Q01
メッセージ
すべてのテンプレートHealthcare & Clinical
Nursing Home Patient Safety Culture Assessment
Surveys nursing home staff on teamwork, staffing adequacy, handoffs, communication openness, and overall resident safety, aligned with the AHRQ Nursing Home Survey on Patient Safety Culture framework. An AI follow-up interview reconstructs a recent safety event or near-miss to surface what actually happened versus what gets reported.
設問の例
テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。
全12問・約7分
Q02
マトリクス必須
Thinking about your day-to-day work, how much do you agree with each statement?
4行 × 5列
- Staff in this nursing home work together as an effective team.
- There are enough staff to handle the workload during evening and night shifts.
- This nursing home relies too much on temporary, agency, or pool staff.
- Staff have to hurry to complete their tasks in this nursing home.
列: Strongly Disagree · Disagree · Neither Agree nor Disagree · Agree · Strongly Agree
Q03
マトリクス必須
How much do you agree with the following statements about communication and feedback in this nursing home?
4行 × 5列
- Staff are told about changes made based on incident reports.
- Staff feel free to question the decisions or actions of those with more authority.
- When a mistake is made with a resident, staff report it, even if no harm resulted.
- Staff are afraid to ask questions when something does not seem right.
列: Strongly Disagree · Disagree · Neither Agree nor Disagree · Agree · Strongly Agree
Q04
マトリクス必須
How much do you agree with the following statements about handoffs and care transitions?
3行 × 5列
- Important resident care information is shared between shifts.
- Things "fall between the cracks" when residents are transferred between units or shifts.
- Staff know what to do and who to contact if a resident's condition worsens.
列: Strongly Disagree · Disagree · Neither Agree nor Disagree · Agree · Strongly Agree
Q05
オピニオンスケール必須
Overall, how would you rate this nursing home on resident safety?
スケール: 1 – 10
最小:Poor最大:Excellent
Q06
選択式必須
In the last 12 months, how many incident or event reports have you personally filled out and submitted?
- None
- 1-2
- 3-5
- 6-10
- 11 or more
Q07
AIインタビュー
Ask the respondent to walk through the most recent safety event or near-miss they witnessed or were involved in at this nursing home: what happened, whether it was reported, and if not, what got in the way of reporting it. If their earlier answers suggest low reporting or fear of speaking up, probe specifically what would make them more comfortable reporting next time. If they say they've never seen a safety event, ask what 'safety' means to them day-to-day instead.
Q08
選択式
What is your primary staff position?
- Certified Nursing Assistant (CNA)
- Licensed Nurse (RN/LPN/LVN)
- Nurse Manager or Director of Nursing
- Administrator
- Other clinical staff
- Other non-clinical staff
- Prefer not to say
Q09
選択式
How long have you worked in this nursing home?
- Less than 6 months
- 6 months to less than 1 year
- 1 to 3 years
- 3 to 6 years
- 6 to 10 years
- 11 years or more
- Prefer not to say
Q10
選択式
On average, how many hours per week do you work in this nursing home?
- Less than 20
- 20-34
- 35-40
- More than 40
- Prefer not to say
Q11
選択式
Which shift do you work most often?
- Day
- Evening
- Night
- Rotating or varies
- Prefer not to say
Q12
メッセージ
Thank you for your candor. Your responses will be combined with your colleagues' answers into a confidential safety culture report used to guide staffing, training, and communication improvements — no individual responses will be shared.
含まれる機能
AIによる深掘り
自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。
注意確認設問
急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。
AIが作成する設問文
文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。
自動レポート
回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。
他ツールとの比較
ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。
このテンプレートを選ぶ理由
- Includes an AI follow-up interview that asks staff to reconstruct a specific recent safety event or near-miss, surfacing what actually happened versus what gets formally reported.
- Covers the core AHRQ Nursing Home Survey on Patient Safety Culture domains — teamwork, staffing adequacy, handoffs/care transitions, and communication openness — via structured matrix questions.
- Captures respondent context (staff position, tenure, weekly hours, shift) and incident-reporting frequency alongside an overall safety rating, so patterns can be segmented by role and shift.
- Automated per-response quality scoring and an auto-generated report turn open-ended event narratives into structured, reviewable findings without manual transcription.
SurveyMonkey
AHRQ Surveys On Patient Safety Culture™(SOPS™) Nursing Home Survey TemplateA fielding-ready template built directly on the same AHRQ SOPS Nursing Home framework, making it the closest direct comparison. It's a static questionnaire meant to be deployed as-is, with SurveyMonkey's standard analytics dashboards for reporting. Good for benchmarking against the AHRQ instrument, but it doesn't probe beyond the fixed item set.
優れている点
- Built on the recognized AHRQ SOPS Nursing Home instrument, giving it face validity and easy benchmarking against the published framework
- Ready to deploy on a widely used, familiar survey platform
- Likely includes standard charting/reporting tools for quantitative item scores
物足りない点
- Fixed-question format with no adaptive AI follow-up to reconstruct specific safety events or near-misses
- No voice AI interview or guided screen-share task option for richer qualitative data
- No automated per-response quality scoring of open-ended answers
SurveySparrow
Patient Safety Culture Survey TemplateA general healthcare patient safety culture template rather than one specifically aligned to the AHRQ Nursing Home framework, so it's broader but less tailored to nursing home staffing/handoff nuances. It's a conversational-style static form, not a template with adaptive interviewing built in. Useful as a general safety-culture starting point but would need customization for nursing home specifics.
優れている点
- Conversational, chat-style question flow that may feel more approachable to respondents than a plain grid survey
- General healthcare patient safety culture focus applicable across care settings
- Likely offers standard SurveySparrow reporting and dashboard views
物足りない点
- Not explicitly aligned to the AHRQ Nursing Home Survey on Patient Safety Culture domains (staffing, handoffs, etc.)
- No adaptive AI follow-up interview to reconstruct a specific safety event or near-miss
- No transparent prompt methodology or automated quality scoring of narrative responses
よくあるご質問
「Nursing Home Patient Safety Culture Assessment」テンプレートにはどのような設問が含まれていますか？
すぐに使える設問が12問含まれており、最初の設問は次のとおりです：「Thanks for taking a few minutes to share your honest perspective on safety culture where you work. Your answers are conf…」・「Thinking about your day-to-day work, how much do you agree with each statement?」・「How much do you agree with the following statements about communication and feedback in this nursing home?」。すべての設問は上でプレビューでき、自由に編集できます。
このアンケートの回答にはどのくらい時間がかかりますか？
回答者は通常、12問を約7分で回答し終えます。
テンプレートは編集できますか？
はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。
このテンプレートは無料で使えますか？
はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。
公開の準備はできましたか？
このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。
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