Prevenção de riscos e agravos à saúde dos trabalhadores no contexto hospitalar à luz da Teoria da Atividade Histórico-Cultural

Abstract

Introduction: concerns for workers' health in the hospital environment have been a relevant theme, especially in the scenario of the Covid-19 pandemic. Prevention of risks and injuries and promotion of workers' health is the key to reduce accidents and work-related diseases, absenteeism, and turnover, as well as providing quality health care and promote the well-being and safety of workers. Goal: to understand the activity of preventing risks and injuries to workers' health in the hospital context). Method: an ethnographic study, anchored in the Cultural-Historical Activity Theory, developed in a University Hospital in the state of São Paulo. Data were collected from individual semi-structured interviews with professionals from the Specialized Safety Engineering and Occupational Medicine Service (SESMT) and managers, field observation and document analysis, in the period from September 2021 to January 2022. We interviewed 14 professionals, carried out 20 hours of field observation that included monitoring the routine of the SESMT, prioritizing the observation of activities, attendance flows, work process and actions developed by different professionals, in addition to the documentary analysis of websites, professionals' work plans, contingency report and absenteeism data. Results: historical and empirical analysis of the current activity show the beginning of SEMST activities, from actions in hygiene and safety of the hospital revitalization process after federalization, the formation of the team, the changes facing the pandemic context in the physical, human resources and operational reorganization of the hospital and the impact on the work process. The main contradictions are related to inadequate infrastructure, under-dimensioning of the team, communication problems between sectors and workers, non-compliance with rules, the purpose of the service and organizational failures. Events over the years have expanded the health needs of workers, which represents an expansion of the object, pointing out that elements such as rules and instruments need to be restructured to cover this new demand, thus rebuilding the SA. Conclusions: in the service studied, the headcount is insufficient and there is no direction for early intervention in relation to illness and occupational accidents; on the contrary, punctual actions are proposed after the exacerbation of problems and to the detriment of legal provisions.