J Gerontol Nurs. 2023 Feb;49(2):13-17. doi: 10.3928/00989134-20230106-03. Epub 2023 Feb 1.
The current qualitative study assessed leadership and staff perceptions related to resident safety at Department of Veterans Affairs (VA) nursing homes with a range of safety climates. We recruited a purposive sample of six VA nursing homes from geographically diverse regions of the United States and with diverse overall safety climate ratings. We conducted semi-structured phone interviews with 43 senior and middle level nursing home leaders and frontline providers (medical and nursing). We performed a thematic analysis of interview data to assess participant perceptions of factors that influence resident safety at higher and lower safety climate sites. Analyses identified two factors that differentiated VA nursing homes with high safety climate ratings from those with medium or low ratings: (1) communication about resident safety, particularly the important role of accessibility of physicians and managers; and (2) leadership support for and responsiveness to resident safety issues raised by frontline staff. Findings from high safety climate nursing homes underscore the importance of leadership accessibility, communication, support, and follow through regarding resident safety concerns. These results may provide a basis for designing safety climate interventions, such as those designed to improve communication, teamwork, and quality improvement structures and processes. [(2), 13-17.].
本定性研究评估了退伍军人事务部（VA）养老院中与居民安全相关的领导力和员工认知，这些养老院的安全氛围各不相同。我们从美国地理分布广泛且整体安全氛围评级各异的地区招募了六家 VA 养老院作为目标样本。我们对 43 名养老院高层和中层领导以及一线服务人员（医疗和护理）进行了半结构化电话访谈。我们对访谈数据进行了主题分析，以评估参与者对影响高安全氛围和低安全氛围养老院居民安全的因素的看法。分析确定了两个因素，可将安全氛围评级较高的 VA 养老院与评级中等或较低的养老院区分开来：（1）关于居民安全的沟通，特别是医生和管理人员的可及性的重要作用；（2）领导层对一线工作人员提出的居民安全问题的支持和回应。高安全氛围养老院的调查结果强调了领导层在居民安全问题上的易接近性、沟通、支持和跟进的重要性。这些结果可能为设计安全氛围干预措施提供依据，例如旨在改善沟通、团队合作以及质量改进结构和流程的干预措施。[(2)，13-17]。
