TABLE 2.
Aggregate^ Patient Safety Culture Nursing Home (NHSPSC) Instrument Scores
| Domain and Survey Items | Strongly Disagree Percent (N) |
Disagree Percent (N) |
Neither Agree Or Disagree Percent (N) |
Agree Percent (N) |
Strongly Agree Percent (N) |
|
|---|---|---|---|---|---|---|
| 1. Teamwork (Cronbach’s alpha = .86) | ||||||
| A1. | Staff in this nursing home treat each other with respect. | 7% (24) | 18% (60) | 19% (64) | 48% (158) | 8% (26) |
| A2. | Staff support one another in th is nurs ing home. | 5% (18) | 21% (71) | 19% (62) | 47% (155) | 8% (25) |
| A5. | S taff feel like they are part of a team . | 10% (32) | 23% (76) | 29% (94) | 33% (106) | 5% (16) |
| A9. | W he n s omeone gets reall y busy in this nurs ing home, other staff help out. | 6% (18) | 25% (77) | 23% (71) | 43% (135) | 3% (10) |
| 2. Staffing (Cronbach’s alpha = .71) | ||||||
| A3. | We have enough staff to handle the workload. | 37% (122) | 42% (137) | 11% (36) | 10% (33) | 0% (1) |
| A8. | Staff have to hurry because they have too much work to do. (N). | 3% (8) | 11% (32) | 13% (41) | 45% (138) | 28% (86) |
| A16. | Residents’ needs are met during shift changes. | 11% (30) | 30% (84) | 33% (94) | 24% (69) | 3% (9) |
| A17. | It is hard to keep residents safe here because so many staff quit their jobs. (N). | 6% (19) | 31% (92) | 27% (81) | 24% (72) | 12% (35) |
| 3. Compliance With Procedures (Cronbach’s alpha = .73) | ||||||
| A4. | Staff follow standard procedures to care for residents. | 3% (10) | 13% (43) | 21% (68) | 54% (176) | 9% (28) |
| A6. | Staff use shortcuts to get their work done faster. (N) | 3% (10) | 18% (53) | 25% (75) | 42% (126) | 11% (33) |
| A14. | To make work easier, staff often ignore procedures. (N) | 9% (28) | 34% (103) | 25% (76) | 27% (80) | 4% (12) |
| 4. Training & Skills (Cronbach’s alpha = .76) | ||||||
| A7. | Staff get the training they need in this nursing home. | 5% (17) | 18% (56) | 18% (55) | 50% (154) | 9% (28) |
| A 11. | Staff have enough training on how to handle difficult residents. | 9% (27) | 35% (102) | 23% (67) | 29% (85) | 3% (8) |
| A 13. | Staff understand the training they get in this nursing home. | 3% (7) | 9% (28) | 25% (75) | 58% (175) | 6% (18) |
| 5. Nonpunitive Response to Mistakes (Cronbach’s alpha = .74) | ||||||
| A10. | Staff are blamed when a resident is harmed. (N) | 4% (12) | 19% (53) | 38% (105) | 32% (89) | 8% (21) |
| A12. | Staff are afr aid t o report their mist akes. (N) | 7% (21) | 27% (77) | 28% (80) | 33% (94) | 5% (14) |
| A15. | Staff are treated fairly when they make mistakes. | 7% (19) | 22% (65) | 32% (92) | 36% (106) | 3% (10) |
| A18. | Staff feel safe reporting their mistakes. | 10% (27) | 30% (84) | 33% (94) | 24% (69) | 3% (9) |
|
Never Percent (N) |
Rarely Percent (N) |
Sometime Percent (N) |
Most of the time Percent (N) |
Always Percent (N) |
||
| 6. Handoffs (Cronbach’s alpha = .86) | ||||||
| B1. | Staff are told what they need to know before taking care of a resident for the first time. | 2% (6) | 15% (42) | 34% (97) | 33% (93) | 16% (47) |
| B2. | Staff are told right away when there is a change in a resident’s care plan. | 7% (19) | 19% (52) | 32% (87) | 29% (79) | 13% (36) |
| B3. | We have all the information we need when residents are transferred from the hospital | 6% (15) | 24% (65) | 37% (99) | 26% (69) | 7% (19) |
| B10. | Staff are given all the information they need to care for residents. | 0% (1) | 5% (14) | 22% (65) | 46% (138) | 28% (83) |
| 7. Feedback & Communication About Incidents (Cronbach’s alpha = .85) | ||||||
| B4. | When staff report something that could harm a resident, someone takes care of it. | 1% (3) | 8% (23) | 25% (74) | 42% (123) | 23% (68) |
| B5. | In this nursing home, we talk about ways to keep incidents from happening again. | 1% (4) | 10% (30) | 30% (90) | 38% (112) | 21% (62) |
| B6. | Staff tell someone if they see something that might harm a resident. | 0% (1) | 5% (14) | 22% (65) | 46% (138) | 28% (83) |
| B8. | In this nursing home, we discuss ways to keep residents safe from harm. | 2% (7) | 8% (24) | 29% (89) | 34% (104) | 27% (81) |
| 8. Communication Openness (Cronbach’s alpha = .84) | ||||||
| B7. | Staff ideas and suggestions are valued in this nursing home. | 10% (30) | 22% (66) | 36% (107) | 21% (63) | 11% (33) |
| B9. | Staff opinions are ignored in this nursing home. (N) | 10% (29) | 21% (62) | 46% (134) | 17% (49) | 6% (18) |
| B11. | It is easy for staff to speak up about problems in this nursing home. | 6% (18) | 20% (58) | 39% (117) | 26% (76) | 9% (28) |
|
9. Supervisor Expectations & Actions Promoting Resident Safety (Cronbach’s alpha = .81) |
Strongly Disagree Percent (N) |
Disagree Percent (N) |
Neither Agree Or Disagree Percent (N) |
Agree Percent (N) |
Strongly Agree Percent (N) |
|
| C1. | My supervisor listens to staff ideas and suggestions about resident safety. | 2% (7) | 8% (25) | 14% (44) | 57% (177) | 19% (60) |
| C2. | My supervisor says a good word to staff who follow the right procedures. | 6% (18) | 12% (39) | 15% (48) | 50% (160) | 16% (52) |
| C3. | My supervisor pays attention to safety problems in this nursing home. | 3% (8) | 4% (13) | 14% (46) | 54% (173) | 25% (80) |
| 10. Overall Perceptions of Resident Safety (Cronbach’s alpha = .86) | ||||||
| D1. | Residents are well cared for in this nursing home. | 4% (14) | 12% (38) | 23% (74) | 48% (154) | 14% (44) |
| D6. | This nursing home does a good job keeping residents safe. | 1% (2) | 8% (27) | 26% (83) | 58% (187) | 8% (25) |
| D8. | This nursing home is a safe place for residents. | 2% (5) | 7% (24) | 23% (75) | 57% (185) | 11% (36) |
| 11. Management Support for Resident Safety (Cronbach’s alpha = .83) | ||||||
| D2. | Management asks staff how the nursing home can improve resident safety. | 9% (27) | 25% (77) | 22% (69) | 35% (109) | 9% (27) |
| D7. | Management listens to staff ideas and suggestions to improve resident safety. | 6% (20) | 20% (64) | 31% (98) | 37% (116) | 5% (15) |
| D9. | Management often walks around the nursing home to check on resident care. | 12% (37) | 20% (62) | 19% (58) | 40% (124) | 10% (30) |
| 12. Organizational Learning (Cronbach’s alpha = .62) | ||||||
| D3. | This nursing home lets the same mistakes happen again and again. (N) | 12% (38) | 45% (138) | 25% (76) | 14% (43) | 5% (15) |
| D4. | It is easy to make changes to improve resident safety in this nursing home. | 3% (10) | 16% (50) | 36% (110) | 38% (117) | 7% (21) |
| D5. | This nursing home is always doing things to improve resident safety. | 1% (3) | 13% (42) | 35% (112) | 42% (135) | 8% (27) |
| D10. | When this nursing home makes changes to improve resident safety, it checks to see | 4% (11) | 15% (44) | 25% (74) | 51% (152) | 5% (16) |
N = negatively worded question;
^
Based on information from 4 nursing homes