Perceived Safety Attitudes Among Filipino Staff of Theatres and Recovery Units in the United Kingdom

Abstract

Millions of UK surgeries highlight the importance of patient safety. However, preventable adverse events persist, despite initiatives like surgical safety checklists and safety protocols. This signifies the need to further understand human factors in perioperative settings. Research suggests demographics influence safety attitudes, yet data on Filipino healthcare workers, a growing population in the UK, are lacking. This study investigates safety attitudes among Filipino theatre and recovery staff in the UK and explores how demographic characteristics influence these attitudes.

A quantitative, non-experimental, descriptive comparative design was employed. Snowball-purposive sampling recruited 44 participants, supplemented by qualitative interviews. Descriptive and inferential statistics were utilized, alongside qualitative insights.

Demographic characteristics revealed that the majority of the staff are female, in their early thirties, primarily presiding in London, practicing a single specialty and workings a part of the scrub team with over a decade of experience.

The Safety Attitude Questionnaire - Operating Room (SAQ-OR) adapted for UK terminology, assessed safety attitudes across domains. While the overall safety attitudes were positive, with high scores in Safety Climate, Stress Recognition, and Teamwork Climate, there were still areas for improvement. Job Satisfaction, Communication/Collaboration, Working Conditions, and Perceptions of Management received lower scores.

Analyzing the safety attitudes of demographic profile groups revealed variations across demographic categories. The Anesthetic team, various specialties, staff under 30 and 35-39 years old, those with less than 2 years of experience, staff residing in North England, and Male staff demonstrated the strongest safety attitudes, consistently achieving high mean scores in a majority of the seven domains. Conversely, Other Perioperative teams, Dual specialties, the 30-34 and 50-year-old age groups, staff with 6-10 years of experience, those in West England, and Female staff reported the poorest safety attitudes, with low scores in most domains.

Findings of specific variations between profile groups allow for targeted interventions such as assessment of stress recognition factors for non-registered staff and staff younger than 30 and older than 50, and stress management for new hires. Interviews also paved the way for targeted suggestions such as mentorship training for new managers, and the use of adaptable leadership styles with proactive management for staff empowerment. Analysis of questionnaire responses, showed a suggested need for intervention, such as in-depth assessment of communication breakdown that delays surgical list, management of staffing and resources, and initiating strategies to prevent burnout, relieve workload pressures of staff, and provide conflict resolution skills.

Statistically significant results show that the scrub team has a better ability to recognize stress compared to Other perioperative team. Additionally, statistical analysis reveals a significant variance in mean scores showing that staff aged 35-39 prioritize safety more than other age groups, particularly those aged 30-34 and those 40 years and older. Despite specialty, experience, location, and sex differences, statistical test results show no significant variation in safety attitudes across profile groups.

Recommendations include a multi-pronged approach. Ongoing safety assessments should be maintained to monitor progress and prioritize patient safety. Educational programs for students and educators should be developed based on the study's findings, particularly regarding Filipino staff experiences, to promote safety centered skills, communication, teamwork, and patient advocacy. Continuous safety education tailored to different age groups, along with promoting stress recognition, is essential for theatre and recovery teams. Theatre and recovery management should implement targeted interventions for specific demographics, such as communication strategies, job satisfaction improvements, and leadership training. Additionally, ongoing safety climate education, regular assessments, addressing staffing concerns, and developing conflict resolution strategies are crucial. Further research could integrate qualitative data, explore the link between safety attitudes and patient outcomes, investigate the role of management in safety culture, and consider including pre-operative staff.