Wacker Johannes, Steurer Johann, Manser Tanja, Leisinger Elke, Stocker Reto, Mols Georg
Institute of Anaesthesia and Intensive Care, Hirslanden Clinic, Witellikerstrasse 40, CH-8032, Zürich, Switzerland.
Horten Center for Patient-Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistrasse 24, CH-8091, Zürich, Switzerland.
BMC Anesthesiol. 2015 Jan 31;15:13. doi: 10.1186/1471-2253-15-13.
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.
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.
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.
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.
ClinicalTrials.gov identifier is NCT01524484. Registration date: January 21, 2012.
麻醉术中事件报告不足是众所周知的问题，这会影响质量记录。此类遗漏的原因尚不清楚。我们对麻醉工作人员进行了一项基于问卷调查的研究，以探讨麻醉期间可靠记录的潜在障碍。
参与者匿名填写纸质问卷。预定义答案涉及潜在障碍。鼓励提供额外的书面评论。使用t检验和卡方检验来检验医生麻醉师和护士麻醉师之间的差异。
25名医生麻醉师和30名护士麻醉师（占总工作人员的81%）完成了调查。报告的问题主要分为三类：（I）与工作条件和数据收集实践相关的潜在影响，如数据过早录入（85%的受访者指出）、职责冲突（87%）以及干扰性中断或噪音（67%）；（II）与数据的机构管理相关的问题，例如缺乏结果反馈（95%）以及对数据用途缺乏了解（75%）；（III）与特定态度相关的问题，例如认为这些数据对质量改进无用（47%）。在这些数据对质量和患者安全的相关性方面，医生比护士更持怀疑态度。
医生麻醉师和护士麻醉师报告的常见困难与已确定的事件报告障碍相似，可能同样成为麻醉期间质量记录的障碍。进一步的研究应调查这些感知到的障碍是否对麻醉质量报告有因果影响。
ClinicalTrials.gov标识符为NCT01524484。注册日期：2012年1月21日。
