Abstract

Objective: This study aimed to measure the knowledge, attitude, and self-reported practices of healthcare providers in Jeddah in relation to the enhanced recovery after surgery (ERAS) to determine the gaps in implementation as relevant to pathway fidelity.
Methods: The study was a cross-sectional observational study, which was conducted in Jeddah between January and September 2024 and involved an English-language, self-administered online survey distributed through snowball sampling via email and social media. The tool measured the level of awareness/adoption of ERAS, level of knowledge (0-8), level of attitude (16-48), and practice (20-100).
Results: There were 146 providers who participated; 75.3% indicated that they were aware of ERAS, and 65.1% of the participants indicated that they adhered to ERAS in the workplace. The level of knowledge was moderate (mean = 4.36 ± 1.78; median 5 [IQR 3-6]) with severe gaps in bowel preparation (14.4% correct) and carbohydrate loading time (17.1% correct). The average attitude score was 41.77 ± 3.54 (α = 0.67), and the average practice score was 76.45 ± 11.64 (α = 0.82). Optimization of comorbidities (93.2%) had the highest uptake rates. ERAS followers had better knowledge (4.61 ± 1.67 vs. 3.88 ± 1.91; p = 0.024) and higher compli ance with the principles of ERAS (80.33 ± 8.87 vs. 69.24 ± 12.78; p < 0.001). Also, the compliance with ERAS was associated with previous awareness of ERAS (p < 0.001) and the level of knowledge (p = 0.035).
Conclusion: The awareness and positive attitude of providers toward ERAS were significant, and the practices were generally ERAS-oriented, yet there was a lack of consistency in the knowledge of the protocols and pre-operative aspects.

Key words: Enhanced recovery after surgery, ERAS, knowledge, attitude, practice, healthcare providers, perioperative care, implementation, cross-sectional survey, Jeddah