Analyze and identify the patient safety culture and possible predictors and areas for improvement related to patient safety culture of Saudi Arabia

One of the main suggestions made by the Institute of Medicine to guarantee that hospitals can create a culture of excellence and patient safety is the development of a patient safety culture [1, 2]. The first stage in developing a strategy for a culture that promotes and supports safety is to evaluate the health organization's present safety culture [3]. Healthcare businesses are able to get a comprehensive picture of factors related to patient safety thanks to the safety culture evaluations for healthcare organizations that are supported by international accrediting bodies. These capabilities include the ability to pinpoint the security culture's strengths and weaknesses [4], assisting healthcare companies in identifying their ongoing patient safety challenges [5], and enabling them to compare their performance to that of other similar businesses [6]. According to earlier research, strong communication based on mutual trust, information flow, a shared understanding of the importance of safety, organizational learning, commitment from the administration and leadership, and the presence of a non-punitive attitude toward incident and error reporting are the key predictors of a positive patient safety culture in hospitals [7]. In a

frequency of incidents reported, and a global patient safety grade provided by staff to their units [8]. According to some of the literature, there are a few patient safety culture concerns that need attention, such as the necessity for hospital employees to record incidents, how the working environment affects safety, and what can be done to improve safety. There have been several research on the frequency and different kinds of patient safety cultures, but there is little data on the correlation between these predictors and results, notably in the Eastern Mediterranean nations. One of the first studies to try to assess the safety culture in hospitals in Lebanon was done by El-Jardali et al. [9]. In the "HSOPSC" American Hospital Survey on Patient Safety Culture, 12 patient safety culture composites are measured, each of which represents a different patient safety culture predictor.Additionally, the HSOPSC requests that respondents assess the patient safety of their work area or unit and react to a question about a few incidents from the previous 12 months [8]. Answers with positive percentages for each composite show which component of patient safety had the greatest favorable ratings; these composites include those for organizational education and ongoing growth, support for patient safety from hospital management, and collaboration within units. Teamwork between hospital units, personnel, a non-punitive reaction to mistake, and hospital handoffs and transitions, on the other hand, received poor scores composites [9]. Alahmadi H (2010) claims that Saudi Arabian hospitals in Riyadh are working to improve the standard of care they provide by placing a strong emphasis on patient safety via the deployment of safety measures and cultivating a culture of safety. His research aims to assess the extent to which Saudi hospitals' traditions assist patient safety. The HSOPSC questionnaire was given out to 223 health experts, including nurses, technicians, managers, and medical personnel, in 13 general hospitals in Riyadh, Saudi Arabia. The findings revealed that 60% of respondents ranked the overall Patient Safety Grade as outstanding or very good, 33% as acceptable, and 7% as failing or bad. There have been positive responses to patient safety culture components ranging from 22% to 87%. Organizational education and ongoing improvement (87%), cooperation within units (84%), and feedback and communication regarding mistakes (77%), were areas of strength for the majority of hospitals. Under-reporting of occurrences (43 percent of events throughout a year went unreported), non-punitive responses to errors (22 percent), staffing (22 percent), and collaboration within hospital units (27 percent) were all potential areas for improvement [10]. The findings of this study emphasized the necessity for doing more, comparable research in other hospitals in other Saudi Arabian locations. The safety culture institutions.

Adverse incidents are influenced by weak PSC; therefore fostering a safety culture is crucial. The majority of the researches analyzed in their bibliometric assessment were carried out in institutional or medical settings. The best journal for safety culture was called "Safety Science." In wealthy nations, information technology has increased patient safety. PSC research in Sweden utilized HSOPSC. Unit collaboration, open communication, the supervisor's/manager's expectations and actions in promoting safety, non-punitive reactions to faults, and error feedback and communication were its components with the highest results. Most hospitals in the Netherlands, the USA, and Taiwan exhibited high levels of collaboration according to a different research utilizing the HSOPSC2 [11, 12]. Transitions and handoffs might be made better in all nations. When it came to hospital safety, Americans had higher expectations than Dutch and Taiwanese respondents. The Turkish translation of HSOPSC was used at four hospitals in Turkey to study PSC. The best methods were teamwork and organizational learning and ongoing development. Non-punitive reactions to mistakes and reporting frequency had the lowest means. Different nations' healthcare systems have varying strengths and need for development [13-15].

Adverse incidents are influenced by weak PSC, therefore fostering a safety culture is crucial. The majority of the research analyzed in their bibliometric assessment were carried out in institutional or medical settings. The best journal for safety culture was called "Safety Science."[16] In wealthy nations, information technology has increased patient safety. PSC research in Sweden utilized HSOPSC. Unit collaboration, open communication, the supervisor's/manager's expectations and actions in promoting safety, non-punitive reactions to faults, and error feedback and communication were its components with the highest results. Most hospitals in the Netherlands, the USA, and Taiwan exhibited high levels of collaboration according to a different research utilizing the HSOPSC2. Transitions and handoffs might be made better in all nations. When it came to hospital safety, Americans had higher expectations than Dutch and Taiwanese respondents [17]. The Turkish translation of HSOPSC was used at four hospitals in Turkey to study PSC. The best methods were teamwork and organizational learning and ongoing development. Non-punitive reactions to mistakes and reporting frequency had the lowest means. Different nations'

A current control group and clinical variables are additional considerations. Other factors that might predict PSC included commitment from management and leadership, information sharing within and across units, a common vision for patient safety, and a non-punitive approach to event and mistake reporting. PSC was predicted by age, job history, bachelor degree, and medical occupation [21]. Negative PSC views were predicted with young, nursing or technical personnel, day-night shift, and extensive hospital experience. PSC was projected to occur in Jordanian hospitals by using evidence-based practice, working with institutions of higher learning, and placing a priority on patient safety [22].

PSC results include employee willingness to report incidents, safety perceptions, and the volume of incidents recorded. Patient outcomes and safety culture are related [23]. Most research focused on a single hospital and time frame. Statistically significant relationships between PSC and nurse-sensitive patient outcomes were very sometimes identified in studies [24]. Hospital safety cultures have been connected to mortality, complications, duration of stay, and readmissions in studies [25–27].

Saudi pharmacists working in local pharmacies participated in a descriptive, cross-sectional, survey-based study. An strategy known as non-probabilistic practical sampling was used to select the study's participants. All pharmacists employed by community pharmacies in this region, including student pharmacists, pharmacy technicians, and pharmacy assistants, were urged to participate in the survey, even if more than one pharmacist was present in the same pharmacy. The Agency for Healthcare Research and Quality (AHRQ)'s "Pharmacy Survey on Patient Safety Culture" (PSOPSC), designed for community pharmacies, was used to collect data for the study. It is a 40-question, self-administered, pre-validated survey that evaluates patient safety culture on a 5-point Likert scale across 11 domains. The poll questions were written in both English and Arabic. At a time that worked for them, the research assistants met the pharmacists one-on-one at their pharmacies. The drugstore sent them a Google Forms survey, and they responded to it electronically. The Statistical Package for Social Sciences (SPSS) version 22 was used to conduct the necessary statistical analyses. The variables related to the items with the lowest positive response rate were found

Gender Male 67 67 Female 33 33 Pharmacy type Chain 83 83 Independent 17 17 Position of Pharmacist Managing Pharmacist 17 17 Pharmacist 64 64 Student Pharmacist 13 13 Technicians 5 5 Experience Year < 5 years 56 56 6–10 years 26 26 11–15 years 7 7 16–20 years 4 4 > 20 years 7 7 Volume of Prescription per week > 250 65 65 < 250 35 35 Hours of Working per week

30–40 48 48 > 40 52 52

For each item, the positive response ratio was calculated and derived for several patient safety culture dimensions (Table 2). The highest Positive Response Rates were for teamwork (94%), patient counseling (94%), and physical environment (93%). The factors with the fewest positive response rates

safety characteristics, from 47.70 to 95.

* PRR = Positive Responses/Total Responses × 100)

their facility as outstanding or very good in 48% and 28%, respectively. A poorer patient safety grade was also given to their pharmacy by 5% of respondents. Only 15 percent of community pharmacists indicated that overall patient safety is good, very good, or outstanding.

Poor 5 5 Very good 4 4 Good 15 15 Very good 28 28 Excellent 48 48

In conclusion, cultivating a culture of patient safety calls for a consistent dedication to constant improvement, Healthcare organizations can foster a culture where patient safety is at the center of all actions and decisions by recognizing the importance of patient safety culture, identifying possible predictors, and actively striving to improve important areas. In the end, a strong patient safety culture helps to improve clinical outcomes, boost patient confidence, and create a safer healthcare ecosystem overall.

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PSMMC, Pharmacist, All PSMMC Riyadh , Saudi Arabia