Perceived barriers to computerised quality documentation during anaesthesia: a survey of anaesthesia staff

Johannes Wacker, Johann Steurer, Tanja Manser, Elke Leisinger, Reto Stocker, Georg Mols, Johannes Wacker, Johann Steurer, Tanja Manser, Elke Leisinger, Reto Stocker, Georg Mols

Abstract

Background: Underreporting of intraoperative events in anaesthesia is well-known and compromises quality documentation. The reasons for such omissions remain unclear. We conducted a questionnaire-based survey of anaesthesia staff to explore perceived barriers to reliable documentation during anaesthesia.

Methods: Participants anonymously completed a paper-based questionnaire. Predefined answers referred to potential barriers. Additional written comments were encouraged. Differences between physician and nurse anaesthetists were tested with t-tests and chi-square tests.

Results: Twenty-five physician and 30 nurse anaesthetists (81% of total staff) completed the survey. The reported problems referred to three main categories: (I) potential influences related to working conditions and practices of data collection, such as premature entry of the data (indicated by 85% of the respondents), competing duties (87%), and interfering interruptions or noise (67%); (II) problems referring to institutional management of the data, for example lacking feedback on the results (95%) and lacking knowledge about what the data are used for (75%); (III) problems related to specific attitudes, e.g., considering these data not useful for quality improvement (47%). Physicians were more sceptical than nurses regarding the relevance of these data for quality and patient safety.

Conclusions: The common perceived difficulties reported by physician and nurse anaesthetists resemble established barriers to incident reporting and may similarly act as barriers to quality documentation during anaesthesia. Further studies should investigate if these perceived obstacles have a causal impact on quality reporting in anaesthesia.

Trial registration: ClinicalTrials.gov identifier is NCT01524484. Registration date: January 21, 2012.

Figures

Figure 1
Figure 1
Window for entry of intraoperative quality data into the anaesthesia information management system (screenshot). Labeling and definition of event items are in german. “Präoperativ“, preoperative. “Intraoperativ“, intraoperative. “Postoperativ“, Postoperative. “Schweregrad“, severity (severity classification of the event). “Speichern“, save button. “Abbruch“, cancel button. Event categories: “Keine“, no events (clicked). “Allergien“, allergies. “Kardiovaskulär“, cardiovascular / heamodynamic events. “Pulmonal/Atemwege“, pulmonary and airway-related events. “Impact“, collective designation for various events, e.g. hypothermia, dental injury, and others. “Spezielles“, specific anaesthesia-related events, e.g. agitation upon emergence, nausea, and others. “Diverses“, organisational and other events.

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Pre-publication history
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