Thus, a limitation of this approach is that these groupings were not based on any empirical estimation, and more refined analyses should develop and use measures more closely resembling resident safety indices. However, we note that no consensus exists on defining and distinguishing these deficiency citations as measures of resident safety. In this analysis, we grouped together deficiency citations related to resident safety. Thus, as more direct measures of resident safety, examining these deficiency citations may be important in further understanding how problematic resident safety issues are in nursing homes. To date, no empirical research has examined deficiency citations for resident safety in nursing homes. However, more direct measures of safety issues in nursing homes exist as violations of Medicare/Medicaid regulations (commonly called deficiency citations). Average scores for almost all areas of resident safety culture assessed in this prior research were low, indicating endemic poor safety culture environments in nursing homes. As documentation of resident safety a proxy measure was used in this prior research – the resident safety culture ( Castle et al., 2007). nursing homes” ( Castle, Handler, Engberg, & Sonon, 2007, p. Research has identified resident safety to be “a potential problem in U.S. Nursing homes provide social, nursing, and medical care therefore, this modification is more specific to the nursing home context (i.e., freedom from accidental or preventable injuries produced by care). The definition was modified slightly by removing “medical” in the text. We use this definition because it is concise, it is commonly cited, and can be applied to the nursing home setting. We use a modified version of the definition of patient safety from The Agency for Healthcare Research and Quality (AHRQ), which is, “Freedom from accidental or preventable injuries produced by medical care” ( AHRQ, 2008, p. Examining internal, organizational, and external factors is important, because it is expected that these factors may help explain why some nursing homes are more likely to receive these deficiency citations than others.Īs several authors have noted, many definitions of patient safety exist ( National Patient Safety Foundation, 2000). Second, internal (i.e., operating characteristics of the facility), organizational (i.e., characteristics of the facility itself) and external (i.e., characteristics generally outside of the influence of the organization) factors associated with deficiency citations for safety violations are examined. Examining scope and severity provides information on the likely impact safety violations have on residents’ quality of life. Scope and severity are classifications used to categorize the extent of potential harm for each deficiency citation received by a facility (described below). nursing homes from 2000 to 2007 are examined (representing a panel of 119,472 observations). First, the scope and severity of deficiency citations for safety violations in U.S. In the research presented here, deficiency citations for violations of resident safety are examined in two ways.
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