SAFETY CULTURE
OR Black Box: Examining Nurses’ Perceptions in a Surgical Setting
Published on
Sep 23, 2025
Surgical Innovation
Pria Nippak, Victoria Ross, Housne Begum, Kimberley Okafor, Mya Rana-Nippak, Stanley J Hamstra, Markku Nousianinen
Overview
This study examined nurses’ perceptions of the OR Black Box® in a surgical setting at a tertiary academic hospital in Ontario, Canada. Using a cross-sectional mixed-methods design, data were collected via a 14-item questionnaire administered to 50 perioperative nurses during the early stages of OR Black Box implementation. The study aimed to assess nurses’ awareness, comfort, and readiness to use the OR Black Box technology, as well as their views on its potential to improve operating room safety culture, communication, teamwork, situational awareness, feedback, debriefing, transparency, and technological advancement. Given the critical role nurses play in surgical care and technology adoption, understanding their perspectives was viewed as essential to supporting successful OR Black Box implementation and reducing barriers to uptake.
Results
Overall, nurses demonstrated generally positive attitudes toward OR Black Box technology, despite limited prior exposure (88% reported no previous experience). More than half of participants agreed that the OR Black Box could improve safety culture, situational awareness, feedback on performance, debriefing processes, identification of intraoperative safety risks, transparency, and technological advancement in healthcare. Gender was significantly associated with several perceptions, with female nurses reporting more favorable views in multiple domains, while perceptions did not significantly differ by role, years of experience, or prior OR Black Box exposure. Qualitative responses revealed both optimism about quality improvement and concerns regarding surveillance, data use, litigation, and potential behavioral impacts, highlighting the need for clear communication, education, and policy safeguards to support nurse acceptance and readiness for OR Black Box adoption.
Peer-reviewed Research
