"At least Mom will be safe there": the role of resident safety in nursing home quality

A Comparison of Two Distribution Methods on Response Rates to a Patient Safety Questionnaire in Nursing Homes

“…Second, the adversarial and punitive nature of US nursing home regulation may promote a negative culture of distrust. 12 The unease with answering sensitive questions (ie, inquiry of job-related stresses, poor practices, perception of patient safety) may prevent nursing staff from completing surveys. Nursing staff may fear retaliation as a result of the answers they provide and therefore be reluctant to participate.…”

“…The consequences for a poor safety record or reputation in the nursing facility are serious in terms of sanctions. 12 Survey instructions urged respondents to take the survey home to complete. Nevertheless, receiving the survey at the workplace may have placed unintentional influence on providing optimistic responses.…”

Nursing Home Safety: Current Issues and Barriers to Improvement

“…Some have suggested that the shift from a culture of blame to a culture of safety may be even more difficult in the NH setting because of already-stretched resources, limited nursing leadership, high staffing turnover, and the current adversarial regulatory environment (39,81). Yet a number of types of adverse events in NHs are affected by multiple inputs and require a complex organizational approach to address them.…”

“…Fear of chastisement and the perception of error reporting as a personal attack prevent NH staff from openly discussing resident safety issues (33,81). The threat of legal action, both civil liability and criminal prosecution, and the potential for negative publicity for the NH similarly discourage honest discussion among stakeholders (39). …”

Drug use in sub-Saharan Africa: quality in processes--safety in use

“…This includes harm that occurs due to either an adverse drug reaction or a medication error. 4 Medication errors are generally considered to be preventable whereas adverse drug reactions (or side effects, in common parlance) are less so. Medication errors may or may not result in ADEs, and a separate but overlapping body of literature examines these in more detail.…”