当前位置： SCI文献检索 > Journal of the American Medical Directors Association期刊下所有文献 > Safety Climate Associated With Adverse Events in Nursing Homes: A National VA Study.

Safety Climate Associated With Adverse Events in Nursing Homes: A National VA Study.

Abstract：

OBJECTIVES:Adverse events in nursing homes are leading causes of morbidity and mortality, prompting facilities to investigate their antecedents. This study examined the contribution of safety climate-how frontline staff typically think about safety and act on safety issues-to adverse events in Veterans Affairs (VA) nursing homes or Community Living Centers (CLCs). DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:A total of 56 CLCs nationwide, 1397 and 1645 CLC staff (including nurses, nursing assistants, and clinicians/specialists), respectively, responded to the CLC Employee Survey of Attitudes about Resident Safety (CESARS) in 2017 and 2018. METHODS:Adverse events (pressure ulcers, falls, major injuries from falls, and catheter use) were measured using the FY2017-FY2018 Minimum Data Set (MDS). Safety climate was defined as 7 CESARS domains (safety priorities, supervisor commitment to safety, senior management commitment to safety, personal attitudes toward safety, environmental safety, coworker interactions around safety, and global rating of CLC). The associations between safety climate domains and each adverse event were determined separately for each frontline group, using beta-logistic regression with random effects. RESULTS:Better ratings of supervisor commitment to safety were associated with lower rates of major injuries from falls [odds ratio (OR) 0.33, 95% confidence interval (CI) 0.11-0.97, clinicians] and catheter use (OR 0.42, 95% CI 0.21-0.85, nurses), and better ratings of environmental safety were associated with lower rates of pressure ulcers (OR 0.23, 95% CI 0.09-0.61, clinicians), major injuries from falls (OR 0.48, 95% CI 0.24-0.93, nurses), and catheter use (OR 0.55, 95% CI 0.32-0.93, nursing assistants). Better global CLC ratings were associated with higher rates of catheter use. No other safety climate domains had significant associations. CONCLUSIONS AND IMPLICATIONS:Nursing homes may reduce adverse events by fostering supportive supervision of frontline staff and a safer physical environment.

journal_name

J Am Med Dir Assoc

journal_title

Journal of the American Medical Directors Association

authors

Quach ED,Kazis LE,Zhao S,Ni P,McDannold SE,Clark VA,Hartmann CW

doi

10.1016/j.jamda.2020.05.028

subject

Has Abstract

pub_date

2020-07-19 00:00:00

eissn

1525-8610

issn

1538-9375

pii

S1525-8610(20)30431-X

pub_type

杂志文章

在线工具

Safety Climate Associated With Adverse Events in Nursing Homes: A National VA Study.