Patient Safety Culture in Assisted Living: Staff Perceptions and Association with State Regulations.
Patient Safety Culture in Assisted Living: Staff Perceptions and Association with State Regulations.
复制标题
辅助生活中的患者安全文化：工作人员的看法以及与国家法规的关联。
DOI：
10.1016/j.jamda.2022.09.007
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发表时间：
2022
影响因子：
7.6
通讯作者：
Zimmerman,Sheryl
中科院分区：
文献类型：
--
作者：
Temkin-Greener,Helena;Mao,Yunjiao;McGarry,Brian;Zimmerman,Sheryl
目的探讨辅助生活（AL）管理人员和直接护理人员（DCWs）对患者安全文化（PSC）的看法，以及他们与国家法规的联系。我们使用医疗保健研究与质量机构开发的PSC仪器进行了一项调查。关于ALs和住院患者的次要数据来源于医疗保险总受益人摘要文件。其他数据来源是地区卫生资源文件，以前编制的国家AL目录，和美国人口普查。有关州人工智能法规的数据可从先前的研究中获得。背景和参与者包括在辅助生活社区为医疗保险受益人居民服务的行政人员和DCWs。方法采用探索性因子分析，检验Pearson相关性，并获得标准化的Cronbach alpha对PSC仪器进行检验。我们估计线性回归模型的因变量是阳性PSC评估的比例，对于每个PSC域，se聚集在AL水平。结果共对257家医院的714名管理人员和护士进行了问卷调查。PSC仪器对AL社区进行了可靠有效的测试。管理员和DCWs对PSC的看法在几乎所有领域都存在显著差异。各州对DCW人员配置的监管特异性每增加1个单位，PSC人员配置领域就会增加4.13个百分点（P< 0.05）。在其他PSC领域也发现了与员工培训中监管特异性的关联。结论与意义spsc是评估组织绩效的重要指标。dcw对PSC的认识明显比管理员差，这表明了解这些不同认识的来源至关重要。由于国家法规与PSC相关，因此全面关注AL患者安全可能需要监管行动，特别是在人员配备和培训方面增加特异性。
ObjectivesTo examine perceptions of patient safety culture (PSC) among assisted living (AL) administrators and direct care workers (DCWs), and their associations with state regulations.DesignWe conducted a survey using the PSC instrument developed by the Agency for Healthcare Research & Quality. Secondary data on ALs and residents were derived from the Medicare Master Beneficiary Summary Files. Other data sources were the Area Health Resource Files, a previously compiled national AL directory, and the US census. Data on state AL regulations were available from a prior study.Setting and ParticipantsParticipants included administrators and DCWs working in assisted living communities serving Medicare beneficiary residents.MethodsWe employed exploratory factor analysis, examined Pearson correlations, and obtained standardized Cronbach alphas to test the PSC instrument. We estimated linear regression models with the dependent variable being the proportion of positive PSC assessments, for each PSC domain, with SEs clustered at the AL level.ResultsSurveys were completed by 714 administrators and DCWs in 257 ALs. The PSC instrument tested reliable and valid for AL communities. Administrators’ and DCWs’ perceptions of PSC differed significantly across almost all domains. A 1-unit increase in state regulatory specificity for DCW staffing was associated with a 4.13–percentage point (P< .05) increase in the PSC staffing domain. Associations with regulatory specificity in staff training were also found for other PSC domains.Conclusions and ImplicationsPSC is an important metric for assessing organizational performance. DCWs have significantly worse perceptions of PSC than do administrators, suggesting it is crucial to understand the source of these differing perceptions. Because state regulations relate to PSC, achieving a comprehensive focus on patient safety in AL may require regulatory action, particularly increasing specificity with regard to staffing and training.