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AHRQ 2014 nursing home survey on safety culture generally positive, but raises concerns about staffing, tendency to blame.Rockville, MD: Agency for Healthcare Research and Quality; November 2014. AHRQ Publication No. 15-0004-EF.

AHRQ Nursing Home Survey on Patient Safety Culture: 2014 User Comparative Database Report.

Sorra J, Famolaro T, Yount N, Burns W, Liu H, Shyy M. Rockville, MD: Agency for Healthcare Research and Quality; November 2014. AHRQ Publication No. 15-0004-EF.

The AHRQ Nursing Home Survey on Patient Safety Culture, a validated tool for measuring safety culture, was initially released in 2008. This comprehensive national survey of registered nurses, nursing aides, and support staff garnered a high response rate. While respondents rated overall safety perceptions highly, similar to outpatient and hospital safety culture surveys, they expressed concerns about adequacy ofstaffing, as prior reports of adverse events in nursing homes would suggest. Even though most respondents believed that feedback and communication about safety problems was positive, many did not endorse a nonpunitive response to error. Instead, there was concern about individual blame. As with multiple studies,managers reported a more positive safety climate than frontline staff, suggesting that leadership on safety climate has not changed on-the-ground staff perceptions despite increasing awareness of safety culture. Given that prior work has demonstrated a link between positive safety climate and patient outcomes in nursing homes, it will be critical to address the problems raised in this analysis. A past AHRQ WebM&Mcommentary discussed the safety and quality of long-term care, and a previous AHRQ WebM&M interviewwith Nicholas Castle explored unique issues surrounding patient safety in the nursing home population.

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COMMENTARY

Wrong Route for Nutrients

Scott-Cawiezell JR, AHRQ WebM&M [serial online]. July 2008.

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Keeping Patients Safe: Transforming the Work Environment of Nurses.

Committee on the Work Environment for Nurses and Patient Safety, Board on Health Care Services, Page A, ed. Washington, DC: National Academies Press; 2004.

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MEASUREMENT TOOL/INDICATOR

Survey User's Guide: Nursing Home Survey on Patient Safety Culture.

Sorra J, Franklin M, Streagle S. Rockville, MD: Agency for Healthcare Research and Quality; 2008. AHRQ Publication No. 08-0060.

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