BMJ  2007;334:68 (13 January), doi:10.1136/bmj.334.7584.68-a

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US nursing homes less safe than hospitals

Two surveys of the culture surrounding patient safety in US nursing homes show that, although professionals working in them generally agree on required safety characteristics, the safety culture in the homes is lower than that found in hospitals and may be placing residents at risk.

A validated method for assessing attitudes to patient safety in acute hospital inpatient settings was extended to 4000 nursing homes, with 2840 of their administrators responding. The greatest difference from hospitals was in organisational learning and team work, with nursing homes attaining a score 47% lower than the predetermined hospital benchmark. Only 7.5% of respondents graded their own unit as being excellent for patient safety while 38% declared a poor or failing level.

In a separate survey, the same researchers asked staff (mostly nurses) about safety characteristics where they worked and found that the scores were generally similar to the benchmark hospital score. The major difference related to non-punitive response to errors: the score for nursing home staff feeling that mistakes were held against them was higher than the corresponding benchmark hospital score. The authors recommend using such surveys to assess standards and identify targets for improvement.

References

Qual Saf Health Care 2006;15:400-4, 405-8, doi: 10.1136/qshc.2006.018408[Abstract/Free Full Text] doi: 10.1136/qshc.2006.018424[Abstract/Free Full Text]

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