Background: Lay press investigations have been published that describe pharmacist errors and the workplace environment in the community pharmacy setting. However, recent studies that explore pharmacists' perceptions of patient safety in the workplace are limited. Objectives: 1) To describe pharmacists' perceptions of workplace patient safety; 2) To compare pharmacists' perceptions of workplace patient safety across practice setting type, pharmacist roles, average hours worked per shift, and average hours worked per week. Methods: Actively licensed Tennessee pharmacists were recruited from January 1 and June 30, 2019 to complete a 13-item survey of workplace patient safety perceptions ( =1391). Descriptive statistics were calculated, and nonparametric statistical tests employed to compare differences in perceptions across practice setting type, pharmacist roles, and hours worked per shift and per week. Results: Statistically significant differences in workplace patient safety perceptions were noted across practice setting type (p values <.001) and pharmacist roles (p values <.001). The extent to which pharmacists agreed/strongly agreed that their employer provides a work environment that allows for safe patient care ranged from 29.7% of chain community pharmacists to 85% of compounding pharmacists. Fifty-two percent of staff pharmacists, 56.5% of relief pharmacists, and 58.5% of managers/pharmacists in charge agreed or strongly agreed that their employer provides a work environment that allows for safe patient care, whereas 89.3% of regional managers/directors/vice-presidents and 72.5% of clinical/specialty pharmacists indicated the same. Average hours per shift was inversely correlated with perceptions of workplace patient safety (p values <.001). Conclusion: Tennessee pharmacists' perceptions of workplace patient safety varied widely across practice setting type and pharmacist roles. Perceptions of safety were notably lower in the chain community pharmacy setting. Additional research is warranted to better understand the relationship between pharmacist perceptions and quantifiable patient safety metrics, particularly in the chain community pharmacy setting.

The aim of this thesis is to examine the contributory factors in drug errors and their reporting so as to design an enhanced reporting scheme to improve the quality of reporting in an acute hospital trust. The related research questions are: 1. What are the contributory factors in drug errors? 2. How effective is the reporting of drug errors? 3. Can an enhanced reporting scheme, predicated on the analysis of local documentary and interview data, identify the contributory factors in drug errors and improve the quality of their reporting in an acute hospital trust? The study aim and research questions reflect a growing consensus, articulated by Boaden and Walshe (2006), that patient safety research should focus on understanding the causes of adverse events and developing interventions to improve safety. Although there are concerns about the value of incident reporting (Wald & Shojania 2003, Armitage & Chapman 2007), it would appear that error reporting systems remain a high priority in advancing patient safety (Kohn et al 2000, Department of Health 2000a, National Patient Safety Agency 2004, WHO & World Alliance for Patient Safety 2004), and consequently it is the area chosen for intervention in this study. Enhancement of the existing scheme is based on a greater understanding of drug errors, their causation, and their reporting.

The need for a positive safety culture in healthcare is essential. It not only advances the prevention and reduction of possible medical errors and threats to patient safety, but also enhances the overall quality of healthcare services provided, especially in respect of medication safety. While the evolution and surge in hospital pharmacies has bolstered treatment possibilities, the risk of harm to patients has also increased as errors in the provision of medication by pharmacists create a threat to patient safety. The increasing need to deploy a protective measure to enhance patient safety culture in the healthcare is imperative suggesting the necessity for the inclusion of new knowledge through the process of organizational learning. Safety culture and organizational learning are complex constructs which may be measured, to some extent, by validated instruments. The current study seeks to assess the reliability and validity of a translated Arabic version of the learning organization survey short-form (LOS-27), and the pharmacy survey on patient safety culture (PSOPSC) through the evaluation of pharmacy staff’s knowledge about organizational learning and patient safety culture in public and private hospital pharmacies of Kuwait. The aim is to explore the relationship between organizational learning and patient safety culture in hospital pharmacy settings through the LOS-27 and PSPOSC instruments. In addition, the relationship between the different dimensions of organizational learning and pharmacy patient safety culture is explored. The results highlighted the adequacy of the Arabic translation of the LOS-27 and PSOPSC questionnaires as they depicted the reliability and validity consistent with the original surveys results. It was also found that in the context of Kuwaiti pharmacies, organizational learning was positively related to performance of the staff in creating a positive patient safety culture. Several dimensions of the organizational learning showed association with various elements of patient safety culture in pharmacy settings, specifically: training, management that reinforces learning, and a supportive learning environment had the strongest effects on the pharmacy patient safety culture dimensions. The contribution of this thesis is in three areas. First, it is the first research that links organizational learning with patient safety culture in a hospital pharmacy setting (theoretical contribution). Second, the research is useful for research scholars as it combines the two questionnaires, LOS-27 and PSOPSC, on the same participants using a single form to explore the relationship between organizational learning and patient safety culture in a hospital pharmacy setting and their dimensions (method contribution). Third, this research contributed to the currently limited literature that examines patient safety culture and organizational learning by considering the context of Kuwait (Contextual Contribution).

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The impact of Computerized Physician Order Entry (CPOE) on the dependent variables of medication-order compliance and time to first dose of antibiotic was investigated in this quasi-experimental study of a naturally-occurring CPOE intervention. The impact of CPOE on compliance and time to first dose was assessed by comparing measures of these variables from the intervention site and a non-equivalent control before and during intervention phases. Medication orders placed using CPOE were significantly more compliant than paper-based medication orders (p<.001), and first doses of antibiotic ordered using CPOE were delivered significantly faster than antibiotic orders placed using the paper-based system (p<.001). Findings support previous research indicating the positive impact of CPOE on patient safety as well as justify and enable future interventions to increase CPOE adoption and use among physicians. Additionally, data collected in this study will be used to provide behavior-based feedback to physicians as part of CPOE adoption and use intervention strategies to be explored in the forthcoming research. / Master of Science

Yes / This article reports the use of a mobile cancer care unit (Cancer Van) to provide continuity of care to patients with cancer who utilise the services of Airedale NHS Foundation Trust. The article contains data that shows the resilience of this service during the Covid19 pandemic and provides evidence that this type of service is beneficial for patient care. / Hope for Tomorrow

Independent on where in the world one is, patient safety is regarded as one of the most important aspects in the healthcare industry. On the contrary, depending on where you are, the patient safety will differ and is therefore location dependent. The patient safety in a developing country will therefore be evaluated in a different way compared to a developed country. This study, therefore aimed to identify the patient safety in Puntland, Somalia and with it, its healthcare environment in the hospitals. The goal was to identify the main factors that affected the patient safety. To investigate this, a field study to the region of interest was made and subsequently interviews with staff at the site were conducted as well as observations in the concerned hospitals. The obtained results were analysed using the method of Qualitative Content Analysis. At a later stage, the results could be thematized into four categories; “​Need​”, “​Device​”, “​Training​” and “​Knowledge​”, which pinpointed the main issues. The study show that there was a common transversal issue of a inherent lack of devices, training and knowledge which in turn could severely affect the patients and their safety in ways such as misdiagnosis, delayed treatment and in worst cases death. Furthermore, it was evident that rather than the lack of actual devices, the absence of knowledge was more prevalent. / Oberoende på var än i världen man befinner sig, anses patientsäkerhet vara en av de viktigaste aspekterna i sjukvården. Å andra sidan, helt beroende på var man befinner sig kommer patientsäkerheten skilja sig och är därför lägesberoende. Patientsäkerheten i ett utvecklingsland kommer därför uppfattas på ett annat sätt i jämförelse med ett I-land. Denna studie syftar till att identifiera patientsäkerheten i Puntland, Somalia och med det dess vårdmiljö i sjukhusen. Målet var att identifiera huvudfaktorerna som påverkar patientsäkerheten. För att undersöka detta utfördes en fältstudie i den valda regionen Puntland, därefter gjordes intervjuer med personal på plats i sjukhusen och dessutom utfördes observationer. De erhållna resultaten analyserades med hjälp av metoden “Qualitative Content Analysis”. Vid ett senare skede tematiseras resultaten till fyra kategorier; “​Behov​”, “​Apparat​”, “​Utbildning​” och “​Kunskap​”, vilka visade på de huvudsakliga problemen. Studien visade slutligen på att det fanns ett gemensamt genomgående problem av brist på apparater, utbildning och kunskap, vilket i sin tur skulle kunna påverka patienter och deras säkerhet på sätt såsom feldiagnoser, försenad behandling och i värsta fall döden. Vidare fastställdes att snarare än bristen på apparater, var avsaknaden av kunskap mer påtaglig.

No / Introduction Patients represent an important and as yet untapped source of information about the factors that contribute to the safety of their care. The aim of the current study is to test the reliability and validity of the Patient Measure of Safety (PMOS), a brief patient-completed questionnaire that allows hospitals to proactively identify areas of safety concern and vulnerability, and to intervene before incidents occur. Methods 297 patients from 11 hospital wards completed the PMOS questionnaire during their stay; 25 completed a second 1 week later. The Agency for Healthcare Research and Quality (AHRQ) safety culture survey was completed by 190 staff on 10 of these wards. Factor structure, internal reliability, test-retest reliability, discriminant validity and convergent validity were assessed. Results Factor analyses revealed 8 key domains of safety (eg, communication and team work, access to resources, staff roles and responsibilities) explaining 58% variance of the original questionnaire. Cronbach’s α (range 0.66–0.89) and test-retest reliability (r=0.75) were good. The PMOS positive index significantly correlated with staff reported ‘perceptions of patient safety’ (r=0.79) and ‘patient safety grade’ (r=−0.81) outcomes from the AHRQ (demonstrating convergent validity). A multivariate analysis of variance (MAMOVA) revealed that three PMOS factors and one retained single item discriminated significantly across the 11 wards. Discussion The PMOS is the first patient questionnaire used to assess factors contributing to safety in hospital settings from a patient perspective. It has demonstrated acceptable reliability and validity. Such information is useful to help hospitals/units proactively improve the safety of their care.