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      Adverse Events and Risk Management in Residential Aged Care Facilities: A Cross-Sectional Study in Hunan, China


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          Adverse events threaten residents’ safety. Risk management is important to provide proper care and maintain quality in residential aged care facilities (RACFs). However, there is little data on adverse events, risk management, and risk early warning in RACFs in the Chinese mainland. This study aimed to fill this gap by investigating the prevalence of the aforementioned aspects and related factors in China.

          Participants and Methods

          Using a cross-sectional design, a field survey of 272 RACFs in Hunan Province was conducted from January 25 to June 1, 2020. Data were collected using four main tools on prevalence of nursing adverse events, risk management, risk early warning, and general information. Descriptive statistics were described by frequency (percentage) and median (interquartile range). Mann–Whitney U-test and Kruskal–Wallis H-test, and Spearman coefficient were used for statistical analysis.


          RACFs experienced an average of five (15) adverse events in 2019, with falls and pressure ulcers being the most common. The total average score of risk management in RACFs was 4.72 (0.98) out of 5, with the environment and personnel management dimensions scoring the highest with 4.75 (1) and the service management dimension scoring the lowest with 4.60 (1). Only 72.79% had trained their staff on ethical and legal knowledge and 84.56% had utilized pre-hospital first aid. Further, 30% to 40% were unprepared for contingency plans of suicide, electric shock, gas poisoning, and drowning. There were significant risk management differences among the following variables: facilities’ locations, accreditation with the Practice Certificate of Social Welfare Facilities, bed-size, nursing hours per resident day, requirement for nursing staff with certificates, and payment for nursing staff (p < 0.05).


          RACFs are facing safety challenges with a high prevalence of nursing adverse events. These facilities need to improve risk early warning and management to ensure residents’ safety.

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              Long-term care system for older adults in China: policy landscape, challenges, and future prospects

              In China, the population is rapidly ageing and the capacity of the system that cares for older people is increasingly a concern. In this Review, we provide a profile of the long-term care system and policy landscape in China. The long-term care system is characterised by rapid growth of the residential care sector, slow development of home and community-based services, and increasing involvement of the private sector. The long-term care workforce shortage and weak quality assurance are concerning. Public long-term care financing is minimal and largely limited to supporting welfare recipients and subsidising the construction of residential care beds and operating costs. China is piloting social insurance long-term care financing models and, concurrently, programmes for integrating health care and long-term care services in selected settings across the country; the effectiveness and sustainability of these pilots remain to be seen. Informed by international long-term care experiences, we offer policy recommendations to strengthen the evolving care system for older people in China.

                Author and article information

                Risk Manag Healthc Policy
                Risk Manag Healthc Policy
                Risk Management and Healthcare Policy
                29 March 2022
                : 15
                : 529-542
                [1 ]School of Nursing, Hunan University of Chinese Medicine , Changsha, People’s Republic of China
                [2 ]School of Nursing, Xiangnan University , Chenzhou, People’s Republic of China
                Author notes
                Correspondence: Chunhong Shi, Tel +86 15907354840, Fax +86 735 2325007, Email shichunhong@xnu.edu.cn
                Author information
                © 2022 Li and Shi.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                : 07 December 2021
                : 14 March 2022
                Page count
                Figures: 4, Tables: 5, References: 82, Pages: 14
                Funded by: the Hunan Social Science Achievement Evaluation Committee;
                Funded by: the General Project of Hunan Philosophy and Social Science Fund;
                Funded by: the General Project of Education Department of Hunan Province;
                Funded by: 2018 key scientific research projects of Hunan Provincial Department of Education;
                This study was supported by the Hunan Social Science Achievement Evaluation Committee (grant no. XSP20YBC164), 2018 key scientific research projects of Hunan Provincial Department of Education [grant no. 18A459], the General Project of Hunan Provincial Department of Education [grant no. 21C0723], the General Project of Hunan Philosophy and Social Science Fund [grant no. 17Y3A361], Hunan Clinical Medical Technology Demonstration Base[grant no. 2021sk4046].
                Original Research

                Social policy & Welfare
                safety measures,quality of nursing care,nursing homes,geriatric care
                Social policy & Welfare
                safety measures, quality of nursing care, nursing homes, geriatric care


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