The Impact of Operating Room Technicians' Adherence to Safety Standards on Ensuring a Safe Working Environment in Public Hospitals (A Field Study at Teaching Hospitals in the Capital Municipality)
DOI:
https://doi.org/10.65693/irss.2026.v7i1.57Keywords:
Operating Room Technicians, Safety Standards, Safe Work Environment, Public Hospitals, Organizational Resilience, Sana'a.Yemen.Abstract
This study aimed to investigate the correlational relationship and statistical impact of operating room (OR) technicians' commitment to occupational safety standards on the sustainability of a safe work environment within public hospitals in Sana'a (Al-Thawra, Al-Kuwait, Military, and 48 Medical Hospital). Utilizing a descriptive-analytical methodology, data were collected via a validated and structured questionnaire distributed to a sample of 147 technicians. The instrument demonstrated high internal consistency with a Cronbach’s alpha coefficient of 0.872.
The findings revealed a "very high" level of professional commitment among technicians, with an overall mean of (4.53/5.00), specifically in infection control and personal protective equipment (PPE) dimensions. Conversely, an organizational gap was identified in the "Safe Work Environment" محور, which scored a lower mean of (3.95), with "Organizational and Psychological Support" reaching its lowest level at (3.13). Linear regression analysis confirmed a statistically significant impact ( Sig = 0.000 ) of technicians' commitment on the work environment, explaining (21.3%) of the variance in environmental safety quality ( R2 = 0.213 ). Statistical tests (T-test and ANOVA) confirmed the homogeneity of professional commitment, showing no significant differences attributable to demographic variables such as gender, experience, or educational level.
The study concludes that the safety system in Yemeni public hospitals currently relies on "individual resilience" and professional ethics rather than institutional frameworks. The study recommends a paradigm shift from "Safety-I" (focusing on error prevention) to "Safety-II" (enhancing resilience and learning from success). Furthermore, it emphasizes the institutionalization of psychological support and the adoption of non-punitive reporting systems to ensure sustainable safety in high-risk surgical environments.
References
المراجع العربية
• جامعة 21 سبتمبر للعلوم الطبية والتطبيقية. (2023). دليل البرامج الأكاديمية والمراكز التدريبية لتطوير القطاع الصحي اليمني.
• منير مصلح الوصابي, & خالد محمد الضبيبي. (2025). مدى تطبيق معايير إدارة النفايات الطبية بالمستشفيات اليمنية وأثرها على صحة وسلامة العاملين فيها (دراسة ميدانية مقارنة على عينة من المستشفيات اليمنية الحكومية والخاصة في العاصمة صنعاء). Al-Razi University Journal of Administrative and Human Sciences, 6(11).
• فاضل، ر. ي. (2025). مدى توافر متطلبات تطبيق نظام الصحة والسلامة المهنية وفقاً للمواصفة ISO 45001:2018 في المستشفيات اليمنية في مدينة الحديدة. مجلة سبأ للعلوم الإنسانية والاجتماعية، 1(1)، 1-32. الرابط: https://doi.org/10.48185/sjhss.v1i1.1517
1. فاضل، ر. ي.، والقرص، ع. ع. م. (2025). أثر القيادة الاستراتيجية في تعزيز نظام الصحة والسلامة المهنية في المستشفيات اليمنية في مدينة الحديدة. مجلة جامعة صنعاء للعلوم الإنسانية، 4(1)، 243-279.الرابط: https://doi.org/10.59628/jhs.v4i1.1402
2. قبان، كمال. الوصابي، منير. (2025). أثر التطوير الوظيفي في تحسين أداء الكوادر التمريضية بالمستشفيات اليمنية دراسة ميدانية على بعض المستشفيات اليمنية - صنعاء. (2025). مجلة جامعة صنعاء للعلوم الإنسانية, 4(11), 277-317. https://doi.org/10.59628/jhs.v4i11.1809
• منظمة الصحة العالمية (WHO EMRO). (2025). استراتيجية التعاون القُطْري بين منظمة الصحة العالمية واليمن 2024-2025. الرابط: https://applications.emro.who.int/docs/9789292742768-ara.pdf
ثانياً: المراجع الأجنبية (English References):
3. Abdo Almoliky, M., Elzilal, H. A., Alzahrani, E., Abo-Dief, H. M., Saleh, K. A., Alkubati, S. A., Saad, M. S., & Sultan, M. A. (2024). Prevalence and associated factors of needle stick and sharp injuries among nurses: A cross-sectional study. SAGE open medicine, 12, 20503121231221445. https://doi.org/10.1177/20503121231221445.
4. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211. DOI: https://doi.org/10.1016/0749-5978(91)90020-T
5. Ali, et al. (2025). Medical waste management practices in government healthcare facilities in Hodeidah, Yemen. Sana'a University Journal of Applied Sciences and Technology. URL: https://journals.su.edu.ye/index.php/jast/article/view/1970
6. Almoliky, M. A., et al. (2024). Prevalence and associated factors of needle stick and sharp injuries among nurses: A cross-sectional study. SAGE Open Medicine, 12. DOI: https://doi.org/10.1177/20503121231221445
7. Alrasheeday, A. M., et al. (2024). Nurses' perceptions of patient safety culture and adverse events in Hail City, Saudi Arabia: A cross-sectional approach to improving healthcare safety. BMJ Open, 14(9)، e084741.
8. Alrasheeday, A. M., et al. (2025). Nursing students' perceptions of patient safety culture and barriers to reporting medication errors: A cross-sectional study. Nurse Education Today, 146, 106539.
9. Alsabri, M., et al. (2021). Patient Safety Culture in Emergency Departments of Yemeni Public Hospitals: A Survey Study. Frontiers in Emergency Medicine, 5(2). DOI: https://doi.org/10.18502/fem.v5i2.5618
10. Alsabri, M., et al. (2025). Enhancing occupational health and safety through strategic leadership in resource-constrained settings. Risk Management and Healthcare Policy. DOI:(https://doi.org/10.2147/RMHP.S506296)
11. Al-Saleet, J. M., Al-Wasabi, M. M., Jowah, H. M. (2025, August 19). Impact of total quality management on healthcare service quality in Yemeni hospitals: A cross-sectional study [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-7115768/v1
12. Alsalit, G. M., Al-Wesabi, M. M., Jowah, H. M., et al. (2026, February 18). Drivers of healthcare quality in a conflict-affected setting: A cross-sectional study on total quality management implementation in Yemen [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-8835527/v1
13. Alswaidi, Fatima. (2023). Patient safety culture among physicians at public hospitals in Sana'a, Yemen. 21 September University Journal of Medical and Applied Sciences. الرابط: https://21umas.edu.ye/wp-content/uploads/2023/07/5-40-53-21-2023.pdf
14. Al-Wesabi, M. (2020). The reality of the Yemeni health sector and the role of September 21 University for Medical and Applied Sciences in reforming it and building the modern Yemeni state (M. Dael, Trans.). Institutional Repository for Scientific Scholarship at 21 September University for Medical and Applied Sciences, 1(1), 106-133. https://doi.org/10.65693/irss.2020.v1i1.47
15. Al-Wesabi, M., & Jarallah. et al, M. (2024). The Reality of Training Quality and its Role in Improving the Performance of Operating Theater Technicians in Yemeni Hospitals: A Comparative Analytical Study Between the Republican Teaching Hospital Authority and Kuwait University Hospital. Institutional Repository for Scientific Scholarship at 21 September University for Medical and Applied Sciences, 5(1), 1-92. https://doi.org/10.65693/irss.2024.v5i1.49
16. Al-Wesabi, M., & Shamlan, M. (2022). The Effect of Applying Infection Prevention and Control Standards in Sana’a Governorate Hospitals at the Level of Reducing the Spread of Diseases and Epidemics. Journal of 21 September University for Medical and Applied Sciences, 1(1). https://doi.org/10.65693/masj.2022.v1i1.17
17. Al-wesabi, Muneer. (2012). The Role of Quality Systems in Improving the Performance of Healthcare Facilities in Yemen: A Case Study of the 48 Model Hospital. https://doi.org/10.13140/RG.2.2.12720.32009
18. Al-wesabi, Muneer. (2017). The Effect of Health Human Resources Development on the Efficacy of Applying Accreditation Standards in Yemeni Hospitals: A Field Study. https://doi.org/10.13140/RG.2.2.28658.67527
19. Alyahawi, A., Al-Wesabi, M., & ALKaf, A. (2022). Antimicrobial susceptibility of Acinetobacter clinical isolates among ICU Patients in Sana’a City, Yemen. Journal of 21 September University for Medical and Applied Sciences, 1(1). https://doi.org/10.65693/masj.2022.v1i1.14
20. AORN. (2024). Guideline for Sharps Safety. Association of periOperative Registered Nurses. URL: https://ortoday.com/new-and-updated-aorn-guidelines-in-2025/
21. ASHRAE. (2025). Standard 170-2021: Ventilation of Health Care Facilities. American Society of Heating, Refrigerating and Air-Conditioning Engineers.
22. Basu, S. (2020). Work intensity, long shifts and heavy workloads: Factors in the emergence of anxiety among healthcare workers. International Journal of Environmental Research and Public Health. DOI: https://doi.org/10.3390/ijerph17207634
23. Bigley, G. A., & Roberts, K. H. (2001). The incident command system: High-reliability organizing for complex and volatile task environments. Academy of Management Journal.
24. Calendine, C. (2024). Surgical smoke risks in the operating room: A hidden threat to healthcare workers. URL: https://www.corycalendinemd.com/post/surgical-smoke-risks-in-the-operating-room-a-hidden-threat-to-healthcare-workers
25. ConMed. (2024, May 15). Breathing danger: The silent killer harming women in the OR. ConMed Advanced Surgical Blog. الرابط: https://www.conmed.com/en/blog/articles/advanced-surgical/breathing-danger-the-silent-killer-harming-women-in-the-or
26. Da Silva Batalha, et al. (2024). Patient safety culture and professional quality of life among nursing professionals. Revista Latino-Americana de Enfermagem. DOI: https://doi.org/10.1590/1518-8345.6888.4063
27. Donaldson, M. S., Corrigan, J. M., & Kohn, L. T. (2000). To Err is Human: Building a Safer Health System. National Academies Press.: https://nap.nationalacademies.org/catalog/9728/to-err-is-human-building-a-safer-health-system
28. Eisenberger, R., et al. (1986). Perceived organizational support. Journal of Applied Psychology, 71(3), 500–507.
29. Erbaş, D. H. (2025). Safe technology use in the operating room and related factors. BMC Health Services Research, 26, 103.
30. Frontiers in Health Services. (2023). Factors associated with healthcare provider performance: Validation of the HCPP scale. Frontiers in Health Services. DOI: https://doi.org/10.3389/frhs.2023.1606078
31. Hacıdursunoğlu Erbaş, D., Azizoğlu, H., Özdere, B. et al. Safe technology use in the operating room and related factors. BMC Health Serv Res 26, 103 (2026). https://doi.org/10.1186/s12913-025-13805-3.
32. Hamdan, M., & Saleem, A. (2013). Assessment of patient safety culture in Palestinian public hospitals. International Journal for Quality in Health Care, 25(2), 167–175.DOI: https://doi.org/10.1093/intqhc/mzs074
33. Harrington, S. M. (2025). Improving systems theoretic process analysis on sociotechnical systems using human factors engineering. MIT Thesis.URL: https://dspace.mit.edu/handle/1721.1/163051
34. Hollnagel, E. (2014). Safety-I and Safety-II: The Past and Future of Safety Management. CRC Press. DOI: https://doi.org/10.1201/9781315607511
35. Hurst, R. D., & Stewart, K. (2024). Hazards of surgical smoke from electrocautery: A critical review of the data. The American Journal of Surgery, 233(1).
36. Insecurity Insight. (2025). Yemen: Violence against health care in conflict 2024.
37. Krstulović, J., Hrgović, Z., Krešo, A., Tavra, A., Znaor, L., & Marušić, A. (2025). Interventions to Improve Compliance to Surgical Safety Checklist Use: Before-and-After Study at a Tertiary Public Hospital in Croatia. Healthcare (Basel, Switzerland), 13(16), 1959. https://doi.org/10.3390/healthcare13161959.
38. Kurniasari, N., et al. (2024). Patient Safety Culture through Organizational Factors and Structural Empowerment. Pakistan Journal of Life and Social Sciences, 22(2). URL: https://pjlss.edu.pk/pdf_files/2024_2/16282-16295.pdf
39. Lari, A. (2024). A longitudinal study on the impact of occupational health and safety practices on employee productivity. ResearchGate.: https://www.researchgate.net/publication/375583603
40. Lee, J., & Lee, K. (2025). Effective medical waste management for sustainable green healthcare environment. Journal of Advances in Environmental Health.
41. Mahajan, A., et al. (2017). A hospital is not just a factory, but a complex adaptive system-implications for perioperative care. Anesthesia & Analgesia, 125(1), 333-341.DOI: https://doi.org/10.1213/ANE.0000000000002144
42. Mahmoudi, & Castelblanco. (2025). Physical environment attributes and workplace violence risk mitigation. Proceedings of the 23rd CIB World Building Congress.
43. Ng, T. W., & Feldman, D. C. (2010). The effects of job stress on employee performance. Journal of Organizational Behavior. DOI: https://doi.org/10.1002/job.654
44. NIOSH. (2024). List of hazardous drugs in healthcare settings, 2024. DHHS (NIOSH) Publication No. 2025-103.DOI:(https://doi.org/10.26616/NIOSHPUB2025103)
45. Okoshi, K., et al. (2015). Health risks associated with exposure to surgical smoke for surgeons and operating room personnel. Surgery Today.
46. Patient Experience Journal. (2024). Prevalence of patient safety culture in healthcare facilities in low- and middle-income countries: A systematic review and meta-analysis. Patient Experience Journal, 11(3). DOI: https://doi.org/10.35680/2372-0247.1909
47. Qabban, K. A., Al-Wesabi, M. M. (2025). The Impact of Career Development on Improving Nursing Performance in Yemen Hospitals - Sana’a. Sana’a University Journal of Human Sciences, 4(11), 277-317. https://doi.org/10.59628/jhs.v4i11.1809
48. Qabban, K. A., Al-Wesabi, M. M., & Jowah, H. M. (2025, May 7). Impact of Joint Commission International patient-centered standards on nursing performance in Sana'a, Yemen hospitals [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-6372401/v1
49. Qabban, K. A., Al-Wesabi, M. M., & Jowah, H. M. (2026). Association between Joint Commission International patient-centered standards and self-reported nursing performance in Sana′a, Yemen hospitals. Journal of Nursing Management, 2026, Article 8353270. https://doi.org/10.1155/jonm/8353270
50. Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768-770. DOI: https://doi.org/10.1136/bmj.320.7237.768
51. Salem, et al. (2025). Healthcare accessibility in Yemen's conflict zones: Comprehensive review focused on strategies and solutions. Conflict and Health, 19(1). DOI: https://doi.org/10.1186/s13031-025-00642-x
52. Shamlan, M. A. M., & Al-Wesabi, M. M. M. (2026, May 26). Clinical governance and healthcare quality in conflict-affected settings: A cross-sectional study of hospitals in Yemen [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-9442217/v1
53. Soltani, et al. (2025). Occupational health and safety under threat: Lessons from recent conflict and the imperative for future preparedness. Iranian Journal of Public Health.URL: http://ijph.tums.ac.ir
54. Sopirala, M. M., et al. (2014). Impact of an infection control link nurse program on healthcare-associated infections. American Journal of Infection Control.
55. Sulaiman, A. M., et al. (2025). Evaluating the Impact of Surgical Safety Checklists on Patient Outcomes: A Multicentre Study. Journal of Surgery and Research, 8, 416-422.
56. Tadia, et al. (2025). Patient safety culture: Insights from a cross-sectional study among healthcare professionals. Journal of Family Medicine and Primary Care, 14(1), 90-96. DOI: https://doi.org/10.4103/jfmpc.jfmpc_753_24
57. Tavra, A., et al. (2025). Interventions to Improve Compliance to Surgical Safety Checklist Use: Before-and-After Study at a Tertiary Public Hospital in Croatia. Healthcare (MDPI), 13(16)، 1959.
58. Van der Voordt, T., & Jensen, P. A. (2023). Supportive and health-conscious work environments and employee contentment. RSIS International.
59. Webster, C. S., et al. (2023). Anaesthesia and patient safety in the socio-technical operating theatre: A narrative review spanning a century. British Journal of Anaesthesia, 131(2). DOI: https://doi.org/10.1016/j.bja.2023.04.023
60. World Bank. (2021). Yemen health policy note: Sep 2021. URL:(https://thedocs.worldbank.org/en/doc/24c916282e1d9826812a4f6bbed06464-0280012021/original/ARA-Yemen-Health-Policy-Note-Sep2021.pdf)
61. World Health Organization. (2015). Safety-I and Safety-II: The white paper.
62. World Health Organization. (2021). Medical waste management plan: Yemen emergency human capital project (P176570). WHO EMRO. الرابط: https://www.emro.who.int/images/stories/yemen/Medical-Waste-Management-Plan-Yemen-Emergency-Human-Capital-Project-P176570-WHO-Final.pdf
Downloads
Published
Issue
Section
License
Copyright (c) 2026 هديل محمد الشجاع، سامي زيد التهامي، آية صالح الحتيوه، حمزة محمد الفايق، منير مصلح الوصابي، اريج ابراهيم الشرفي وآخرون (المؤلف)
This work is licensed under a Creative Commons Attribution 4.0 International License.
