Culture at work in Swedish pharmacies: Safety, stress, and dispensing errors

• Background: Relationships between domains of safety culture and medical errors have been established in health care. Such an association could also be expected between safety culture domains and dispensing errors at pharmacies. The relationship has however never been studied. Methods: A cross-sectional study was performed, encompassing 546 (62.8%) of the 870 Swedish community pharmacies. The pharmacies were at the time of the study organised by the National Corporation of Pharmacies. All staff listed as employed 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 examine the relationship between dimensions of pharmacy climate and dispensing errors. Results: Significant relationships between SAQ dimensions safety climate, teamwork climate, job satisfaction, and stress recognition were found, when regressed onto dispensing errors. These relationships disappeared after controlling for respondent and pharmacy demographic variables.  When controlling for demographic variables, only Stress Recognition was still associated with dispensing errors. Conclusion: This study replicated previous work linking safety to errors, but went one step further and controlled for a variety of demographic variables. After controlling these variables, the relationship between safety climate and dispensing errors was rendered insignificant, while the relationship to stress recognition remained significant. The directional arrow between stress recognition and dispensing errors could not be established, but implications for future research into incident reporting, safety culture, and risk management are discussed.

Keyword

Safety climate

dispensing errors

community pharmacy

stress recognition

Publication and Content Type

vet (subject category)

ovr (subject category)