Haeger Mathias, Garay Sandra, Krieger Kristin, Eggert Simon
Center for Quality in Care (ZQP), Berlin, Germany.
J Nurs Manag. 2025 Jul 25;2025:3887187. doi: 10.1155/jonm/3887187. eCollection 2025.
This study explores the latest intervention strategies, contributing factors, and measurement instruments aimed at enhancing safety culture in long-term care settings. A positive safety culture is associated with increased patient safety. While strategies to enhance safety culture are well documented in medical and clinical settings, evidence from the long-term care sector remains limited. Furthermore, the literature is heterogeneous regarding contributing factors and measurement approaches. Strengthening the understanding of how to enhance safety culture in long-term care could raise safety awareness among formal caregivers working with this highly vulnerable population of older adults. A rapid integrative review was conducted to update our previous work on interventions. Relevant empirical and theoretical studies were retrieved from eight databases. The title, abstract, and full-text screening, as well as data extraction, were performed by two independent reviewers. Discrepancies were resolved through discussion with a third reviewer. Study quality was assessed using critical appraisal tools, and PRISMA guidelines were followed. Results were synthesized narratively. 17 studies were identified, including only one intervention study. Findings on interventions remain still heterogeneous, but several strategies and factors contributing to safety culture were identified. Some studies emphasized the benefits of critical incident reporting systems. Moreover, several instruments to assess safety culture are available without a known gold standard. Due to the short search period and potential biases within the included studies, conclusions should be drawn cautiously. Nevertheless, the review provides valuable insights into strategies, contributing factors, and measurement instruments that can inform the development of future intervention planning to improve safety culture in long-term care. Further research should aim to determine the most impactful contributing factors and design tailored interventions accordingly. Enhancing safety culture in long-term care settings requires a multifaceted approach. Key elements include staff training, implementation of reporting systems, and process optimization, supported by strong leadership engagement. Regular evaluations based on a suitable measurement instrument and a protracted timeframe are advisable to achieve a meaningful and sustainable cultural change.
本研究探讨了旨在加强长期护理机构安全文化的最新干预策略、促成因素和测量工具。积极的安全文化与提高患者安全相关。虽然在医疗和临床环境中，加强安全文化的策略已有充分记录，但长期护理领域的证据仍然有限。此外，关于促成因素和测量方法的文献也存在异质性。加强对如何在长期护理中加强安全文化的理解，可能会提高与这一极易受伤害的老年人群体打交道的正规护理人员的安全意识。进行了一项快速综合综述，以更新我们之前关于干预措施的工作。从八个数据库中检索了相关的实证和理论研究。由两名独立评审员进行标题、摘要和全文筛选以及数据提取。通过与第三名评审员讨论解决分歧。使用批判性评估工具评估研究质量，并遵循PRISMA指南。结果进行了叙述性综合。共识别出17项研究，其中只有一项干预研究。关于干预措施的研究结果仍然存在异质性，但确定了一些有助于安全文化的策略和因素。一些研究强调了关键事件报告系统的好处。此外，有几种评估安全文化的工具，但尚无已知的金标准。由于搜索期较短且纳入研究中存在潜在偏差，应谨慎得出结论。尽管如此，该综述为策略、促成因素和测量工具提供了有价值的见解，可为未来改善长期护理安全文化的干预计划制定提供参考。进一步的研究应旨在确定最具影响力的促成因素，并据此设计量身定制的干预措施。在长期护理机构中加强安全文化需要采取多方面的方法。关键要素包括员工培训、报告系统的实施和流程优化，并得到强有力的领导参与的支持。建议基于合适的测量工具并在较长时间内进行定期评估，以实现有意义且可持续的文化变革。
