Elsevier

Geriatric Nursing

Volume 28, Issue 2, March–April 2007, Pages 126-136
Geriatric Nursing

Feature article
Assessment of Safety Attitudes in a Skilled Nursing Facility

https://doi.org/10.1016/j.gerinurse.2007.01.001Get rights and content

Safety has not been well studied in the long-term care setting. This pilot study assesses staff attitudes regarding safety culture at one 250-bed skilled nursing facility. A valid and reliable Safety Attitudes Questionnaire (SAQ) was administered once to a sample of 51 employees. Nursing staff and other health care staff were generally satisfied with their jobs (42% and 67% had a positive attitude, respectively) but gave low scores to Management (22% and 13%, respectively) and Safety Climate (28% and 33%, respectively). Registered nurses, licensed practical nurses, and nurse management/supervisors received the highest ratings for quality of collaboration and communication (range: 3.6–4.1 on a 5-point Likert scale with 1 = very low, 5 = very high), whereas nurse practitioners and physician assistants received the lowest (range: 2.5–2.9). The SAQ provided insight into employees’ safety attitudes and can be used to identify opportunities for improvements in safety.

Section snippets

Setting and Study Design

This one-time study using a convenience sample was undertaken at a 250-bed skilled nursing facility located on the campus of a suburban community hospital in western New York State. This not-for-profit facility is maintained by a religious organization. It does not serve as a teaching site for any health profession schools.

This study received institutional review board approval.

Sample

All nursing and allied health care staff with direct or indirect patient care responsibilities were eligible to

Results

The majority of respondents identified themselves as female (94%), non-Hispanic White (70%), and working full-time (80%) on the day shift (76%). Demographic characteristics of nonrespondents were not available for comparison. Although a greater number of nursing staff than other health care staff self-identified as non-Hispanic Black (28% vs. 14%) and working on the evening shift (28% vs. 7%), respectively, there were no statistically significant differences between the 2 groups (Table 2).

Summary and Key Findings

The SAQ was successfully adapted for and administered in the long-term care setting. Despite a low response rate, it provided a preliminary overview of the safety culture in the institution in which it was piloted. No statistically significant differences were found between Nursing and Other Health Care Staff in ratings of the 6 safety constructs or the quality of collaboration and communication between staff members.

It is encouraging that overall a majority of respondents had a positive

Acknowledgements

Funding for this study was provided through a grant from the ASHP Foundation Pharmacy/Nursing Partnership for Medication Safety Grant Program. The authors thank Jim Smith for facilitating data collection, Letitia Cowens for data entry, and Andy Danzo for his critical review of the manuscript. We also thank Dr. Thomas Rosenthal and John Taylor for their continued support of our research endeavors.

ANGELA M. WISNIEWSKI, PharmD, is a Clinical Assistant Professor, University at Buffalo, School of Medicine and Biomedic Sciences, Department of Family Medicine.

References (32)

  • L.T. Kohn et al.

    To err is human: building a safer health system

    (2000)
  • J.H. Gurwitz et al.

    The epidemiology of adverse and unexpected events in the long-term care setting

    J Am Geriatr Soc

    (1994)
  • J.W. Cooper

    Probable adverse drug reactions in a rural geriatric nursing home population: a four-year study

    J Am Geriatr Soc

    (1996)
  • J.W. Cooper

    Adverse drug reaction-related hospitalizations of nursing facility patients: a 4-year study

    South Med J

    (1999)
  • M.B. Gerety et al.

    Adverse events related to drugs and drug withdrawal in nursing home residents

    J Am Geriatr Soc

    (1993)
  • T.S. Field et al.

    Risk factors for adverse drug events among nursing home residents

    Arch Intern Med

    (2001)
  • Cited by (38)

    • Safety climate in the operating room: Translation, validation and application of the Safety Attitudes Questionnaire

      2016, Revista Portuguesa de Saude Publica
      Citation Excerpt :

      There are significant differences related to communication between the operating room team. Nurses also have the highest average (3.8) which suggests higher quality of communication between them and the other professions which agrees with studies using the same instrument29 followed by Auxiliaries (3.4), Radiographers (3.4) and Anesthesiologists (3.3). Surgeons have the lowest average (3.1).

    View all citing articles on Scopus

    ANGELA M. WISNIEWSKI, PharmD, is a Clinical Assistant Professor, University at Buffalo, School of Medicine and Biomedic Sciences, Department of Family Medicine.

    WILLLIAM S. ERDLEY, RN, DNS, is a Clinical Associate Professor, University at Buffalo, School of Nursing.

    RANJIT SINGH, MD, MBA, is a Clinical Assistant Professor, Associate Director, Patient Safety Research Center, University at Buffalo, School of Medicine and Biomedical Sciences, Department of Family Medicine.

    TIMOTHY J. SERVOSS, MA, is an Interim Assistant Professor, Canisius College, Department of Psychology.

    BRUCE J. NAUGHTON, MD, is an Associate Professor, University at Buffalo, School of Medicine and Biomedical Sciences, Department of Medicine; Kaleida Health, Department of Medicine, Division of Geriatrics and Gerontology.

    GURDEV SINGH, PhD, is Director, Patient Safety Research Center, University at Buffalo, School of Medicine and Biomedical Sciences, Department of Family Medicine.

    View full text