The past few decades have seen increasing concern about the quality of nursing home (NH) care. As with other health care sectors, NHs have attempted to embrace a culture of safety, but the additional barriers that they face place the NH industry at a distinct disadvantage. In this review, we provide a summary of current models of NH quality and an overview of two important clinical areas for quality improvement: pressure ulcers and falls. Despite heavy regulation of the NH industry, hoped-for improvements in quality have been limited. We argue that systemic barriers, such as staffing shortages, NH organization, and an adversarial regulatory environment, preclude advances in NH quality.

中文翻译：

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疗养院安全：当前的问题和改进的障碍。

在过去的几十年中，人们越来越关注养老院（NH）的护理质量。与其他医疗保健部门一样，NHs尝试采用安全文化，但是它们所面临的其他障碍使NHs行业处于明显的劣势。在这篇综述中，我们提供了目前NH质素模型的摘要，并概述了两个重要的可改善质量的临床领域：压疮和跌倒。尽管对NH行业进行了严格的监管，但改善质量的希望仍然有限。我们认为，系统性障碍（例如人员短缺，NH组织和对抗性监管环境）阻碍了NH质量的提高。