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Nursing Home Survey on Patient Safety Culture

The AHRQ Nursing Home Survey on Patient Safety Culture shows staff opinions in the 2023 database. Survey from over 3,200 nursing home staff members provide results on the safety culture for residents in US nursing homes. The survey had a 40% average response rate, from 62 participating nursing homes. While overall perceptions of resident safety, feedback about incidents, and supervisors promoting safety received relatively high marks, there were a number of low-scoring areas. Nursing home staffing received the lowest ratings of any category. Key concerns were having enough staff to handle the workload, and having to hurry or use shortcuts because staff have too much work to do. Perceptions that staff are blamed when a resident is harmed, being afraid to report their mistakes, and staff opinions being ignored in their nursing home also were lower-scoring areas. Staff generally felt that it was hard to keep residents safe because so many staff had quit their jobs. See Charts 5-1 and 5-2 for the overview. Detailed breakouts by position and type of nursing home are in the appendixes. In general, large nursing homes of 100 beds or more scored lower than staff at smaller nursing homes. Only 50% of staff at large nursing homes gave an overall rating on resident safety of “excellent” or “very good”, compared to six out of 10 staff at smaller nursing homes. For-profit nursing homes scored lower than nonprofit or governmental nursing homes. The biggest differences were in resident safety and communication openness. Breakouts of opinions held by nursing assistants compared to other employee groups are enlightening. Published by the Agency for Healthcare Research and Quality, AHRQ, January 2023.

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