What is the level of safety culture in French nursing homes? The EHPAGE study.
Factor
Measurement
Nursing homes
Quality improvement
Risk management
Safety culture
Survey
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
11 Dec 2021
11 Dec 2021
Historique:
received:
16
12
2020
accepted:
25
11
2021
entrez:
13
12
2021
pubmed:
14
12
2021
medline:
15
12
2021
Statut:
epublish
Résumé
French nursing homes (NHs) are in the early stages of implementing their risk management approach. The latter includes the development of a safety culture (SC) among professionals. A training package to support NHs in implementing a risk management strategy has been designed by QualiREL Santé, a regional body that provides support in quality and risk management. The aim is to improve SC. No data are available about the level of SC in French NHs. This study evaluates the level of SC and identifies predictors of SC scores in NHs that will subsequently benefit from the training package. The study was proposed to NHs who are members of QualiREL Santé in 2 French departments. Inclusion criteria were voluntary participation, the commitment of top management to benefit from the training package, and the absence of previous risk management support provided by QualiREL Santé. The NHSOPS-F questionnaire (22 items measuring 7 dimensions of SC) was administered to professionals between January and March 2016. 14 variables related to the structural profile of the NHs and the strategic choices of top management in terms of healthcare safety were recorded. Scores for 7 dimensions were calculated for all of the included NHs. Further modelling identified predictive factors. 58 NHs were included. The response rate for the NHSOPS-F (n = 1946 professionals) was 64% (Q1-Q3 = [49.4;79.0]). Staffing was the least-developed dimension (11.8%), while scores were highest for Feedback and communication about incidents (84.8%). Being attached to a public hospital was associated with poorer perceptions of SC, notably for the dimension "Overall perceptions of resident safety and organizational learning" (β = - 19.59;p-value< 0.001). A less-developed SC was also significantly linked to existing Quality initiatives. Overall, French NHs must prioritise issues of staffing, teamwork and compliance with procedures. The role of human factors within teams should be exploited by top management. Our initial findings will help to adapt improvement approaches and are particularly relevant to local and national policies during the ongoing pandemic.
Sections du résumé
BACKGROUND
BACKGROUND
French nursing homes (NHs) are in the early stages of implementing their risk management approach. The latter includes the development of a safety culture (SC) among professionals. A training package to support NHs in implementing a risk management strategy has been designed by QualiREL Santé, a regional body that provides support in quality and risk management. The aim is to improve SC. No data are available about the level of SC in French NHs. This study evaluates the level of SC and identifies predictors of SC scores in NHs that will subsequently benefit from the training package.
METHOD
METHODS
The study was proposed to NHs who are members of QualiREL Santé in 2 French departments. Inclusion criteria were voluntary participation, the commitment of top management to benefit from the training package, and the absence of previous risk management support provided by QualiREL Santé. The NHSOPS-F questionnaire (22 items measuring 7 dimensions of SC) was administered to professionals between January and March 2016. 14 variables related to the structural profile of the NHs and the strategic choices of top management in terms of healthcare safety were recorded. Scores for 7 dimensions were calculated for all of the included NHs. Further modelling identified predictive factors.
RESULTS
RESULTS
58 NHs were included. The response rate for the NHSOPS-F (n = 1946 professionals) was 64% (Q1-Q3 = [49.4;79.0]). Staffing was the least-developed dimension (11.8%), while scores were highest for Feedback and communication about incidents (84.8%). Being attached to a public hospital was associated with poorer perceptions of SC, notably for the dimension "Overall perceptions of resident safety and organizational learning" (β = - 19.59;p-value< 0.001). A less-developed SC was also significantly linked to existing Quality initiatives.
CONCLUSIONS
CONCLUSIONS
Overall, French NHs must prioritise issues of staffing, teamwork and compliance with procedures. The role of human factors within teams should be exploited by top management. Our initial findings will help to adapt improvement approaches and are particularly relevant to local and national policies during the ongoing pandemic.
Identifiants
pubmed: 34895228
doi: 10.1186/s12913-021-07336-w
pii: 10.1186/s12913-021-07336-w
pmc: PMC8666034
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1332Informations de copyright
© 2021. The Author(s).
Références
Epidemiol Serv Saude. 2017 Jul-Sep;26(3):455-468
pubmed: 28977171
BMC Health Serv Res. 2019 Jul 15;19(1):490
pubmed: 31307443
Open Access Maced J Med Sci. 2018 May 18;6(5):925-930
pubmed: 29875873
BMC Nurs. 2018 Aug 7;17:36
pubmed: 30100816
BMJ Qual Saf. 2018 Jun;27(6):464-473
pubmed: 28951531
BMJ Qual Saf. 2011 Apr;20(4):338-43
pubmed: 21303770
Int J Qual Health Care. 2013 Sep;25(4):459-68
pubmed: 23833029
J Patient Saf. 2021 Dec 1;17(8):e1209-e1215
pubmed: 29596134
Maedica (Bucur). 2018 Mar;13(1):34-43
pubmed: 29868138
BMC Health Serv Res. 2011 Jul 11;11:165
pubmed: 21745354
Geriatr Nurs. 2014 Nov-Dec;35(6):441-7
pubmed: 25305674
Nurse Educ Pract. 2017 Nov;27:128-133
pubmed: 28892726
Hosp Health Netw. 1996 Mar 20;70(6):43-4, 46, 48
pubmed: 8593505
Geriatr Psychol Neuropsychiatr Vieil. 2017 Jun 1;15(2):117-126
pubmed: 28625931
J Am Geriatr Soc. 2017 Oct;65(10):2244-2250
pubmed: 28846129