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International Journal for Quality in Health Care Advance Access published online on September 7, 2006

International Journal for Quality in Health Care, doi:10.1093/intqhc/mzl038
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© The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved
Accepted August 5, 2006

Article

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

Nicholas G. Castle 1 *

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

* To whom correspondence should be addressed.
Nicholas G. Castle, E-mail: castlen{at}pitt.edu


   Abstract

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.
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