Knowledge and attitudes toward perioperative patient blood management: A cross‐sectional study among Anaesthesiology and Orthopaedic Surgery Departments at a university hospital

BACKGROUND: Perioperative patient blood management (PBM) is a crucial, multidisciplinary, evidence-based approach aimed at optimising patient outcomes by reducing unnecessary erythrocyte transfusions. This study assessed the knowledge and attitudes of healthcare professionals in two key surgical specialties toward PBM. METHODS: This cross-sectional questionnaire-based survey involved personnel from the Department of Anaesthesiology and the Department of Orthopaedic Surgery at a university hospital. The questionnaire assessed knowledge (scored out of 100) and attitudes (specifically self-reported adherence, scored out of 100). The correct responses were based on the PBM guidelines and institutional protocols. Multivariable logistic regression was used to identify predictors of adherence. RESULTS: The overall response rate was 86.2% (n = 250) from 163 Anaesthesiology and 87 Orthopaedic Surgery. The Orthopaedic Surgery group scored significantly lower on knowledge assessments than the Anaesthesiology group (median score 48 vs. 58, p < 0.001). However, the attitude scores were statistically similar (median score 77 vs. 76, p = 0.237), revealing a knowledge-attitude paradox. Multivariable logistic regression identified hierarchical position as the only significant independent predictor: staff physicians were 7.1 times more likely to report adherence compared to residents (adjusted odds ratios 7.1, 95% confidence interval 3.1-16.2, p < 0.001). Individual knowledge level was not a significant predictor. CONCLUSIONS: Our study demonstrates that hierarchical mandate, not individual knowledge or department affiliation, is the primary driver of PBM adherence. Implementation efforts must therefore leverage staff physician leadership to mandate PBM as the institutional standard of care, ensuring that positive attitudes translate into consistent practice.