Representativeness Test.

This primary study assessed the patient safety culture in five major public government hospitals in Eswatini. A cross-sectional survey was conducted among hospital employees using the validated Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ). The average positive patient safety culture (PSC) score was 43%. The highest-rated composite was “teamwork within units” (75%), while the lowest-rated was “staffing” (25%). All 11 PSC composites scored below the 2018 AHRQ survey benchmarks. These findings underscore the need for significant improvements in PSC across Eswatini’s hospitals. Additionally, the study revealed a lack of robust patient safety reporting systems in the five hospitals, which hinders efforts to address safety issues and reduce medical errors.