Table 1.

Dimensions, items and reliability of the NHSPSC-pLTC used in the present study

1. Teamwork: published reliability of this dimension—Cronbach’s alpha (4 items) = .86, this sample = .84

A1. Staff in this facility treat each other with respect.

A2. Staff support one another in this facility.

A5. Staff feel like they are part of a team.

A9. When someone gets really busy in this facility, other staff help out.

2. Staffing: published reliability of this dimension—Cronbach’s alpha (4 items) = .71, this sample = .55

A3. We have enough staff to handle the workload.

A8. Staff have to hurry because they have too much work to do (negatively worded).

A16. Children’s needs are met during shift changes

A17. Because so many staff quit their jobs, there are few experienced staff to provide safe care (negatively worded).

3. Compliance With Procedures: published reliability of this dimension—Cronbach’s alpha (3 items) = .73, this sample = .68

A4. Staff follow standard procedures to care for children.

A6. Staff use shortcuts to get their work done faster (negatively worded).

A14. To make work easier, staff often ignore procedures (negatively worded).

4. Training & Skills: published reliability of this dimension—Cronbach’s alpha (3 items) = .76, this sample = .72

A7. Staff get the training they need in this facility.

A11. Staff have enough training on how to handle difficult children.

A13. Staff understand the training they get in this facility.

5. Nonpunitive Response to Mistakes: published reliability of this dimension—Cronbach’s alpha (4 items) = .74, this sample = .74

A10. Staff are blamed when a child is harmed (negatively worded).

A12. Staff are afraid to report their mistakes (negatively worded).

A15. Staff are treated fairly when they make mistakes.

A18. Staff feel safe reporting their mistakes.

6. Handoffs: published reliability of this dimension—Cronbach’s alpha (4 items) = .86, this sample = .83

B1. Staff are told what they need to know before taking care of a child for the first time.

B2. Staff are told right away when there is a change in a child’s care plan.

B3. We have all the information we need when children are transferred from the hospital.

B10. Staff are given all the information they need to care for children.

7. Feedback & Communication About Incidents: published reliability of this dimension—Cronbach’s alpha (4 items) = .85, this sample = .84

B4. When staff report something that could harm a child someone takes care of it.

B5. In this facility, we talk about ways to keep incidents from happening again.

B6. Staff tell someone if they see something that might harm a child.

B8. In this facility we discuss ways to keep children safe from harm.

8. Communication Openness: published reliability of this dimension—Cronbach’s alpha (3 items) = .84, this sample = .85

B7. Staff ideas and suggestions are valued in this facility.

B9. Staff opinions are ignored in this facility (negatively worded).

B11. It is easy for staff to speak up about problems in this facility.

9. Supervisor Expectations & Actions Promoting Resident Safety: published reliability of this dimension—Cronbach’s alpha (3 items) = .81, this sample = .82

C1. My supervisor listens to staff ideas and suggestions about the safety of children.

C2. My supervisor says a good word to staff who follow the right procedures.

C3. My supervisor pays attention to child safety problems in this facility.

10. Overall Perceptions of Resident Safety: published reliability of this dimension—Cronbach’s alpha (3 items) = .86, this sample = .84

D1. Children are well cared for in this facility.

D6. This facility does a good job keeping children safe.

D8. This facility is a safe place for children.

11. Management Support for Resident Safety: published reliability of this dimension—Cronbach’s alpha (3 items) = .83, this sample = .84

D2. Management asks staff how the facility can improve safety for children.

D7. Management listens to staff ideas and suggestions to improve safety for children.

D9. Management often walks around the facility to check on care for children.

12. Organizational Learning: published reliability of this dimension—Cronbach’s alpha (4 items) = .81, this sample = .72

D3. This facility lets the same mistakes happen again and again (negatively worded).

D4. It is easy to make changes to improve safety for children in this facility.

D5. This facility is always doing things to improve safety for children.

D10. When this facility makes changes to improve safety for children, it checks to see if the changes have worked.

13. Overall Ratings

E1. I would tell friends that this is a safe facility for their children.

E2. Please give this facility an overall rating on safety for children.

Note: “NHSPSC” is Nursing Home Survey on Patient Safety Culture; “p-LTC” is pediatric long term care facility