Vol. 2, Issue 2, Part A (2025)

Background: Medication errors and near-misses represent critical threats to patient safety, particularly within hospital pharmacies where complex dispensing processes demand precision and accountability. Despite international initiatives promoting a culture of safety, under-reporting of near-misses remains widespread, limiting organizational learning and prevention strategies.
Objectives: This study aimed to evaluate the existing medication safety culture and its relationship with near-miss reporting among hospital pharmacy personnel. It further sought to identify the barriers and facilitators influencing reporting behavior and to explore thematic perceptions of safety practices.
Methods: A cross-sectional mixed-method design was implemented across tertiary hospital pharmacies. The Hospital Survey on Patient Safety Culture (HSOPSC) adapted for pharmacy use, along with a structured questionnaire on near-miss reporting, was administered to 186 participants. Quantitative data were analyzed using descriptive statistics, Pearson’s correlation, and multiple linear regression, while qualitative responses underwent thematic analysis following Braun and Clarke’s approach.
Results: The overall safety culture composite score was 3.24 ± 0.47, indicating a moderately positive safety climate. The strongest domains were teamwork and organizational learning, while non-punitive response to error and feedback mechanisms scored lowest. Approximately 69% of respondents reported detecting near-misses, but only 27% consistently reported all events. Regression analysis revealed that non-punitive response to error (β = 0.32, p = 0.001) and feedback/communication about error (β = 0.21, p = 0.012) were significant predictors of reporting frequency. Qualitative themes highlighted fear of blame, time constraints, and ambiguous definitions as major deterrents.
Conclusion: A positive safety culture significantly enhances near-miss reporting behavior in hospital pharmacies. Strengthening non-punitive environments, improving communication channels, and ensuring constructive feedback are crucial for promoting transparency and organizational learning. Practical implementation of just-culture principles, simplified reporting systems, continuous safety education, and adequate staffing can collectively foster a sustainable culture of safety and reduce medication-related harm.