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International Journal for Quality in Health Care Advance Access originally published online on September 7, 2006
International Journal for Quality in Health Care 2006 18(5):370-376; doi:10.1093/intqhc/mzl038
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International Journal for Quality in Health Care vol. 18 no. 5 © The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved

Nurse Aides’ ratings of the resident safety culture in nursing homes

Nicholas G. Castle

Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA, USA

Purpose. First, the resident safety culture of nursing homes from a Nurse Aide’s perspective was compared with existing data from hospitals. Second, how the safety culture of nursing homes varied according to facility characteristics and market characteristics was examined.

Methods. Data came from 72 nursing homes and 1579 Nurse Aides (response rate of 55%). From these nursing homes, Nurse Aides completed The Hospital Survey on Patient Safety Culture (HSOPSC) instrument, a previously validated survey with 12 subscales used to assess safety culture. The nursing home scores from this instrument were compared with the hospital scores. Ordinary least squares regression was used to examine the association between nine nursing home facility characteristics and two market characteristics and the overall safety culture score.

Results. All of the 12 HSOPSC subscale scores from the nursing home sample were considerably lower than the benchmark hospital scores, indicating a less well-developed safety culture. The significant facility and market characteristics from the regression analysis resembled many of those found when similar characteristics are used in examinations of quality.

Conclusions. These results are important in clearly showing that the resident safety culture of Nurse Aides in many nursing homes may be poorly developed.

Keywords: culture, nursing homes, safety

Address reprint requests to Nicholas G. Castle, A649 Crabtree Hall, Graduate School of Public Health, Department of Health Policy and Management, 130 DeSoto Street, Pittsburgh, PA 15261, USA. E-mail: castlen{at}pitt.edu

Accepted for publication August 5, 2006.


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