SURVEY INSTRUCTIONS

This survey asks for your opinions about patient safety in this community pharmacy and takes about 15 minutes to complete. Answer only about the pharmacy location/store where you received this survey.

Staff means EVERYONE who works in this community pharmacy, including pharmacists, pharmacy technicians, pharmacy clerks, etc.

Patient safety is the prevention of patient harm resulting from the processes of health care delivery. In the pharmacy setting, it means that:

  • The right patient receives the right medication in the right dose at the right time by the right route, and


  • The patient or caregiver understands the purpose and proper use of the medication.


A mistake is any type of medication error, mistake, incident, or quality-related event, regardless of whether or not it reaches the patient or results in patient harm. Mistakes may be related to, or include:

  • Prescribing, transcribing, dispensing, administering, monitoring (use of medication), unsafe conditions or procedures in the pharmacy, etc.
If a question does not apply to you or you don’t know the answer, please answer “Does Not Apply or Don’t Know.”

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