Patient safety culture among community pharmacists in Cairo

Al‑Tehewy et al. Journal of the Egyptian Public Health Association https://doi.org/10.1186/s42506-023-00136-6 Journal of the Egyptian Public Health Association (2023) 98:10 Open Access RESEARCH Patient safety culture among community pharmacists in Cairo Mahi Al‑Tehewy1, Samera Mohamed2 and Noura Ammar1* Abstract Background Measuring perception of patient safety culture among pharmacists working in community pharma‑ cies is crucial to identify opportunities and areas that require improvement. The aim of this work is to measure patient safety culture among pharmacists working in community pharmacies in Cairo. Methods A cross-sectional study was conducted among pharmacists working in community pharmacies in the center and south regions of Cairo. The Pharmacy Survey on Patient Safety Culture (PSOPSC), developed by the Agency for Healthcare Research and Quality (AHRQ) was used to collect data. Results The study included 210 community pharmacies with a 95% response rate. The mean age of pharmacists was 28 ± 5.4 years. The overall positive response percentage (PRP) ranged between 35 and 69% with a mean of 57.4%. The highest PRP was identified in the domains of “teamwork” (68.97%), “organizational learning–continuous improvement” (64.93%) and “patient counseling” (61.83%). The PRP was less than 60% in 6 out of the 11 composites. The lowest PRP was found in the domain of “staffing, work pressure, and pace”, which scored 34.98%. Conclusion The study identified areas of patient safety culture that require improvement in community pharmacies, especially in allocating staff, appropriate working hours, and training community pharmacists on the importance and principles of patient safety. The overall mean PRP of patient safety culture among community pharmacists highlights the need to include patient safety as the strategic priority at the level of community pharmacies. Keywords Patient safety, Safety culture, Community pharmacy 1 Introduction Patient safety is a key pillar of healthcare quality. In recent years, there has been growing interest in patient safety movement. This stimulated research to measure and report on organizational attributes that are believed to promote patient safety. One such attribute is safety culture, defined as a product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and *Correspondence: Noura Ammar 1 Department of Community Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt 2 Memorial Ophthalmic Institute, Cairo, Egypt the style and proficiency of an organization’s health and safety management [1]. Promoting safety culture in community pharmacies becomes a pressing issue as community pharmacies expand their roles from their traditional functions of efficiently dispensing prescriptions [2] to include other services such as immunization which is greatly obvious in supporting the delivery of the coronavirus (COVID-19) vaccination roll-out [3], delivering public health interventions as smoking cessation programs, weight management programs and others [4]. Many tools have been developed for evaluation of patient safety culture [5]. Measuring patient safety in community pharmacies can provide insights that can significantly contribute to organizational quality improvement efforts by raising staff awareness about patient © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Al‑Tehewy et al. Journal of the Egyptian Public Health Association (2023) 98:10 safety as well as identifying areas of strengths and those that require improvement. The Pharmacy Survey on Patient Safety Culture (PSOPSC) developed by AHRQ (The Agency for Healthcare Research and Quality) is designed specifically for community pharmacies. It measures safety dimensions as they relate to the work environment, communication among pharmacy staff, error mitigation, error documentation, and error handling as well as staff perception about the overall safety rating of the pharmacy [6]. Most of the research has always focused on patient safety culture in hospital settings. Little is known about patient safety practices and safety culture in community pharmacies. These care environments continue to be an essential but underappreciated part of the patient care system. The aim of this study was to measure patient safety culture dimensions using PSOPC and to identify factors affecting patient safety culture among pharmacists working in some community pharmacies in center and south of Cairo, Egypt. 2 Methods 2.1 Study design and setting A cross-sectional study was conducted among a purposive sample of pharmacists who work in community pharmacies in central and southern Cairo. 2.2 Study sample A sample size of 210 pharmacists was calculated using Epi-info 7 software at a 95% confidence level and a margin of error of ± 0.05, based on the results of a previous study conducted by Alsaleh et al. 2018 in Kuwait [7] who found that the proportion of pharmacists with positive response for patient safety culture was 83.7%. Due to the unavailability of a list with the names and addresses of all community pharmacies in Cairo, a purposive sample of pharmacists who work in community pharmacies in central and southern Cairo was included in the study. The selection was based upon the accessibility of these regions to the investigators. If a pharmacy employed more than one pharmacist, only the most senior pharmacist who had worked for a long time in the pharmacy and was aware of all the details of the working place was invited to participate to prevent shared opinions. Three hundred fifty-one community pharmacies were invited to complete the questionnaire; however, 70 pharmacies were operating without a pharmacy on duty during the visit time, and 61 pharmacies refused to participate. Finally, 220 questionnaires were distributed and 210 were completed and included in the study. The Page 2 of 9 response rate was 95.5% among those who agreed to participate. 2.3 Data collection methods 2.3.1 Survey instrument The Community Pharmacy Survey on Patient Safety Culture (CPSPC) was developed by the Agency for (...truncated)