# Enhancing Safety Culture for Formal Caregivers in Long-Term Care: A Rapid Review

## TL;DR

This paper reviews strategies to improve safety culture for caregivers in long-term care, highlighting the need for better interventions and measurement tools.

## Contribution

The study provides a rapid review of recent strategies and factors influencing safety culture in long-term care settings.

## Key findings

- Few intervention studies exist, and findings remain heterogeneous.
- Critical incident reporting systems and staff training are emphasized as beneficial.
- No gold standard measurement instrument for safety culture was identified.

## Abstract

Aim: This study explores the latest intervention strategies, contributing factors, and measurement instruments aimed at enhancing safety culture in long-term care settings.

Background: A positive safety culture is associated with increased patient safety. While strategies to enhance safety culture are well documented in medical and clinical settings, evidence from the long-term care sector remains limited. Furthermore, the literature is heterogeneous regarding contributing factors and measurement approaches. Strengthening the understanding of how to enhance safety culture in long-term care could raise safety awareness among formal caregivers working with this highly vulnerable population of older adults.

Methods: A rapid integrative review was conducted to update our previous work on interventions. Relevant empirical and theoretical studies were retrieved from eight databases. The title, abstract, and full-text screening, as well as data extraction, were performed by two independent reviewers. Discrepancies were resolved through discussion with a third reviewer. Study quality was assessed using critical appraisal tools, and PRISMA guidelines were followed. Results were synthesized narratively.

Results and Conclusion: 17 studies were identified, including only one intervention study. Findings on interventions remain still heterogeneous, but several strategies and factors contributing to safety culture were identified. Some studies emphasized the benefits of critical incident reporting systems. Moreover, several instruments to assess safety culture are available without a known gold standard. Due to the short search period and potential biases within the included studies, conclusions should be drawn cautiously. Nevertheless, the review provides valuable insights into strategies, contributing factors, and measurement instruments that can inform the development of future intervention planning to improve safety culture in long-term care. Further research should aim to determine the most impactful contributing factors and design tailored interventions accordingly.

Implications for Nursing Management: Enhancing safety culture in long-term care settings requires a multifaceted approach. Key elements include staff training, implementation of reporting systems, and process optimization, supported by strong leadership engagement. Regular evaluations based on a suitable measurement instrument and a protracted timeframe are advisable to achieve a meaningful and sustainable cultural change.