Development of a Risk Management Model to Prevent Surgical Errors in Ophthalmic Surgery at Phra Achan Fan Acharo Hospital

Abstract

The objectives of this research and development (R&D) study were to 1) investigate the situation and risk factors associated with surgical errors in ophthalmic surgery, 2) develop a risk management model to prevent surgical errors in ophthalmic surgery, 3) compare knowledge, attitudes, and practices (KAP) of surgical team personnel before and after implementation of the model, and (4) evaluate patient safety outcomes. The study was conducted in the Ophthalmology Department of Phra Achan Fan Acharo Hospital from January to September 2025. Participants consisted of 11 persons selected purposively, including ophthalmologists, nurse anesthetists, and registered nurses. Research instruments were a knowledge, attitude, and practice questionnaire, an observational checklist, a satisfaction questionnaire, in-depth interview guides, and focus group discussion guides. Quantitative data were analyzed using descriptive statistics, including frequencies, percentages, means, standard deviations, and paired t-tests. Qualitative data were analyzed using thematic analysis. Statistical significance was set at p<0.05.

Results showed that, after the implementation of the model, the surgical team demonstrated significantly higher knowledge, attitude, and practice scores than before the implementation (p<0.001). The average knowledge scores increased from 71.52±5.65 to 93.33±3.65, while the average attitude score increased from 3.90±0.42 to 4.42 ± 0.17, and the average practice score increased from 73.98±4.10 to 92.34±6.00. No surgical errors were reported during the implementation period, and participant satisfaction with the developed model was at the highest level.

It can be concluded that the developed risk management model, integrating the PDCA cycle with surgical safety measures, effectively improved the knowledge, attitudes, and practices of surgical team personnel, reduced the risk of surgical errors, and enhanced patient safety. The model can be applied to improve the quality of perioperative nursing and surgical services in community hospitals.