TABLE 3.
Patient Safety Culture Nursing Home (NHSPSC) Instrument Positive Scores by Staff Type
| Domain and Survey Items | Admin / Manager Mean (N) |
Licensed Nurse Mean (N) |
Nurse Aide Mean (N) |
Direct Care Staff Mean (N) |
Support Staff Mean (N) |
|
|---|---|---|---|---|---|---|
| 1. Teamwork (Cronbach’s alpha = .86) | ||||||
| A1. | Staff in this nursing home treat each other with respect. | 0.65 (40) | 0.60 (47) | 0.56 (101) | 0.55 (42) | 0.49 (102) |
| A2. | Staff support one another in th is nurs ing home. | 0.68 (40) | 0.53 (47) | 0.51 (101) | 0.55 (42) | 0.52 (101) |
| A5. | S taff feel like they are part of a team . | 0.43 (40) | 0.28 (47) | 0.42 (101) | 0.38 (40) | 0.36 (96) |
| A9. | W hen s omeone gets reall y busy in this nurs ing home, other staff help out. | 0.26 (35) | 0.32 (44) | 0.36 (100) | 0.34 (41) | 0.24 (91) |
| 2. Staffing (Cronbach’s alpha = .71) | ||||||
| A3. | We have enough staff to handle the workload. | 0.18 (38) | 0.02 (47) | 0.08 (100) | 0.10 (41) | 0.14 (102) |
| A8. | Staff have to hurry because they have too much work to do. (N). | 0.63 (35) | 0.89 (45) | 0.79 (98) | 0.78 (40) | 0.62 (87) |
| A16. | Residents’ needs are met during shift changes. | 0.32 (34) | 0.42 (45) | 0.43 (94) | 0.11 (35) | 0.29 (76) |
| A17. | It is hard to keep residents safe here because so many staff quit their jobs. (N). | 0.57 (35) | 0.42 (45) | 0.29 (96) | 0.34 (35) | 0.36 (88) |
| 3. Compliance With Procedures (Cronbach’s alpha = .73) | ||||||
| A4. | Staff follow standard procedures to care for residents. | 0.69 (39) | 0.68 (47) | 0.63 (101) | 0.55 (42) | 0.60 (97) |
| A6. | Staff use shortcuts to get their work done faster. (N) | 0.57 (35) | 0.51 (45) | 0.61 (97) | 0.51 (37) | 0.46 (83) |
| A14. | To make work easier, staff often ignore procedures. (N) | 0.45 (33) | 0.56 (45) | 0.43 (98) | 0.36 (36) | 0.41 (87) |
| 4. Training & Skills (Cronbach’s alpha = .76) | ||||||
| A7. | Staff get the training they need in this nursing home. | 0.26 (35) | 0.38 (45) | 0.19 (99) | 0.30 (40) | 0.18 (91) |
| A 11. | Staff have enough training on how to handle difficult residents. | 0.36 (33) | 0.16 (45) | 0.31 (96) | 0.28 (39) | 0.43 (76) |
| A 13. | Staff understand the training they get in this nursing home. | 0.64 (33) | 0.53 (45) | 0.66 (99) | 0.61 (38) | 0.68 (88) |
| 5. Nonpunitive Response to Mistakes (Cronbach’s alpha = .74) | ||||||
| A10. | Staff are blamed when a resident is harmed. (N) | 0.23 (35) | 0.38 (45) | 0.46 (93) | 0.29 (34) | 0.44 (73) |
| A12. | Staff are afr aid t o report their mist akes. (N) | 0.21 (33) | 0.44 (43) | 0.28 (95) | 0.55 (31) | 0.45 (84) |
| A15. | Staff are treated fairly when they make mistakes. | 0.70 (33) | 0.24 (45) | 0.34 (91) | 0.49 (35) | 0.39 (88) |
| A18. | Staff feel safe reporting their mistakes. | 0.40 (30) | 0.23 (44) | 0.31 (96) | 0.18 (33) | 0.25 (80) |
| 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. | 0.62 (34) | 0.38 (45) | 0.37 (99) | 0.67 (36) | 0.58 (71) |
| B2. | Staff are told right away when there is a change in a resident’s care plan. | 0.52 (31) | 0.29 (45) | 0.44 (96) | 0.36 (36) | 0.48 (65) |
| B3. | We have all the information we need when residents are transferred from the hospital | 0.27 (33) | 0.24 (45) | 0.25 (85) | 0.38 (39) | 0.49 (65) |
| B10. | Staff are given all the information they need to care for residents. | 0.66 (32) | 0.53 (45) | 0.40 (100) | 0.59 (39) | 0.55 (75) |
| 7. Feedback & Communication About Incidents (Cronbach’s alpha = .85) | ||||||
| B4 . | When staff report something that could harm a resident, someone takes care of it. | 0.82 (33) | 0.80 (45) | 0.56 (97) | 0.58 (40) | 0.67 (76) |
| B5. | In this nursing home, we talk about ways to keep incidents from happening again. | 0.03 (34) | 0.11 (45) | 0.11 (99) | 0.05 (38) | 0.18 (82) |
| B6. | Staff tell someone if they see something that might harm a resident. | 0.80 (35) | 0.89 (45) | 0.72 (98) | 0.70 (40) | 0.65 (83) |
| B8. | In this nursing home, we discuss ways to keep residents safe from harm. | 0.77 (35) | 0.58 (45) | 0.57 (100) | 0.65 (40) | 0.58 (85) |
| 8. Communication Openness (Cronbach’s alpha = .84) | ||||||
| B7. | Staff ideas and suggestions are valued in this nursing home. | 0.56 (34) | 0.18 (45) | 0.22 (96) | 0.33 (39) | 0.41 (85) |
| B9. | Staff opinions are ignored in this nursing home. (N) | 0.56 (34) | 0.23 (44) | 0.19 (95) | 0.37 (38) | 0.37 (81) |
| B11. | It is easy for staff to speak up about problems in this nursing home. | 0.61 (33) | 0.20 (45) | 0.31 (95) | 0.26 (39) | 0.42 (85) |
| 9. Supervisor Expectations & Actions Promoting Resident Safety (Cronbach’s alpha =.81) | ||||||
| C1. | My supervisor listens to staff ideas and suggestions ab out resident safety. | . 0.87 (39) | 0.68 (47) | 0.71 (98) | 0.86 (39) | 0.75 (92) |
| C2. | My supervisor says a good word to staff who follow the right procedures. | 0.74 (39) | 0.64 (47) | 0.61 (98) | 0.68 (38) | 0.71 (95) |
| C3. | My supervisor pays attention to safety problems in this nursing home. | 0.85 (39) | 0.77 (47) | 0.78 (100) | 0.82 (39) | 0.78 (95) |
| 10. Overall Perceptions of Resident Safety (Cronbach’s alpha = .86) | ||||||
| D1. | Residents are well cared for in this nursing home. | 0.05 (39) | 0.15 (47) | 0.13 (101) | 0.22 (41) | 0.22 (96) |
| D6. | This nursing home does a good job keeping residents safe. | 0.74 (39) | 0.66 (47) | 0.67 (101) | 0.56 (41) | 0.64 (96) |
| D8. | This nursing home is a safe place for residents. | 0.82 (39) | 0.63 (46) | 0.70 (99) | 0.62 (42) | 0.66 (99) |
| 11. Management Support for Resident Safety (Cronbach’s alpha = .83) | ||||||
| D2. | Management asks staff how the nursing home can improve resident safety. | 0.68 (38) | 0.28 (47) | 0.37 (95) | 0.47 (36) | 0.48 (93) |
| D7. | Management listens to staff ideas and suggestions to improve resident safety. | 0.68 (37) | 0.23 (44) | 0.35 (97) | 0.49 (41) | 0.45 (94) |
| D9. | Management often walks around the nursing home to check on resident care. | 0.66 (38) | 0.41 (46) | 0.47 (98) | 0.39 (36) | 0.54 (93) |
| 12. Organizational Learning (Cronbach’s alpha = .62) | ||||||
| D3. | This nursing home lets the same mistakes happen again and again. (N) | 0.10 (39) | 0.15 (47) | 0.22 (93) | 0.25 (40) | 0.19 (91) |
| D4. | It is easy to make changes to improve resident safety in this nursing home. | 0.45 (38) | 0.24 (45) | 0.47 (90) | 0.49 (39) | 0.51 (96) |
| D5. | This nursing home is always doing things to improve resident safety. | 0.67 (39) | 0.43 (47 | 0.43 (98) | 0.57 (42) | 0.54 (96) |
| D10. | When this nursing home makes changes to improve resident safety, it checks to see if the changes worked. |
0.70 (37) | 0.61 (44) | 0.48 (91) | 0.51 (35) | 0.59 (90) |
N = negatively worded question
Proportion of positive answers are given (i.e., Agree/Strongly Agree or Most of the Time/Always for positively worded items was calculated, and for negatively worded items the proportion of Disagree/Strongly Disagree or Rarely/Never responses was calculated)