title: Nursing home safety: current issues and barriers to improvement.
abstract: The past few decades have seen increasing concern about the quality of nursing home (NH) care. As with other health care sectors, NHs have attempted to embrace a culture of safety, but the additional barriers that they face place the NH industry at a distinct disadvantage. In this review, we provide a summary of current models of NH quality and an overview of two important clinical areas for quality improvement: pressure ulcers and falls. Despite heavy regulation of the NH industry, hoped-for improvements in quality have been limited. We argue that systemic barriers, such as staffing shortages, NH organization, and an adversarial regulatory environment, preclude advances in NH quality.
authors.affiliation: Department of Community Health, Brown University, Providence, RI 02912, USA. agruneir@klaru-baycrest.on.ca
authors.forename: Andrea
authors.initials: A
authors.lastname: Gruneir
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D006801:Humans; D009735:Nursing Homes / Q000458:organization & administration / Q000592:standards*; D015279:Organizational Culture; D017060:Patient Satisfaction; D003668:Pressure Ulcer / Q000453:epidemiology / Q000517:prevention & control; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards; D019984:Quality Indicators, Health Care; D011788:Quality of Life; D017751:Safety Management / Q000379:methods* / Q000592:standards; D014481:United States