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 Nursing Center Patient Safety Ratings Vary By Staff Category

Skilled nursing center staff rate their resident care and safety highly but believe that staffing rates are too low, according to the “2016 Nursing Home Survey on Patient Safety Culture” from the Agency for Healthcare Research and Quality (AHRQ).

According to results from 12,395 staff respondents from 209 nursing centers, 86 percent of all respondents perceive that their facility provides excellent care and keeps residents safe, while 48 percent said there aren’t enough staff to meet the workloads and resident needs.

A strong majority (85 percent) of all respondents were positive about feedback and communication regarding incidents in their facilities; that is, they feel that there are effective ways for staff to discuss how to keep residents safe and report if they see something that might harm a resident.  However, the responses suggested that they are less positive about how facilities respond to mistakes, and only about half said that their facility effectively pursues nonpunitive responses to mistakes.
This report is an expansion of AHRQ’s Hospital Survey on Patient Safety Culture to the nursing center setting. It is designed to measure the culture of resident safety in nursing centers from the perspective of providers and staff. The respondents included administrators/managers, administrative support staff, licensed nurses, nurse assistants/aides, physicians/other providers, and support staff.
The results suggest that administrative personnel have higher opinions of their facilities’ ability to keep residents safe than their teams do. For example, 80 percent of administrators/managers and 72 percent of administrative support staff rated resident safety as “excellent” or “very good,” while only 61 percent of direct care staff and 59 percent of licensed nurses did so. Physicians/other providers had the lowest numbers—only 53 percent called resident safety “excellent.”
It is important to note that very few respondents in any job category said their facility’s safety is “poor.” Only 3 percent of all respondents gave safety the lowest possible rating.
When asked if they would be willing to recommend their nursing center, most said “yes.” However, 91 percent of administrators/managers said they would recommend their facility, while only 68 percent of physicians/other providers said “yes.” Only 3 percent of administrators/managers and administrative support staff said they would not recommend their facility, while 6 percent of all other groups would be unwilling to make this recommendation.
Nursing centers with 50-199 beds made up the largest percentage of nursing centers in the database (77 percent), and the majority identified as for profit (60 percent). About three-fourths are located in urban areas (76 percent).
Most respondents indicated they worked in many different units or no specific unit (49 percent). Skilled nursing was the second largest work unit identified (30 percent). Most respondents (71 percent) said they have direct interaction with residents, and two-thirds indicated that they work between 25 and 40 hours per week, while 20 percent said they worked more than 40 hours.
This report was developed as a tool to allow nursing centers to compare their patient safety culture results with others and to provide data to facilitate the internal assessment of their patient safety improvement efforts. Additionally, it provides supplemental information to help nursing centers identify their strengths and areas with potential for improvement in patient safety culture.
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