Abstract
BackgroundThe potential for unsafe acts to result in harm to patients is constant risks to be managed in any health care delivery system including pharmacies. The number of reported errors is influenced by a various elements including safety culture. The aim of this study is to investigate a possible relationship between reported dispensing errors and safety culture, taking into account demographic and pharmacy variables, in Swedish community pharmacies.MethodsA cross-sectional study was performed, encompassing 546 (62.8%) of the 870 Swedish community pharmacies. All staff in the pharmacies on December 1st, 2007 were included in the study. To assess safety culture domains in the pharmacies, the Safety Attitudes Questionnaire (SAQ) was used. Numbers of dispensed prescription items as well as dispensing errors for each pharmacy across the first half year of 2008 were summarised. Intercorrelations among a number of variables including SAQ survey domains, general properties of the pharmacy, demographic characteristics, and dispensing errors were calculated. A negative binomial regression model was used to further examine the relationship between the variables and dispensing errors.ResultsThe first analysis demonstrated a number of significant correlations between reported dispensing errors and the variables examined. Negative correlations were found with SAQ domains Teamwork Climate, Safety Climate, Job Satisfaction as well as mean age and response rates. Positive relationships were demonstrated with Stress Recognition (SAQ), number of employees, educational diversity, birth country diversity, education country diversity and number of dispensed prescription items. Variables displaying a significant relationship to errors in this analysis were included in the regression analysis. When controlling for demographic variables, only Stress Recognition, mean age, educational diversity and number of dispensed prescription items and employees, were still associated with dispensing errors.ConclusionThis study replicated previous work linking safety to errors, but went one step further and controlled for a variety of variables. Controlling rendered the relationship between Safety Climate and dispensing insignificant, while the relationship to Stress Recognition remained significant. Variables such as age and education country diversity were found also to correlate with reporting behaviour. Further studies on the demographic variables might generate interesting results.
Highlights
The potential for unsafe acts to result in harm to patients is a constant risk to be managed in any health care delivery system
A significant negative correlation was found between dispensing errors and Teamwork Climate (−0.09), Safety Climate, (−0.12) and Job Satisfaction (−0.12) respectively; high levels in these Safety Attitudes Questionnaire (SAQ) dimensions were associated with low levels of errors
A significant positive relationship was demonstrated between the Stress Recognition dimension (0.10) and dispensing errors, i.e., respondents that acknowledged the impact of stress on their performance, were more likely to report dispensing errors
Summary
The potential for unsafe acts to result in harm to patients is constant risks to be managed in any health care delivery system including pharmacies. The potential for unsafe acts to result in harm to patients is a constant risk to be managed in any health care delivery system. In pharmacies these unsafe acts might consist of dispensing errors that can result in patients receiving the wrong medicine. In community which these errors occur have a strong impact and includes such variables as fatigue, high workload, overwork and interruptions [2,5,9]. The reasons include inadequate and unsatisfactory safety procedures, resulting in a lack of common definitions and classification of errors [12], staff ignorance of the purpose of reporting, [13] or shortcomings in staff abilities to follow existing guidelines. [14] They include the impact of inter- and intra-professional values and interactions. [14] Other reasons can be attributed to the safety culture in the workplace, including employees’ shared perceptions of policies, practices, and procedures that are rewarded, supported and expected [15]
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