Half of nursing home workers say problems unfairly blamed on staff, survey shows

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Many nursing homes need to treat staff more fairly so that workers feel safe to report mistakes, according to the results of a large survey from the Agency for Healthcare Research and Quality.

More than 16,100 nursing home staff members responded to the survey, which is meant to gauge how nursing home practices contribute to resident safety. It included 42 questions in 12 areas.

“Nonpunitive response to mistakes” was the area with the lowest average positive response rate, of 51%. This indicates widespread problems with workers being blamed when residents experience harm, staff members being treated unfairly when they make a mistake, and not feeling they can safely report mistakes.

The area with the highest average positive response was “overall perceptions of resident safety.” Nearly 90% of respondents said that residents receive good care and are safe.

These same categories ranked at the top and bottom in the prior AHRQ survey report, in 2011.

A strong majority of respondents also said that they discuss ways to keep residents safe from harm and that supervisors pay attention to resident safety issues. Staffing levels are a problem area, with many respondents saying they have to hurry because of workloads.

More than a third of respondents were nursing assistants or aides, followed by support staff and licensed nurses. More than 75% of respondents from a nonprofit ranked their facility “excellent” or “very good,” compared with about 60% in for-profits.

Nursing homes that administer the survey can access a database to compare their results to other facilities' scores. Leaders are encouraged to develop action plans for improvement based on their results, and the report includes a chapter on steps to take.

AHRQ is part of the U.S. Department of Health and Human Services. Click here to access the complete survey results, released Thursday.