Nursing Home Survey on Patient Safety Culture

Feedback Results

Text Version of a Slide Presentation

---

Slide 1

{Site Name}
{City, State}
{Date}

For further information about this feedback report, contact:

Name:
Title:
Address:
Phone:
E-mail:

Slide 2

Background on the Nursing Home Survey

• An expansion of the Agency for Healthcare Research and Quality's (AHRQ) Hospital Survey on Patient Safety Culture http://www.ahrq.gov/qual/hospculture.
• Specifically designed to measure the culture of resident safety in nursing homes from a staff perspective:
  • Assesses staff attitudes and beliefs about resident safety.
  • Assess many areas similar to the hospital survey, but items are different.
• Pilot tested in 2007 in 40 U.S. nursing homes with 3,698 respondents; final survey released on AHRQ Web site in 2008.

Slide 3

Assesses 12 Areas of Resident Safety

Survey areas:

1. Overall Perceptions of Resident Safety
2. Feedback and Communication About Incidents
3. Supervisor/Manager Expectations and Actions Promoting Patient Safety
4. Organizational Learning
5. Management Support for Resident Safety
6. Training and Skills
7. Compliance With Procedures
8. Teamwork
9. Handoffs
10. Communication Openness
11. Nonpunitive Response to Mistakes
12. Staffing

Two overall rating questions:

• Whether staff would tell friends this is a safe nursing home for their family.
• Overall rating on resident safety.

Slide 4

Survey Data Collection

[Describe your nursing home's data collection methods here:]

• When survey was administered & how.
• To whom the survey was administered (if not a census, how was the sample selected?)
• Response rate.

Slide 5

Demographic Data About Respondents

1. Staff position in the nursing home:

___ % Administrator/Manager
___ % Physician (MD, DO)
___ % Other Provider
___ % Licensed Nurse
___ % Nursing Assistant/Aide
___ % Direct Care Staff
___ % Administrative Support Staff
___ % Support Staff
___ % Other

2. Tenure with the nursing home:

___ % Less than 2 months
___ % 2 to 11 months
___ % 1 to 2 years
___ % 3 to 5 years
___ % 6 to 10 years
___ % 11 years or more

3. Hours worked per week:

___ % 15 or fewer hours per week
___ % 16 to 24 hours per week
___ % 25 to 40 hours per week
___ % More than 40 hours per week

Slide 6

Demographic Data About Respondents (continued)

4. Time of shift:

___ % Days
___ % Evenings
___ % Nights

5. Paid by a staffing agency:           ___ % Yes   ___ % No

6. Direct contact with residents:   ___ % Yes    ___ % No

7. Work area or unit in the nursing home:

___ % Many different areas or units in this nursing home/No specific area or unit
___ % Alzheimer's/Dementia unit
___ % Rehab unit
___ % Skilled nursing unit
___ % Other area or unit

Slide 7

Main Findings: Strengths

A number of strengths emerged from the results:

• Most respondents...
• Respondents...

Slide 8

Main Findings: Areas for Improvement

A number of areas for improvement emerged from the results:

• Most respondents...
• Respondents...

Slide 9

Nursing Home Recommendation

I would tell friends that this is a safe nursing home for their family

Bar chart displays percentage of respondents responding Yes: 75%, Maybe: 5%, or No: 20%.

Slide 10

Overall Rating on Resident Safety

Give this nursing home an overall rating on resident safety

Bar chart displays percentage of respondents providing an overall rating of Excellent: 60%, Very Good: 20%, Good: 10%, Fair: 5%, and Poor: 5%.

Slide 11

Interpreting the Results

• Positively and negatively worded items are used in the survey.
• A positive response to an item is when respondents answer:
  • "Strongly Agree/Agree" or "Always/Most of the time" with a positively worded item.
  • "Strongly Disagree/Disagree" or "Never/Rarely" with a negatively worded item.

Slide 12

Interpreting the Results (continued)

Example of Positive Responses on Compliance With Procedures:

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
1. Staff follow standard procedures to care for residents. (A4)	10	10	80
R2. Staff use shortcuts to get their work done faster. (A6)	80	10	10
R3.To make work easier, staff often ignore procedures. (A14)	80	10	10

^R This item is negatively worded so disagreeing is "positive".

Slide 13

Overall Perceptions of Resident Safety

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
1. Residents are well cared for in this nursing home. (D1)	10	15	75
2. This nursing home does a good job keeping residents safe. (D6)	10	15	75
3. This nursing home is a safe place for residents. (D8)	10	15	75

Note: The item's survey location is in parentheses.

Slide 14

Feedback and Communication About Incidents

Survey Items	% Never/ Rarely	% Sometimes	% Most of the Time/Always
1. When staff report something that could harm a resident, someone takes care of it. (B4)	5	20	75
2. In this nursing home, we talk about ways to keep incidents from happening again. (B4)	5	20	75
3. Staff tell someone if they see something that might harm a resident. (B6)	5	20	75
4. In this nursing home, we discuss ways to keep residents safe from harm. (B8)	5	20	75

Note: The item's survey location is in parentheses.

Slide 15

Supervisor Expectations and Actions Promoting Resident Safety

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
1. My supervisor listens to staff ideas and suggestions about resident safety. (C1)	5	20	75
2. My supervisor says a good word to staff who follow the right procedures. (C2)	5	20	75
3. My supervisor pays attention to resident safety problems in this nursing home. (C3)	5	20	75

Note: The item's survey location is in parentheses.

Slide 16

Organizational Learning

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
R1. This nursing home lets the same mistakes happen again and again. (D3)	75	5	20
2. It is easy to make changes to improve resident safety in this nursing home. (D4)	20	5	75
3. This nursing home is always doing things to improve resident safety. (D5)	20	5	75
4. When this nursing home makes changes to improve resident safety, it checks to see if the changes worked. (D10)	20	5	75

^R Indicates a negatively worded item.
Note: The item's survey location is in parentheses.

Slide 17

Management Support for Resident Safety

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
1. Management asks staff how the nursing home can improve resident safety. (D2)	5	20	75
2. Management listens to staff ideas and suggestions to improve resident safety. (D7)	5	20	75
3. Management often walks around the nursing home to check on resident care. (D9)	5	20	75

Note: The item's survey location is in parentheses.

Slide 18

Training and Skills

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
1. Staff get the training they need in this nursing home. (A7)	20	5	75
2. Staff have enough training on how to handle difficult residents. (A11)	20	5	75
3. Staff understand the training they get in this nursing home. (A13)	20	5	75

Note: The item's survey location is in parentheses.

Slide 19

Compliance with Procedures

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
1. Staff follow standard procedures to care for residents. (A4)	20	5	75
R2. Staff use shortcuts to get their work done faster. (A6)	75	5	20
R3. To make work easier, staff often ignore procedures. (A14)	75	5	20

^R Indicates a negatively worded item.
Note: The item's survey location is in parentheses.

Slide 20

Teamwork

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
1. Staff in this nursing home treat each other with respect. (A1)	20	5	75
2. Staff support one another in this nursing home. (A2)	20	5	75
3 Staff feel like they are part of a team. (A5)	20	5	75
4. When someone gets really busy in this nursing home, other staff help out. (A9)	20	5	75

Note: The item's survey location is in parentheses.

Slide 21

Handoffs

Survey Items	% Never/ Rarely	% Sometimes	% Most of the Time/Always
1. Staff are told what they need to know before taking care of a resident for the first time. (B1)	5	20	75
2. Staff are told right away when there is a change in a resident's care plan. (B2)	5	20	75
3. We have all the information we need when residents are transferred from the hospital. (B3)	5	20	75
4. Staff are given all the information they need to care for residents. (B10)	5	20	75

Note: The item's survey location is in parentheses.

Slide 22

Communication Openness

Survey Items	% Never/ Rarely	% Sometimes	% Most of the Time/Always
1. Staff ideas and suggestions are valued in this nursing home. (B7)	5	20	75
R2. Staff opinions are ignored in this nursing home. (B9)	75	20	5
3. It is easy for staff to speak up about problems in this nursing home. (B11)	5	20	75

^R Indicates a negatively worded item.
Note: The item's survey location is in parentheses.

Slide 23

Nonpunitive Response to Mistakes

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
R1. Staff are blamed when a resident is harmed. (A10)	75	20	5
R2. Staff are afraid to report their mistakes. (A12)	75	20	5
3. Staff are treated fairly when they make mistakes. (A15)	5	20	75
4. Staff feel safe reporting their mistakes. (A18)	5	20	75

^R Indicates a negatively worded item.
Note: The item's survey location is in parentheses.

Slide 24

Staffing

Survey Items	% Strongly Disagree/ Disagree	% Neither	% Strongly Agree/ Agree
1. We have enough staff to handle the workload. (A3)	5	20	75
R2. Staff have to hurry because they have too much work to do. (A8)	75	20	5
3. Residents' needs are met during shift changes. (A16)	5	20	75
R4. It is hard to keep residents safe here because so many staff quit their jobs. (A17)	75	20	5

^R Indicates a negatively worded item.
Note: The item's survey location is in parentheses.

Slide 25

Comparison With 40 Pilot Study Nursing Homes

Patient Safety Culture Area	[Site name] % Positive	NH Pilot Study Comparison: Average % Positive
1. Overall Perceptions of Resident Safety	[Your data]	87
2. Feedback and Communication About Incidents	[Your data]	85
3. Supervisor/Manager Expectations and Actions Promoting Patient Safety	[Your data]	81
4. Organizational Learning	[Your data]	76
5. Management Support for Resident Safety	[Your data]	72
6. Training and Skills	[Your data]	72
7. Compliance With Procedures	[Your data]	67
8. Teamwork	[Your data]	67
9. Handoffs	[Your data]	63
10. Communication Openness	[Your data]	58
11. Nonpunitive Response to Mistakes	[Your data]	55
12. Staffing	[Your data]	48

Current as of March 2009

---

Internet Citation:

Nursing Home Survey Feedback Report Template. Text Version of a Slide Presentation. March 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/nhsurvey08/nhsopstxt.htm

---