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Patient Safety Culture Survey in Pediatric Complex Care Settings: A Factor Analysis

Amanda J Hessels1, Meghan Murray, Bevin Cohen

  • 1From the Columbia University School of Nursing, New York, New York.

Journal of Patient Safety
|April 21, 2017
PubMed

Insights

The Nursing Home Survey on Patient Safety Culture can be adapted to measure patient safety culture in pediatric long-term care facilities. This validated tool helps identify areas for improvement in these specialized settings.

Area of Science:

  • Healthcare Management
  • Patient Safety
  • Pediatric Care

Background:

  • The number of children with complex medical needs is rising, increasing demand for pediatric long-term care (pLTC) facilities.
  • A strong patient safety culture (PSC) is crucial in pLTC, but no validated measurement tool exists for this unique setting.
  • Existing tools need evaluation for suitability in the hybrid acute care-residential environment of pLTC.

Purpose of the Study:

  • To evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture (NHSOPSC) adapted for pLTC.
  • To determine if the NHSOPSC, with minor modifications, is a reliable instrument for assessing PSC in pediatric long-term care.

Main Methods:

  • Factor analyses (principal axis factoring, confirmatory, and exploratory) were conducted on data from 239 staff across 3 pLTC facilities.
  • Reliability was assessed using Cronbach's alpha.
  • The original 12-dimension structure was tested and compared to a modified structure.

Main Results:

  • Exploratory factor analysis suggested 4 dimensions (staffing, nonpunitive response to mistakes, communication openness, organizational learning) might not fit well.
  • Both original and modified NHSOPSC factor solutions showed similar reliabilities to those reported for adult nursing homes.
  • Items factored nearly identically as theorized in the pLTC setting.

Conclusions:

  • The NHSOPSC, with minimal modifications, appears appropriate for measuring PSC in pLTC settings.
  • Further psychometric testing is recommended to validate its use and examine relationships with safety outcomes.
  • Wider use can provide benchmarking data to guide improvements in pediatric long-term care safety.
Abstract

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