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Older Adults’ Perceptions of Feeling Safe in Urban and Rural Acute Care

Lasiter, Sue PhD, RN; Duffy, Joanne PhD, RN, FAAN

JONA: The Journal of Nursing Administration: January 2013 - Volume 43 - Issue 1 - p 30–36
doi: 10.1097/NNA.0b013e3182786013

OBJECTIVE: The purposes of this study were to identify factors that influenced hospitalized older adults’ perceptions of feeling safe and to identify differences in perceptions between rural and urban contexts.

BACKGROUND: Efforts are underway to ensure patient physical safety and improve care quality in acute-care environments. Perception of care is a unique and independent dimension of quality that includes patients’ views of care and how these perceptions might affect responses to illness.

METHOD: Grounded theory method was used to identify the basic social process of feeling safe in acute care.

RESULTS: Older adults felt safe when nurses provided oversight, were predictable, provided personalized care, and were willing to advocate for them.

CONCLUSIONS: Findings are consistent with professional models that center on the human relational components of care. Nurse leaders can facilitate practice environments where relational aspects of nurse work, including patients’ perceptions of feeling safe, are the norm, thereby creating exceptional patient care delivery systems.

Author Affiliations: Assistant Professor of Nursing (Dr Lasiter), School of Nursing, Department of Adult Health, Indiana University, Indianapolis; Professor (Dr Duffy), The WVUH Endowed Professor of Research and Evidence-Based Practice, West Virginia University, Robert C. Byrd Health Sciences Center, Morgantown, and Adjunct Professor, School of Nursing, Indiana University, Indianapolis.

Funding was received from the American Organization of Nurse Executives Seed Grant 2011.

The authors declare no conflicts of interest.

Correspondence: Dr Lasiter, School of Nursing, Department of Adult Health, Indiana University, NUR 433W, Indianapolis, IN 46202 (

© 2013 Lippincott Williams & Wilkins, Inc.