250788 Relationships among patient safety culture, processes of care, and resident falls in nursing homes

Monday, October 31, 2011: 11:42 AM

Kali Thomas, MA , School of Aging Studies, University of South Florida, Tampa, FL
Studies have shown that patient safety culture, defined as the outcome of a concerted organizational effort to move towards safety, is poorly developed in nursing homes (NHs) and therefore, residents of nursing homes may be at risk of harm. Using the Revised Version of Donabedian's Structure-Process-Outcome (SPO) Model, this study examines the relationships among top management's ratings of NH patient safety culture, safe processes of care, and resident outcomes. Using directors of nursing and NH administrators' responses from a nationally representative sample of 3559 NHs on the Agency for Healthcare Research and Quality 2008 Nursing Home Survey on Patient Safety Culture, the Online Survey Certification and Reporting Database, and the Minimum Data Set, we examine if the patient safety culture of NHs is related to processes of care (restraint use and catheterization) and patient safety outcomes (falls). Using hierarchical generalized linear models, we find that higher ratings of patient safety culture were significantly related to lower prevalence of physical restraints (est. = -.003; p<.001) and resident falls (est= -.001; p<.05). Furthermore, poorer processes of care (catheterization and restraint use) were related to negative patient safety outcomes when controlling for structural characteristics and patient safety culture (est.= 0.109, p<.001; est.= 0.573, p<.001; respectively). These findings hopefully will contribute to the development of a patient safety culture in NHs and promote improvements in health care that can be measured by processes of care and resident outcomes.

Learning Areas:
Administration, management, leadership

Learning Objectives:
Describe the relationship between patient safety culture, processes of care, and resident outcomes in nursing homes.

Keywords: Nursing Homes, Long-Term Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD candidate in the School of Aging Studies at the University of South Florida and my research focuses on quality of nursing home care, particulary patient safety.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.