University of Louisville

Assessing Elements of the Person-Centered Culture of Safety in Long-Term Nursing Care Facilities

Institution

University of Louisville

Abstract

Maintaining a working culture and structure that sets reasonable expectations for staff members and maintains open lines of communication is paramount to establishing a Person-Centered Culture of Safety (PCCS) in Long-Term Care Facilities (LTCF). The purpose of this study was to describe characteristics of the person-centered culture of safety in LTCF from employees’ perspective. This study was guided by the Agency for Healthcare Research and Quality (AHRQ) PCCS framework. Cross-sectional survey data were collected from 211 (response rate 70%). LTCF employees were [(licensed nurses (27%), nursing assistants (35%), administrators/managers (8%), administrative support (3%), and rehabilitation staff (13%)] on all shifts at five LTCF. A survey packet containing a consent letter, the AHRQ Nursing Home Survey on Patient Safety Culture, and a return envelope was distributed to each employee. Thirty percent of the participants reported strongly agreeing with “not having adequate staff to handle the workload”; 29% “used shortcuts to get work done faster”; and 38% “having to hurry because of having too much work to do”. Seventy percent strongly agreed that “they helped when a fellow staff member was overwhelmed”; 21% strongly agreed that they “were afraid to report their mistakes”; and only 53% strongly agreed “feeling safe reporting their mistakes”. Thirteen percent strongly agreed that “they were treated unfairly by management when they made mistakes”; 19% strongly agreed that “staff opinions were ignored”. There is a need for interventions that would assure a non-blaming culture when mistakes are made or reported. Additionally, further research on communication pathways, particularly between staff and management, is needed.

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Assessing Elements of the Person-Centered Culture of Safety in Long-Term Nursing Care Facilities

Maintaining a working culture and structure that sets reasonable expectations for staff members and maintains open lines of communication is paramount to establishing a Person-Centered Culture of Safety (PCCS) in Long-Term Care Facilities (LTCF). The purpose of this study was to describe characteristics of the person-centered culture of safety in LTCF from employees’ perspective. This study was guided by the Agency for Healthcare Research and Quality (AHRQ) PCCS framework. Cross-sectional survey data were collected from 211 (response rate 70%). LTCF employees were [(licensed nurses (27%), nursing assistants (35%), administrators/managers (8%), administrative support (3%), and rehabilitation staff (13%)] on all shifts at five LTCF. A survey packet containing a consent letter, the AHRQ Nursing Home Survey on Patient Safety Culture, and a return envelope was distributed to each employee. Thirty percent of the participants reported strongly agreeing with “not having adequate staff to handle the workload”; 29% “used shortcuts to get work done faster”; and 38% “having to hurry because of having too much work to do”. Seventy percent strongly agreed that “they helped when a fellow staff member was overwhelmed”; 21% strongly agreed that they “were afraid to report their mistakes”; and only 53% strongly agreed “feeling safe reporting their mistakes”. Thirteen percent strongly agreed that “they were treated unfairly by management when they made mistakes”; 19% strongly agreed that “staff opinions were ignored”. There is a need for interventions that would assure a non-blaming culture when mistakes are made or reported. Additionally, further research on communication pathways, particularly between staff and management, is needed.