Researchers administered the AHRQ Nursing Home Survey on Patient Safety Culture to nurses employed at 98 nursing homes across 5 states. They found that nurses born and trained abroad had higher perceptions of patient safety culture than those born and educated in the United States.

… nursing home residents and their families. A previous WebM&M commentary reviewed efforts to enhance nursing home care …

Reducing acute care hospitalizations from nursing homes is a patient safety priority. This cluster-randomized controlled trial compared a multimodal quality improvement intervention at long-term care facilities and found no difference in the rate of acute care hospitalizations compared to usual nursing home care. These results emphasize the challenge of improving safety outcomes in real-world clinical settings.

Safety problems—particularly medication errors—are common in nursing homes and other long-term care settings. Prior studies have also shown that safety culture in long-term care settings is generally poor. One manifestation of poor safety culture can be that errors go unreported, and this survey of nearly 400 nursing homes found evidence confirming that substandard error reporting is a problem in long-term care. Few nursing homes surveyed used computerized methods to report errors or to monitor adverse event data, and respondents reported both technological and cultural barriers to voluntary error reporting. As most nursing homes also did not use computerized provider order entry or any other form of electronic medical record, the authors recommend more widespread adoption of health information technology in general, and error reporting systems specifically, in the long-term care setting. One such system for voluntarily reporting medication errors has been successfully implemented in nursing homes in North Carolina.

This qualitative study examined nursing error communication in long-term care settings.

In this study, nursing homes that received hand hygiene deficiency citations were more likely to have low staffing levels or to have received other citations for poor quality of care.

… safety in long-term care are discussed in an AHRQ WebM&M commentary . …

… and quality improvement is discussed in this AHRQ WebM&M commentary . …

… whose perceptions were less favorable. … Castle NG, Wagner LM, Ferguson JC, Handler SM. Safety culture of nursing …

Recent efforts to withhold payment for certain preventable adverse events have increased the importance of determining whether such conditions are present on admission to the hospital. This study found that, if the present-on-admission indicator was not used, the AHRQ Patient Safety Indicators overestimated the incidence of postoperative complications.

Measuring and improving the culture of safety are essential to safety improvement activities. AHRQ developed the Nursing Home Survey on Patient Safety Culture to specifically assess safety climate in this setting, where nursing home residents are vulnerable to a host of safety issues including medication errors. This study mirrored prior research in documenting an overall poor level of safety culture in a sample of 40 nursing homes. Administrators and managers had a more positive perception of safety culture than did frontline personnel, also similar to prior research. Suboptimal communication between nurses and physicians has been implicated as a driver of poor safety climate in nursing homes.

… of the AHRQ Hospital Survey on Patient Safety Culture . … Wagner LM, Capezuti E, Rice JC. Nurses' perceptions of safety culture in …

The authors discuss the value of near-miss reporting within the long-term care environment and recommend strategies for implementing reporting systems.