1. Surveys
  2. 2015
  3. May
  4. V
  5. Virtua - Mt. Holly Rehabilitation

Virtua - Mt. Holly Rehabilitation

Virtua Health and Rehabilitation Center at Mount Holly
Nursing Home Survey on Patient Safety
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This survey asks for your opinions about resident safety issues in your nursing home. It will take about 15 minutes to complete.


If a question does not apply to your job or you do not know the answer, please mark the box in the last column. If you do not wish to answer a question, you may leave your answer blank.

  • In this survey "resident safety" means preventing resident injuries, incidents, and harm to residents in the nursing home.

Please do NOT use the 'Back' or 'Refresh' buttons in your browser while taking the survey. This might create errors during filling up or submitting the survey.


Section A: Working in This Nursing Home
 
How much do you agree or disagree with the following statements?
Strongly Disagree Disagree Neither Agree Strongly Agree Does Not Apply/Don't Know
1. Staff in this nursing home treat each other with respect.
2. Staff support one another in this nursing home.
3. We have enough staff to handle the workload.
4. Staff follow standard procedures to care for residents.
5. Staff feel like they are part of a team.
6. Staff use shortcuts to get their work done faster.
7. Staff get the training they need in this nursing home.
8. Staff have to hurry because they have too much work to do.
9. When someone gets really busy in this nursing home, other staff help out.
10. Staff are blamed when a resident is harmed.
Strongly Disagree Disagree Neither Agree Strongly Agree Does Not Apply/Don't Know
11. Staff have enough training on how to handle difficult residents.
12. Staff are afraid to report their mistakes.
13. Staff understand the training they get in this nursing home.
14. To make work easier, staff often ignore procedures.
15. Staff are treated fairly when they make mistakes.
16. Residents' needs are met during shift changes.
17. It is hard to keep residents safe here because so many staff quit their jobs.
18. Staff feel safe reporting their mistakes.
 
 
Section B: Communications
 
How often do the following things happen in your nursing home?
Never Rarely Sometimes Most of the time Always Does Not Apply/Don't Know
1. Staff are told what they need to know before taking care of a resident for the first time.
2. Staff are told right away when there is a change in the resident's care plan.
3. We have all the information we need when residents are transferred from the hospital.
4. When staff report something that could harm a resident, someone takes care of it.
5. In this nursing home, we talk about ways to keep incidents from happening again.
6. Staff tell someone if they see something that might harm a resident.
7. Staff ideas and suggestions are valued in this nursing home.
8. In this nursing home, we discuss ways to keep residents safe from harm.
9. Staff opinions are ignored in this nursing home.
10. Staff are given all the information they need to care for residents.
11. It is easy for staff to speak up about problems in this nursing home.
 
 
Section C: Your Supervisor
 
How much do you agree or disagree with the following statements?
Strongly Disagree Disagree Neither Agree Strongly Agree Does Not Apply/Don't Know
1. My supervisor listens to staff ideas and suggestions about resident safety.
2. My supervisor says a good word to staff who follow the right procedures.
3. My supervisor pays attention to resident safety problems in this nursing home.
 
 
Section D: Your Nursing Home
 
How much do you agree or disagree with the following statements?
Strongly Disagree Disagree Neither Agree Strongly Agree Does Not Apply/Don't Know
1. Residents are well cared for in this nursing home.
2. Management asks staff how the nursing home can improve resident safety.
3. This nursing home lets the same mistakes happen again and again.
4. It is easy to make changes to improve resident safety in this nursing home.
5. This nursing home is always doing things to improve resident safety.
6. This nursing home does a good job keeping residents safe.
7. Management listens to staff ideas and suggestions to improve resident safety.
8. This nursing home is a safe place for residents.
9. Management often walks around the nursing home to check on resident care.
10. When this nursing home makes changes to improve resident safety, it checks to see if the changes worked.
 
 
Section E: Overall Ratings
 
 
I would tell my friends that this is a safe nursing home for their family.
 
Yes
 
Maybe
 
No
 
 
Please give this nursing home an overall rating on resident safety.
Poor Fair Good Very Good Excellent
 
 
Section F: Background Information

In this survey, think of your "unit" as the work area, department, or clinical area of the hospital where you spend most of your work time or provide most of your clinical services.

Physicians - Please use your best judgment to select the unit where you provide the most service.
 
 
What is your primary work unit?
 
 
 
What is your job in this nursing home? Check the box that best applies to your job. If more than one category applies, check the highest level job.
 
Administrator/Manager
     Executive Director/Administrator
     Medical Director
     Director of Nursing/Nursing Supervisor
     Department Head
     Unit Manager/Charge Nurse
     Assistant Director/Assistant Manager
     Minimum Data Set (MDS) Coordinator/Resident Nurse
     Assessment Coordinator (RNAC)
 
Physician (MD, DO)
 
Other Provider
     Nurse Practitioner
     Clinical Nurse Specialist
     Physician Assistant
 
Licensed Nurse
     Registered Nurse (RN)
     Licensed Practical Nurse (LPN)
     Wound Care Nurse
 
Nursing Assistant/Aide
     Certified Nursing Assistant (CNA)
     Geriatric Nursing Assistant (GNA)
     Nursing Aide/Nursing Assistant
 
Direct Care Staff
     Activities Staff Member
     Dietician/Nutritionist
     Medication Technician
     Pastoral Care/Chaplain
     Pharmacist
     Physical/Occupational/Speech/Respiratory Therapist
     Podiatrist
     Social Worker
 
Administrative Support Staff
     Administrative Assistant
     Admissions
     Billing/Insurance
     Secretary
     Human Resources
     Medical Records
 
Support Staff
     Drivers
     Food Service/Delivery
     Housekeeping
     Laundry Service
     Maintenance
     Security
 
Other (Please write the title of your job):
 
 
 
How long have you worked in this nursing home?
 
Less than 2 months
 
2 to 11 months
 
1 to 2 years
 
3 to 5 years
 
6 to 10 years
 
11 years or more
 
 
How many hours per week do you usually work in this nursing home?
 
15 or fewer hours per week
 
16 to 24 hours per week
 
25 to 40 hours per week
 
More than 40 hours per week
 
 
When do you work most often?
 
Days
 
Evenings
 
Nights
 
 
Are you paid by a staffing agency when you work for this nursing home?
 
Yes
 
No
 
 
In your job in this nursing home, do you work directly with residents most of the time?
 
YES, I work directly with residents most of the time.
 
NO, I do NOT work directly with residents most of the time.
 
 
In this nursing home, where do you spend most of your time working?
 
Many different areas or units in this nursing home/No specific area or unit
 
Alzheimer's/Dementia Unit
 
Rehab Unit
 
Skilled Nursing Unit
 
Other area or unit (Please Specify):
 
 
 
Section G: Your Comments

Please feel free to write any comments about resident care and safety in this nursing home.