Exploring Surgical Team Members’ Perceptions and Attitudes towards Human Factors that affect Patient Safety in the Operating Room Department at a Single Hospital in the Kingdom of Saudi Arabia: A Questionnaire Survey Study

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Background: Human factors (HFs) are important in terms of patient safety in operating rooms (ORs), since many studies show that many surgical errors in ORs are result of a breakdown in HFs rather than the technical skills of the surgical team. However, there are few studies world-wide exploring surgical teams’ attitudes regarding HFs that affect patient safety in ORs, particularly in Saudi Arabia (SA), where no such study highlights the importance of HFs. Aim of the study: To assess attitudes and perceptions regarding human factors related to patient safety among surgical teams in the operating department in a military hospital in SA. Study Method: This study was a quantitative cross-sectional survey, conducted in a single military hospital in SA. Convenience sampling methods were applied with 215 participants who were eligible for this study. The Operating Room Management Attitudes Questionnaire (ORMAQ) was distributed online to collect data. Both descriptive and inferential statistical tests were utilising to analyse the data using the Statistical Package for the Social Sciences (IBM-SPSS®) (version 21.0). Findings: In total, 193 questionnaires were completed and returned, yielding a response rate of 89.9%. Overall, surgical teams have positive attitudes toward teamwork, organisational climate, work value and information sharing. Regarding leadership, confidence-assertion, awareness of stress and fatigue and error management/procedural compliance, the scores were moderate. Surgical team members with more years of experience had significantly more positive attitudes toward confidence–assertion, teamwork and information-sharing. Consultant physicians showed a significantly more positive attitude towards leadership structure, confidence–assertion and teamwork. Surgical nurses showed a significantly more positive attitude toward information-sharing and awareness of stress and fatigue than physicians. Physicians had a significantly more positive attitude toward error management and procedural compliance. Conclusion: This study shows various discrepancies in attitudes to HFs and safety between surgical teams. However, the findings revealed that hierarchy was one of the main aspects that might influence surgical team members’ attitude toward HFs, whilst the lack of training and continued education might affect surgical teams in ORs. Enhancing the self-reporting system in ORs might result in improvement in preventing the recurrence of surgical errors. Finally, attitude surveys provide a method for assessing patient safety in surgery, in order to apply an effective strategy for safety improvement in ORs.

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