC) e o Safety Attitudes Questionnaire (SAQ), e um instrumento para levantamento das informações sociodemográficas e profissionais. Para a análise de dados utilizou-se o teste de confiabilidade das escalas pelo Alfa de Cronbach. Foi verificada a presença de associações das escalas com variáveis de estudo pelo qui-quadrado de Pearson ou teste exato de Fischer nas variáveis qualitativas, a ANOVA para as variáveis quantitativas. A presença de correlação entre os instrumentos SAQ e HPSOPSC foi verificada pelo teste de correlação de Pearson. Resultado: os dados sociodemográficos quanto a sexo e idade e cargo foram homogêneos nas três UTI. A UTI Neonatal possuía profissionais com mais tempo de trabalho na unidade e na especialidade quando comparada as demais unidades. Ambas as escalas apresentaram boa confiabilidade pelo alfa de Cronbach, 0,853 para o SAQ e 0,889 para o HSPOSC. Na análise dos domínios do SAQ, observou-se pontuação 62 para as Condições de Trabalho e para Percepções da Gerência, enquanto para o HSPOSC a dimensão Resposta não punitiva aos erros obteve o menor percentual de repostas positivas (29,6%), e as dimensões Abertura da comunicação e Retorno da comunicação e das informações sobre o erro uma proporção de neutros maior de 30%. A nota total de segurança do paciente pelo HSPOSC foi de 85% (somados ótima e muito boa). Analisando-se o comportamento das UTIs através de cada escala, a UTI Neonatal apresentou maior satisfação no trabalho do que as demais UTIs. A UTI Adulto apresentou menores pontuações em cada domínio quando comparada com as demais e para os domínios do HSPOSC somente o domínio Abertura de comunicação obteve uma proporção de respostas positivas discretamente superior às demais UTIs. A correlação entre as escalas através da correlação de Pearson foi de força moderada (coeficiente de Pearson de 0,656). As respostas abertas evidenciaram que as mudanças ocorridas no hospital em decorrência dos processos de acreditação, contribuíram para a melhor percepção dos profissionais sobre a segurança do paciente. Conclusões: há diferenças de percepções quanto a segurança do paciente entre as UTIs dentro de um mesmo hospital, o que corrobora com a existência de microculturas locais. As escalas de avaliação de clima/ cultura de segurança do paciente parecem medir fenômenos semelhantes. / Introduction: Patient safety has become a formal concern in several health systems in the world, in the last decades. In 2004 the World Health Organization (WHO) proposes the Alliance for patient safety and aims safety culture evaluation in healthcare institutions as one of the key aspects to this process. Method: Cross-sectional quantitative research approach, performed in a teaching hospital in São Paulo State between the months of March and April 2014. The study population was composed of all the professional who were part of the work schedule of intensive care unit (ICU) adult, pediatric and neonatal and did not fit the exclusion criteria (less than six months in the unit). Two instruments for assessing the culture environment and patient safety, the Hospital Survey on Patient Safety (HSOPSC) the Safety Attitudes Questionnaire (SAQ), and an instrument for survey of demographic and professional information were applied. For data analysis, the test of reliability of the scales by Cronbachs alpha was used. The presence of associations of scales with study variables was checked by Pearsons chi-square test or Fishers exact test in the qualitative variables, the ANOVA for quantitative variables. The presence of correlation between the SAQ and the HPSOPSC instruments was tested by Pearson correlation test. Result: sociodemographic data regarding gender and age and position were homogenous in the three ICUs. Professional of the Neonatal ICU had worked longer time in this unit and specialty when compared to other units. Both scales showed good reliability by Cronbachs alpha, 0.853 for SAQ and 0.889 for HSPOSC. In the analysis of the SAQ domains, it was observed score 62 for Working Conditions and Perceptions of Management, while for HSPOSC dimension Non-punitive Response to Error had the lowest percentage of positive responses (29.6%), the dimension Open Communication and Return of Communication and Information on the Error a proportion of neutral responses more than 30%. The total score of patient safety by HSPOSC was 85% (summed up great and very good). Analyzing the behavior of ICUs through each scale, Neonatal ICU had higher job satisfaction than the other ICUs. Adult ICU had lower scores in each domain compared to other domains and for HSPOSC only the area Open Communication obtained the proportion of positive responses slightly superior to the other ICUs. The correlation between the scales through Pearson correlation was of moderate strength (Pearson correlation coefficient of 0.656). The open responses showed that changes in hospital as a result of accreditation processes, contributed to a better perception of professionals about patient safety. Conclusions: There are differences in perceptions of patient safety among ICUs within the same hospital, which corroborates the existence of local microcultures. Rating scales of climate/culture of patient safety seems to measure similar phenomena.

Orientador: João Eduardo Guarnetti dos Santos / Banca: Jair Rosas da Silva / Banca: Luis Gonzaga Campos Porto / Resumo: O setor da cana-de-açúcar sempre foi muito bem visto no Brasil; nos séculos XVI e XVII com a grande aceitação do açúcar no mercado europeu e alto valor financeiro agregado ao produto, houve uma grande expansão do setor no nordeste brasileiro devido à adaptação da plantação ao clima e à grande presença do trabalho escravo africano no cultivo. Na década de 70 do século XX houve um salto do setor sucroenergético com a produção do etanol como fonte alternativa de energia e à fabricação do carro a álcool em um período de altas do petróleo no mercado mundial. Junto com a rápida evolução do setor sucroenergético, vieram também os problemas ecológicos e sociais. Grandes corporações subsidiadas pelo Governo Federal no Projeto Próacool, recebiam as verbas e benefícios para uma produção mais eficiente e limpa. Com todos esses problemas, no final da década de 80 do século XX, o setor entrou em desaceleração. No início do século XXI o setor vive uma oportunidade histórica, pois com o fim anunciado das reservas de petróleo e as catástrofes devido às mudanças climáticas causadas pelo homem, hoje o etanol brasileiro é visto pelo mundo como uma fonte alternativa e sustentável; sem contar com o alto valor do açúcar pelo mercado europeu como nos séculos XVI e XVII. Mas o setor não é só alegria, pois luta contra os problemas de vivência dos tratos dos trabalhadores do setor, que se assemelha muito ao trabalho escravo sofrido pelos africanos no período áureo do açúcar. Apesar de o governo fiscalizar e criar novas leis, como a NR 31 (Norma Regulamentadora - Segurança e Saúde no trabalho na agricultura, pecuária silvicultura, exploração florestal e aquicultura); os trabalhadores do setor sucroenergético tem tido pouca atenção dos profissionais que desenvolvem produtos para este setor. Tudo que se é exigido... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The sector of cane sugas has always been well regarded in Brazil, in the sixteenth and seventheenth centuries with great acceptance in the European market for sugar and high value added to the product, there was a great expansion of the sector in northeastern Brazil due to adaptation plantation climate and large presence of African slave labor in cultivation. In the 70s of the twentieth century there was a jump of the sugarcane industry with the production of ethanol as an alternative energy source and manufacture the car with alcohol in period of high oil on the world market. Along with the rapid development of the sugarcane industry, came also the ecological and social problems. Large corporations subsidized by the Federal Government in Proálcool Project, received the money and benefits for a cleaner and more efficient production. With all these problems in the late 80s of the twentieth century, the industry went into deceleration. At the beginning of the XXI century industry is experiencing a historic opportunity, because with the announced end of oil reserves and disasters due to climate change caused by humans, today Brazilian ethanol is seen by the world as an alternative and sustainable source, not counting the high amount of sugar in the European market as the sixteenth and seventeenth centuries. But the industry is not only joy, for combating the problems of living the treatment of workers in the sector, which closely resembles slave labor suffered by Africans in the heyday of sugar. Althrough the government oversee and create new laws, as the NR 31 (Norm - Safety and Health at Work in agriculture, forestry livestock, forestry and aquaculture); workers in the sugarcane industry has had little attention from professionals who develope products for this sector. All that is required is adapted from another industry... (Complete abstract click electronic access below) / Mestre

Il est préconisé de développer le climat de sécurité (CS) pour améliorer la sécurité des soins. Dans cette thèse, nous essaierons de préciser l’utilisation du concept de CS pour l’évaluation d'interventions d’amélioration de la sécurité des soins.Les objectifs des travaux présentés étaient d’élaborer un questionnaire de CS en français et d’évaluer l’impact de l’analyse de vignettes d’événements indésirables associés aux soins (EIAS) sur le CS d’unités de soins en milieu hospitalier.Ces travaux ont montré la faisabilité de mesurer le CS avec une version française du questionnaire américain, le Hospital Survey On Patient Safety Culture (HSOPSC). Ils ont permis de proposer une version française aux performances psychométriques suffisantes. Ils ont montré l’importance du rôle de l’encadrement, de l’organisation apprenante et du travail d’équipe entre services. La version française de l’HSOPSC a été utilisée pour évaluer l’effet de l’analyse de vignettes d’EIAS. Testée dans un essai contrôlé randomisé en clusters, cette intervention a amélioré les perceptions des professionnels sur l’organisation apprenante et l’amélioration continue, sans modifier les autres dimensions.Face à la difficulté de modifier dans un temps court l’ensemble des dimensions, le CS devrait être utilisé pour caractériser le contexte d'implémentation des interventions afin de les adapter et de mieux en comprendre l’impact, plutôt que pour servir de critère de résultat.Les pistes de recherche sont d’étudier la pérennité d’une intervention au-delà de son évaluation initiale au travers du maintien ou du développement de la culture de sécurité ; et d’étudier les perceptions des patients en matière de sécurité de soins / It is recommended to develop the safety climate (SC) to improve patient safety. In this thesis, we will try to clarify the use of the CS concept for the evaluation of interventions aiming to improve patient safety.The objectives of the articles presented were to develop a French version of a SC questionnaire and to assess the impact of a vignette-based analysis of adverse events (AEs) on the SC of care units.The studies demonstrated the feasibility of measuring the SC with a French version of the American questionnaire, the Hospital Survey On Patient Safety Culture (HSOPSC). They made it possible to propose a French version with sufficient psychometric performance. They showed the importance of the role of supervision, the organisational learning and teamwork between units. The French version of the HSOPSC was used to evaluate the effect of the vignette-based analysis of AEs. Tested in a randomized controlled cluster trial, this intervention improved professionals' perceptions of the organisational learning and continuous improvement, without modifying other dimensions.Given the difficulty of modifying all dimensions in a short period of time, SC should be used to characterize the context in which interventions are implemented in order to adapt them and better understand their impact, rather than being used as an outcome criterion.The research areas are to study the sustainability of an intervention beyond its initial evaluation through the maintenance or development of a safety culture; and to study patients' perceptions of care safety

An organizational culture of safety affects employees' attitudes, beliefs, perceptions, and values related to safe practice as well as their behaviors and level of engagement. The purpose of this project was to determine the influence of introducing the just culture model through staff engagement in an interactive workshop. A convenience sample of acute care staff were recruited for this 1-sample pretest and posttest project design. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture instrument was used to measure safety culture perceptions on 7 dimensions pre and post intervention. For the theoretical framework, Ajzen's theory of planned behavior and Kantar's empowerment theory were used. Welch's t test results showed significant improvement in perception scores overall (t = 2.7, p < 0.01), with posttest mean scores ('= 3.7) higher than pretest mean scores ('= 3.5). The dimension-specific mean posttest scores were significantly higher on 3 of the 7 dimensions including teamwork (t = 2.99, p < 0.05), feedback and communication (t = 2.14, p < 0.05), and frequency of event reporting (t = 2.31, p < 0.05). Major implications for social change include reduction of preventable errors and iatrogenic events; creating a healthcare environment that is safe, fair, transparent, and reliable; creating organizational learning through evidence-based patient safety training; and promoting the use of perception surveys to measure and improve the culture in one's organization. The project may provide a road map for just culture implementation. Future qualitative and quantitative research should explore effects of a just culture on safety reporting patterns and specific events such reducing medication errors or risk-taking behaviors.

Home care nurses (HCNs) have reported a high rate of exposure to work-related injuries (WRIs). Nurses are challenged by the multidimensional problems associated with home care safety. These contextual risk factors increase the physical and social health problems of health care workers and of community suffering as a whole. This quantitative, cross-sectional study was designed to examine the relationship between the organization-related factors (ORFs) and the environment-related factors (ERFs) and their influences on safety behaviors (SBs) and the WRIs of HCNs. The PRECEDE framework was used to guide the study. Self-reported data were obtained from 74 home health care (HHC) nurses using the Safety Home Care Nursing questionnaire. A linear regression model was applied to determine the nature of the association between the independent variables and dependents variables. Findings showed the ORFs demonstrate a stronger effect on the SBs than the impact of the ERFs. The management commitment and the home-based care significantly affected the SBs. The supervisory support and safety access to a client's home were decreasing the WRIs. Therefore, the integration of efforts: The management and leadership of the health organization, the health care providers, and the clients' family would improve safety of HHC. This study is expected to help develop safety strategies for home care and thus attempt to minimize WRIs among HCNs. Nurses free of injuries are able to provide a quality of care and improve patients' health outcomes that in turn have an effect on reducing community suffering and financial costs.

Identifying and understanding the relationships between observed driving behavior over long-term periods and corresponding crash involvement rates is paramount to enhancing safety improvement programs and providing useful insights for transportation safety engineers, policy markers, insurance industries, and the public. Unlike previous data collection methods, recent advancement in mobile computing and accuracy of global positioning systems (GPS) allow researchers to monitor driving activities of large fleets of vehicles, for long-time study periods, at great detail. This study investigates the driving patterns of drivers who have and who have not experienced crashes during a 14-month study period using the longitudinally collected GPS data during a six-month Commute Atlanta study. This investigation allows an empirical investigation to assess whether drivers with recent crash experiences exhibit different driving or activity patterns (travel mileage, travel duration, speed, acceleration, speed stability duration, frequency of unfamiliar roadway activities, frequency of turn movement activities, and previous crash location exposures). This study also discusses various techniques of implementing GPS data streams in safety analyses. Finally, this study provides useful guidance for researchers who plan to evaluate the relationships between driver driving behavior and crash risk with large sample data and proposes driving behavior activity exposure metrics of individual drivers for possible safety surrogate measures as well as for driver re-training and education programs.

Intrinsically safe (IS) active power supplies subjected to certain transient load conditions can deliver power to a circuit at significantly higher levels than indicated on their nameplate ratings. During a transient load such as an intermittent short-circuit, energy is transferred from the power supply to the short-circuit and an electrical arc may form when the short-circuit is applied or removed. This poses a spark ignition risk as energy is transferred from the arc to the surrounding atmosphere. Currently various International and Australian Standards define the performance requirements for IS electrical apparatus. A duly accredited laboratory is required to establish the intrinsic safety compliance of an apparatus with the Standards. It involves an assessment of the apparatus and may include testing. The assessment of the apparatus determines adequate segregation, separation, construction, and selection of components. The tests performed on the apparatus include a temperature rise test and in some cases, the sparking potential of the circuit is tested using the spark test apparatus (STA). Testing the sparking potential of active power supplies to establish compliance adds significantly to the time and costs involved in establishing compliance. A new alternative assessment method is proposed in this report to augment or replace the testing phase of the compliance certification process for active power supplies. The proposed alternative assessment method (PAAM) is derived from a determination of the steady-state and transient output characteristics of the active power supply under consideration. Parameters such as peak output current, time constant of peak current decay, and the output voltages at these times are measured from the circuit's output characteristics. These measurements can subsequently be used to derive the topology and component values of an equivalent circuit. The resulting equivalent circuit is then considered like a linear power supply and the sparking potential can be determined using existing assessment methods. This thesis investigates in detail the equivalent circuit of a number of direct current (DC) active power supplies whose transient output characteristics exhibit predominantly capacitive behaviour. The results of the PAAM using the equivalent circuit are then compared with results achieved using the current testing procedure with a STA. A small sample of active power supplies is used to generate data from which a relationship between the current testing procedure and the PAAM can be established. The PAAM developed in this research project can be used as a pre-compliance check by designers, manufacturers, or IS testing stations. A failure of this test would indicate that the active power supply's sparking energy is not low enough to be regarded as intrinsically safe. The PAAM requires fewer resources to establish a result than the STA. The benefits of a simplified spark ignition test would flow on from designers and manufacturers to end users.

This thesis presents a program of research exploring the multilevel organisational structure of fleet safety management. The aim of this research was to investigate three current fleet safety initiatives, and individual and contextual factors influencing safe driving behaviour in a work vehicle. Three studies were conducted to achieve this aim. This research utilised a sample of employees from a range of Queensland Government agencies.----- Study one evaluated three current fleet safety initiatives within the Queensland Government. From a sample of fleet co-ordinators (N=24) and drivers (N=88), this study established the extent to which specific psychological processes underlying the fleet safety initiatives were adopted, and the attitude change associated with their use. This study found mixed support for the Hypotheses, with the influence of the fleet safety initiatives on fleet co-ordinators' and drivers' attitude change being consistent with processes associated with the persuasive communication framework, and behaviour management. However, the study found no support for the behavioural management processes hypothesised to underlie the incentive scheme (CPP). The findings of the study suggested that while fleet safety initiatives can have an influence on fleet co-ordinator and driver attitude change, their impact depends on the extent to which safety issues are viewed as relevant, and the extent to which there is reinforcement within the organisational environment to support these safety initiatives. Therefore, the findings from this study, combined with existing research into the impact of safety climate, suggest the workplace context needs to be taken into account. For this reason, study two investigated the role of perceptions of the safety climate, in addition to individual attributes, as predictors of self-reported crash involvement.----- Study two applied a framework incorporating driver attributes, including attitudes towards traffic safety and self-efficacy, and drivers' perceptions of the safety climate, as predictors of self-reported crashes in a work vehicle. Within this framework, drivers' perception of the safety climate, and their individual attributes were conceptualised as antecedents of driving performance, and driver safety motivation and knowledge mediated the relationship between these factors and self-reported crashes. A total of 385 drivers participated in this study, which found motivation to drive safely mediated the relationship between driver attributes and self-reported crashes. The initial analysis did not find a significant relationship between safety climate and safety motivation. However, posthoc analyses exploring this non-significant relationship found managerial safety values could be distinguished from other facets of the safety climate construct. Subsequently, the results indicated managerial safety values predicted safety motivation, when drivers perceived a strong safety climate. This study provided a more thorough understanding of the variables predicting driver behaviour at an individual level of analysis. However, a shortcoming is the study did not consider the various influences impacting on drivers' safety perceptions, and individual attributes within the context of the work environment.----- Study three extended on the framework established in study two, and investigated the contribution of leader attributes to the prediction of drivers' safety perceptions, and individual attributes. The leader attribute measures, specifically, perceptions of the safety climate, motivation, knowledge, and work overload were collected from a sample of fleet co-ordinators (N=52) and supervisors (N=88). Through multi-level analyses, both supervisors and fleet co-ordinators were shown to influence the safety perceptions and individual attributes of individuals who drive work vehicles. Support was found for positive relationships between supervisor safety knowledge, and the individual attributes. However, there was a large amount of variation due to group membership unaccounted for by supervisor safety knowledge and the safety performance factors investigated within the supervisor groups. These findings suggested supervisors may not be interacting with drivers in relation to fleet safety matters, but that other factors associated with work group membership are having an impact on drivers' safety perceptions. In comparison, there was a small amount of variation accounted for by fleet co-ordinator group membership. However, the results suggested the fleet co-ordinator leader attributes accounted for a high percentage of this variation in group membership. Support was found for a positive relationship between fleet co-ordinator safety perceptions, and driver safety perceptions. Other results found fleet co-ordinators were engaging in higher workloads to enhance the safety perceptions, and attitudes towards traffic safety of drivers within their groups.----- Overall, these studies establish a multilevel organisational process of effect, whereby individual and leader attributes, and organisational initiatives all play a role in influencing the safety performance of work-related drivers. The results also indicated an unclear structure in the management of fleet safety, as perceived by drivers, and through the roles and responsibilities of supervisors and fleet co-ordinators. The implications of these results for the management of fleet safety are discussed.

Thesis (MPhil)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: The increasing financial pressures exerted on ship owners in recent years due to cost inflation, overtonnage and low freight rates in many sectors, have forced ship owners to increase cost savings and contain costs. That induced certain shipowners to operate substandard ships. The cost advantages in substandard ships are through failing to maintain safety equipment and procedures, employing cheap and untrained crews, repairing only essential equipment on breakdown and register under flags that do not comply with all the international regulatory, economic and social requirements for ships. Those ships undercut the true costs of operating a ship and eventually drive the obedient shipowner out of the market at the cost of safe and clean seas. Because of the complex international environment in which shipping operates an international regulatory framework is needed to ensure safety at sea. This assignment gives a layout of that framework, which is co-ordinated by the International Maritime Organisation (!MO), as well as the ways in which it is implemented and regulated in individual countries, with reference to South Africa. The functioning of the South African Maritime Safety Agency (SAMSA), which has been established on 1 April 1998, is also discussed. The benefit of safe ports is highlighted and also the cost savings in marine insurance if ships are classified as safe. A brief description of the navigation instruments that SAMSA use to assist in achieving maritime safety is given. Finally, the diseconomies of substandard ships are debated against quality ships for cleaner seas. / AFRIKAANSE OPSOMMING: Die toenemende finansiële druk op skeepseienaars, as gevolg van koste inflasie, oortonnemaat en lae vragtariewe in verskeie sektore, het hulle gedwing om oor die laaste aantal jare hul kostes te beperk. Gedwonge kostebesparings gee aanleiding daartoe dat sekere skeepseienaars onveilige skepe bedryf. Kostevoordele in onveilige skepe word bereik deur veiligheidstoerusting en -prosedures nie in stand te hou nie, goedkoop en onopgeleide bemanning aan te stel, slegs die nodige herstelwerk aan toerusting te doen en deur te registreer onder vlae wat nie voldoen aan internasionale regulering, ekonomiese en sosiale vereistes vir skepe nie. Eienaars van sulke skepe, onderskruip die ware bedryfskoste van 'n skip en uiteindelik dryf dit die wetsgetroue skeepseienaars uit die mark ten koste van 'n veilige en skoon see. As gevolg van die komplekse internasionale omgewmg waann skeepvaart funksioneer, word 'n internasionale reguleringsraamwerk benodig om veiligheid ter see te verseker. Hierdie werkstuk gee 'n uitleg van daardie raamwerk, wat gekoordineer word deur die Internasionale Maritieme Organisasie (!MO), asook die manier waarop dit geïmplementeer en gereguleer word in individuele lande met verwysing tot Suid-Afrika. Die funksionering van die Suid-Afrikaanse Maritieme Veiligheids Agentskap (SAMSA), wat tot stand gebring is op 1 April 1998, word bespreek. Die voordele van veilige hawens word uitgelig, sowel as die besparings in maritieme versekeringskoste indien 'n skip as veilig geklassifiseer word. 'n Kort beskrywing van navigasie-instrumente wat SAMSA gebruik om maritieme veiligheid te bewerkstellig, word kortliks bespreek. Ten slotte, die dis-ekonomie van onveilige skepe word gedebateer teenoor die kwaliteit van skepe vir 'n skoner see.

Made available in DSpace on 2014-12-17T14:47:06Z (GMT). No. of bitstreams: 1 LivaGGF_DISSERT.pdf: 1222166 bytes, checksum: 880b584c8c56e4cbea7f570ca7c755fe (MD5) Previous issue date: 2014-04-04 / Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Question?rio Atitudes de Seguran?a , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety / A partir da publica??o do relat?rio Errar ? Humano pelo Institute of Medicine (IOM), o qual estimou que entre 44.000 e 98.000 americanos morrem anualmente em decorr?ncia de erros da assist?ncia ? sa?de, a seguran?a do paciente passou ganhar destaque, surgindo estudos que avaliam a cultura de seguran?a atrav?s da mensura??o do clima de seguran?a. Nesse contexto, o objetivo deste estudo foi identificar a cultura de seguran?a percebida pelos profissionais de enfermagem que atuam nas unidades de terapia intensiva de uma maternidade-escola em Natal/RN, atrav?s do Question?rio Atitudes de Seguran?a (SAQ). Tratou-se de um estudo do tipo descritivo, transversal, com abordagem quantitativa, realizado nas Unidades de Terapia Intensiva Materna e Neonatal de uma maternidade-escola na cidade de Natal/RN. O projeto foi submetido ? Plataforma Brasil e aprovado pelo CEP/UFRN sob o n?mero 309.540 e CAAE 16489713.7.0000.5537. Utilizaram-se para a coleta de dados dois instrumentos: um question?rio com a finalidade de coletar dados sociodemogr?ficos dos sujeitos e o Question?rio Atitudes de Seguran?a, uma adapta??o transcultural para a l?ngua portuguesa do instrumento da Organiza??o Mundial da Sa?de intitulado Safety Attitudes Questionnaire (SAQ) Short Form 2006. Os dados coletados foram analisados quantitativamente atrav?s da organiza??o em banco de dados eletr?nico no Microsoft Excel 2010 e exportados para planilha do SPSS (Statistical Package for the social sciences) vers?o 2.0 para serem codificados, tabulados, e analisados mediante estat?stica descritiva. Participaram do estudo 50 profissionais de enfermagem, sendo 31 da UTI Neonatal e 19 da UTI Materna, predominantemente do sexo feminino, com idade m?dia de 35 anos, tempo de forma??o m?dio de 10 anos e que trabalhavam na maternidade, em sua maioria, havia menos de 5 anos. Como resultado, foram produzidos dois artigos. O primeiro refere-se aos dois primeiros dom?nios do instrumento, intitulados Clima de trabalho em equipe e Clima de seguran?a . Os escores dos dois dom?nios foram ligeiramente mais elevados na UTI Materna se comparada ? UTI Neonatal, por?m nenhum setor atingiu o escore m?nimo ideal de 75: 7 no primeiro dom?nio a UTI Materna obteve m?dia de 74,77, com medianas de 75 e 100, e a UTI Neonatal atingiu m?dia de 69,61 com medianas tamb?m de 75 e 100; enquanto que no segundo dom?nio as m?dias foram de 69,35 e 66,01 para as UTIs Materna e Neonatal respectivamente, com mediana de 100 nos dois setores. O segundo artigo diz respeito ao dom?nio Percep??o da Ger?ncia da Unidade e do Hospital , que avaliou a percep??o da ger?ncia das unidades e da maternidade por parte dos profissionais. Em geral, os itens do dom?nio em quest?o tamb?m obtiveram escores aqu?m do m?nimo ideal: 63,68 para a UTI Materna e 51,02 para a Neonatal, caracterizando um evidente distanciamento entre a gest?o e os profissionais que atuavam na assist?ncia direta. Tais achados indicam um sinal de alerta para a institui??o e apontam para a necessidade de implementar a??es que visem a seguran?a do paciente