US EPA

3251452 

Journal Article 

Patient safety culture assessment in the nursing home 

Handler, SM; Castle, NG; Studenski, SA; Perera, S; Fridsma, DB; Nace, DA; T Hanlon, J 

2006 

1 

Quality and Safety in Health Care
ISSN: 1475-3898
EISSN: 1475-3901 

15 

6 

400-404 

10.1136/qshc.2006.018408 

WOS:000242481800006 

Objective: To assess patient safety culture (PSC) in the
nursing home setting, to determine whether nursing home professionals differ in their PSC
ratings, and to compare PSC scores of nursing homes with those of hospitals. Methods: The
Hospital Survey on Patient Safety Culture was modified for use in nursing homes (PSC-NH) and
distributed to 151 professionals in four non-profit nursing homes. Mean scores on each PSC-NH
dimension were compared across professions (doctors, pharmacists, advanced practitioners and
nurses) and with published benchmark scores from 21 hospitals. Results: Response rates were 68.9%
overall and 52-100% for different professions. Most respondents (76%) were women and had worked
in nursing homes for an average of 9.8 years, and at their current facility for 5.4 years.
Professions agreed on 11 of 12 dimensions of the survey and differed significantly (p < 0.05)
only in ratings for one PSC dimension (attitudes about staffing issues), where nurses and
pharmacists believed that they had enough employees to handle the workload. Nursing homes scored
significantly lower (ie, worse) than hospitals (p < 0.05) in five PSC dimensions (non-punitive
response to error, teamwork within units, communication openness, feedback and communication
about error, and organisational learning). Conclusions: Professionals in nursing homes generally
agree about safety characteristics of their facilities, and the PSC in nursing homes is
significantly lower than that in hospitals. PSC assessment may be helpful in fostering
comparisons across nursing home settings and professions, and identifying targets for
interventions to improve patient safety.