Hospitals

Background: Patient safety is evaluated using both internal assessments of safety culture and external hospital rating systems; however, the extent to which these measures capture related dimensions of patient safety remains uncertain. Methods: This study examined the association between hospital patient safety culture ratings and hospital safety grades. Using 2024 hospital-level data, patient safety culture was measured using the overall safety rating from the AHRQ Hospital Survey on patient safety culture and hospital safety grades derived from Leapfrog Safety Grades. Results: No significant association was observed between patient safety culture ratings and the likelihood of receiving higher Leapfrog Grades. Hospital bed size, however, was significantly associated with Leapfrog Grades, with larger hospitals demonstrating lower odds of receiving higher grades. Conclusions: These findings indicate that further research is needed to assess congruence between internal perceptions of patient safety culture and external hospital safety ratings. The results underscore potential measurement differences between federal survey-based assessments and private nonprofit grading methodologies and suggest caution in assuming equivalence across patient safety metrics. Further research is warranted to clarify how these tools align and to determine their respective roles in evaluating hospital patient safety.

This study analyzed environmental noise levels in neonatal hospital units, including both low- and high-risk nurseries, as well as neonatal intensive care units (NICUs). Continuous 24 h measurements over ten days revealed that average sound levels significantly exceeded international recommendations. Hourly $L_{Aeq}$ values frequently reached or surpassed 65 dB, with over 20% of daily recordings exceeding this limit, and in some instances, more than 50%. Heatmaps indicated consistent noise patterns: high-risk nurseries experienced peaks during late morning and afternoon, low-risk nurseries at night, while NICU maintained elevated levels throughout the day. The main sources of noise included alarms, medical equipment, and activity from staff or visitors. This highlights the need for hospital policies aimed at protecting the neurosensory health of neonates. These findings provide evidence-based recommendations for creating quieter environments in neonatal care.

This study explores how hospital location (rural/non-rural) may moderate the nurse staffing ratio’s impact on three hospital-acquired infections. This study used data from 2022 to 2024 on nurse staffing and hospital characteristics from the American Hospital Association Annual Survey and data on hospital-acquired infection rates from the Medicare Care Compare dataset provided by the Centers for Medicare and Medicaid Services. After removing missing values, the final dataset included 7997 hospital-year observations across the US. Independent variables include rural hospital designation, nursing hours per patient day, and RN FTE per adjusted day. The dependent variables included infection rates of Central Line-Associated Bloodstream Infection, Catheter-Associated Urinary Tract Infection, and Methicillin-Resistant Staphylococcus aureus. Multiple regression was performed in Stata 18. Our research found that across all three infection types, an increase in nursing hours per patient day is significantly associated with a decrease in the infection rate, and that impact was not moderated by hospital rurality. Extra time spent with patients in either a rural or non-rural hospital decreased hospital-acquired infection rates. While RN FTEs were included in the model, total nursing hours per patient day emerged as the more consistent predictor of lower hospital-acquired infection rates.