title: Safety culture perceptions of pharmacists in Malaysian hospitals and health clinics: a multicentre assessment using the Safety Attitudes Questionnaire.
abstract: OBJECTIVE
  To assess the safety attitudes of pharmacists, provide a profile of their domains of safety attitude and correlate their attitudes with self-reported rates of medication errors.
  
  
  METHODS
  A cross-sectional study utilising the Safety Attitudes Questionnaire (SAQ).
  
  
  METHODS
  3 public hospitals and 27 health clinics.
  
  
  METHODS
  117 pharmacists.
  
  
  METHODS
  Safety culture mean scores, variation in scores across working units and between hospitals versus health clinics, predictors of safety culture, and medication errors and their correlation.
  
  
  RESULTS
  Response rate was 83.6% (117 valid questionnaires returned). Stress recognition (73.0±20.4) and working condition (54.8±17.4) received the highest and lowest mean scores, respectively. Pharmacists exhibited positive attitudes towards: stress recognition (58.1%), job satisfaction (46.2%), teamwork climate (38.5%), safety climate (33.3%), perception of management (29.9%) and working condition (15.4%). With the exception of stress recognition, those who worked in health clinics scored higher than those in hospitals (p<0.05) and higher scores (overall score as well as score for each domain except for stress recognition) correlated negatively with reported number of medication errors. Conversely, those working in hospital (versus health clinic) were 8.9 times more likely (p<0.01) to report a medication error (OR 8.9, CI 3.08 to 25.7). As stress recognition increased, the number of medication errors reported increased (p=0.023). Years of work experience (p=0.017) influenced the number of medication errors reported. For every additional year of work experience, pharmacists were 0.87 times less likely to report a medication error (OR 0.87, CI 0.78 to 0.98).
  
  
  CONCLUSIONS
  A minority (20.5%) of the pharmacists working in hospitals and health clinics was in agreement with the overall SAQ questions and scales. Pharmacists in outpatient and ambulatory units and those in health clinics had better perceptions of safety culture. As perceptions improved, the number of medication errors reported decreased. Group-specific interventions that target specific domains are necessary to improve the safety culture.
authors.affiliation: Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia Department of Pharmacy Practice and Development, Malacca State Pharmaceutical Services Division, Ayer Keroh, Malacca, Malaysia.
authors.forename: Srima Elina
authors.initials: SE
authors.lastname: Samsuri
authors.affiliation: Community Health Research Cluster, Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kampus Gong Badak, Kuala Nerus, Terengganu, Malaysia.
authors.forename: Lua
authors.initials: L
authors.lastname: Pei Lin
authors.affiliation: Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia Department of Pharmaceutical & Life Sciences, Communities of Research, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia.
authors.forename: Mathumalar Loganathan
authors.identifier: http://orcid.org/0000-0002-9042-4290
authors.initials: ML
authors.lastname: Fahrni
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008296:Malaysia; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data; D008508:Medication Errors / Q000706:statistics & numerical data; D008875:Middle Aged; D015279:Organizational Culture; D061214:Patient Safety; D010595:Pharmacists / Q000523:psychology*; D010607:Pharmacy Service, Hospital; D017751:Safety Management / Q000592:standards*; D011795:Surveys and Questionnaires; D017132:Workplace / Q000592:standards
keywords: HEALTH SERVICES ADMINISTRATION & MANAGEMENT