Mercer University

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 article emphasizes the need for enhanced leadership development across all levels of nursing education, particularly focusing on social change and health equity. While leadership is a core nursing competency, many programs offer limited or late-stage preparation. We review current approaches to leadership development and advocate for embedding leveled competencies throughout nursing curricula using the Social Action, Leadership, and Transformation (SALT) model as a framework to cultivate empathy, critical consciousness, justice, and community engagement. The SALT model supports the development of nurses capable of leading transformative changes in health care systems. It aligns with the American Association of Colleges of Nursing Essentials and other established frameworks. By incorporating the SALT model, nursing programs can better prepare graduates to address systemic health inequities and promote social change. The article calls on nurse educators to adopt this model to ensure leadership education is purposeful, equitable, and action-oriented.

Background/Objective: Effective topical delivery of 4-phenylbutyric acid (4-PBA) for arsenical vesicant-induced skin injury requires nanocarrier systems that maintain physicochemical and chemical stability during extended storage. This study systematically evaluated the six-month stability of five 4-PBA-loaded micro/nanoparticulate formulations—chitosan nanoparticles (N31, N35), emulsomes (E2), microsponges (MSs), and PLGA nanoparticles (P1)—to identify lead candidates suitable for field deployment and foam integration. Methods: Formulations were subjected to ICH-accelerated stability testing at 25 °C/60% RH and 40 °C/75% RH, with monthly evaluation of particle size, polydispersity index, zeta potential, drug content by HPLC, and chemical/thermal stability by FTIR and DSC. Results: N31 demonstrated superior colloidal stability, maintaining particle size within acceptable limits at both conditions despite progressive surface charge neutralization. E2 showed consistent drug content retention and preserved chemical integrity, though moderate vesicle fusion occurred. MS underwent complete physical degradation at 40 °C within the first month, while P1 exhibited hydrolytic degradation with substantial drug loss. N35 showed severe aggregation indicating colloidal instability. Conclusions: N31 and E2 emerged as lead candidates: N31 is recommended for field deployment where environmental control is limited, while E2 is suitable for controlled storage settings prioritizing drug loading capacity.