Healthcare Staff Perceptions of Patient Safety Culture in Nursing Home Settings—A Cross-Sectional Study

In nursing homes, knowledge about patient safety culture is still limited. This study investigates staff perceptions of patient safety culture in Norwegian nursing homes, measured with the Nursing Home Survey on Patient Safety Culture (NHSOPSC). 466 (69%) staff from 12 different nursing homes participated. The total percentages of positive responses for each patient safety culture dimension and differences in perceptions according to staff’s educational background and position were calculated. Multiple linear regression analysis was used to test if the NHSOPSC dimensions predicted participants’ ratings of the question “Please give this nursing home an overall rating on patient safety”. The proportion of positive responses was high, with six of ten dimensions having an average percentage above 70%. “Supervisor expectations and actions promoting patient safety” (88%), “feedback and communication about incidents” (87%), and a “non-punitive response to mistakes” (78%) had high average scores, while “staffing” (46%) and “training and skills” (56%) had the lowest average scores. Managers reported higher scores on all dimensions, except for “compliance with procedures” compared with other staff groups. Educational level had less influence on staff’s perceptions of patient safety culture than management position. The ten NHSOPSC dimensions explained 47.2% of the variance for the overall rating question “Please give this nursing home an overall rating on patient safety” (F [10, 384] = 34.39, p < 0.001). “Management and organizational learning” had the strongest unique contribution (28.1%). This study suggests that staff working at the bedside have confidence in their nursing managers’ attention to patient safety issues and that a non-punitive environment is prevalent in Norwegian nursing homes.

The Relationship between Understaffing of Nurses and Patient Safety in Hospitals—A Literature Review with Thematic Analysis

Introduction: Patient safety and the occurrence of adverse events in hospitals is a topic which has been widely addressed over the last decades. In that respect, there has been an increasing interest in the effect of working conditions on patient safety, and whether understaffing and adverse events are correlated. This paper therefore reports results from a study of under- staffing of nurses understood as a lack of nurses available to conduct the tasks required of them. This implies that nurses are forced to ignore or postpone important tasks, thereby compromising patient safety. Purpose: The purpose of the study is to increase the knowledge of understaffing of hospital nurses, and the consequences that understaffing may have on patient safety. Methods: A literature search of the databases Chinal, Medline, Cochrane library, Isi Web of Science and Academic Search premiere was conducted in the period January 2014 to February, 2016. Results: Results are categorized into two main themes and four subthemes. The first main theme describes the direct relationship between understaffing and patient safety. Poor staffing increases the risk of mortality, and adverse conditions such as pressure ulcers, deep vein thrombosis and hospital-related infections. The second main theme relates to the indirect implications of understaffing for patient safety. These implications pertain to the lack of time that nurses could give each patient, limitations in the quality of nursing, and challenges in safe medication administration. Conclusions: The study documents the relationship between understaffing of nurses and adverse events in hospitals, revealingthat understaffing of nurses is a risk factor for hospitalized patients.