title: Perceived barriers to computerised quality documentation during anaesthesia: a survey of anaesthesia staff.
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.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier is NCT01524484. Registration date: January 21, 2012.
authors.affiliation: Institute of Anaesthesia and Intensive Care, Hirslanden Clinic, Witellikerstrasse 40, CH-8032, Zürich, Switzerland. johannes.wacker@hirslanden.ch.
authors.forename: Johannes
authors.initials: J
authors.lastname: Wacker
authors.affiliation: Horten Center for Patient-Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistrasse 24, CH-8091, Zürich, Switzerland. johann.steurer@usz.ch.
authors.forename: Johann
authors.initials: J
authors.lastname: Steurer
authors.affiliation: Institute for Patient Safety, Faculty of Medicine, University of Bonn, Stiftsplatz 12, D-53111, Bonn, Germany. tanja.manser@ukb.uni-bonn.de.
authors.forename: Tanja
authors.initials: T
authors.lastname: Manser
authors.affiliation: Institute of Anaesthesia and Intensive Care, Hirslanden Clinic, Witellikerstrasse 40, CH-8032, Zürich, Switzerland. elke.leisinger@hirslanden.ch.
authors.forename: Elke
authors.initials: E
authors.lastname: Leisinger
authors.affiliation: Institute of Anaesthesia and Intensive Care, Hirslanden Clinic, Witellikerstrasse 40, CH-8032, Zürich, Switzerland. reto.stocker@hirslanden.ch.
authors.forename: Reto
authors.initials: R
authors.lastname: Stocker
authors.affiliation: Department of Anaesthesia & Surgical Intensive Care Medicine, Hospital Lahr-Ettenheim, Klostenstr. 19, D-77933, Lahr, Germany. georg.mols@le.ortenau-klinikum.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Mols
mesh_terms: D000776:Anesthesiology; D001291:Attitude of Health Personnel; D003625:Data Collection; D004282:Documentation / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019221:Mandatory Reporting; D016347:Medical Records Systems, Computerized / Q000592:standards*; D008505:Medical Staff, Hospital; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires