Assessing Resident Safety Culture in Six Nursing Homes in Belgium

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The primary aim was to measure resident safety culture in six nursing homes in northern Belgium (Flanders). In addition, differences in safety culture perceptions between professions were also examined. Finally, results of the present study were compared with the Nursing Home Comparative Database from the Agency for Healthcare Research and Quality (USA).


A cross-sectional study was conducted by administering the Nursing Home Survey on Patient Safety Culture in six nursing homes in Belgium (Flanders). Each nursing home has 92 to 170 licensed nursing home beds. Data collection occurred between December 2016 and January 2017.


Highest mean scores were found for “feedback and communication about incidents” (mean [SD] = 4.20 [0.58]), “overall perceptions of resident safety” (mean [SD] = 4.07 [0.52]), and “supervisor expectations and actions promoting resident safety” (mean [SD] = 4.04 [0.70]). The lowest mean score was found for “staffing” (mean [SD] = 2.99 [0.61]). In addition, managers/supervisors scored significantly higher on all resident safety dimensions, with the exception of the dimensions “teamwork” and “supervisor expectations and actions promoting resident safety.” Finally, the present study scored higher on the dimensions “teamwork,” “nonpunitive response to mistakes,” “handoffs,” “feedback and communication about incidents,” and “communication openness” than the benchmarking data from the Nursing Home Comparative Database.


More work is necessary to improve the safety of resident care in nursing homes, especially regarding staffing issues and turnover rates. The present research findings serve to shine a light on an often-overlooked patient population and emphasize the need to develop improvement strategies for preventing resident safety incidents in nursing homes.

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