JMIR Publications

ABSTRACT

Background:

The global health landscape is significantly impacted by perioperative adverse events. The emergence of information technology, particularly clinical decision support systems, offers promising solutions for addressing these challenges. Effective implementation and optimization of these systems hinge on understanding the experiences and perspectives of anesthesia providers in reporting and management.

Objective:

This study aims to evaluate the knowledge, attitudes, and willingness to adopt a mobile application based clinical decision support system for managing perioperative adverse events among anesthesiologists and nurse anesthetists in China.

Methods:

Guided by the CHERRIES (Checklist for Reporting Results of Internet E-Surveys) reporting guidelines, we developed a questionnaire based on the Knowledge, Attitudes, and Practices theory to collect data anonymously. Univariable and multivariable analyses were used to examine factors associated with the level of knowledge, attitudes, and willingness to adopt this system. Nurse anesthetists were also separately analyzed for sensitivity.

Results:

This survey was conducted from September 5 to December 31, 2023, involving 2,440 anesthesia professionals across China, including 2,226 anesthesiologists and 214 nurse anesthetists. Only 39.2% (956/2,440) of respondents expressed satisfaction with existing incident management systems, while 87.3% (2,130/2,440) of participants, demonstrated a strong willingness to adopt this system. This included 87.5% (1,947/2,226) anesthesiologists and 85.5% (183/214) nurse anesthetists. Multivariable regression analysis revealed that factors such as females (coefficient = 0.19, P = .003), higher education, and lack of experience with informatics tools (coefficient = 0.29, P < .001) were associated with greater knowledge. Conversely, nurse anesthetists (coefficient = -0.76, P < .001) and those dissatisfied with current systems (coefficient = -0.51, P = .007) exhibited lower awareness. Negative attitudes toward PAE management were notably prevalent among older individuals (coefficient = -0.13, P < .001), females (coefficient = -0.66, P < .001), nurse anesthetists (coefficient = -1.12, P = .003), and respondents without prior incidents encounters (coefficient = -0.97, P < .001). Anesthesia practitioners in Southwest China (coefficient = 0.10, P = .048), those with a favorable attitude (coefficient = 0.06, P < .001), and individuals dissatisfied (coefficient = 0.32, P < .001) or neutral (coefficient = 0.11, P = .02) about current systems showed a higher propensity to adopt the innovative system. In contrast, infrequent departmental discussions about incidents (coefficient = -0.08, P = .01) were identified as a negative factor affecting practice willingness.

Conclusions:

This study highlights the need for and significance of developing a mobile application based clinical decision support system, and reveals potential barriers and enablers to using this innovative system in managing perioperative adverse events. Drawing from these insights, local authorities, healthcare facilities, anesthesia departments, and technology developers should devise customized strategies considering their unique attributes, which is essential for improving perioperative incident reporting and enhancing the safety of surgical patients. Clinical Trial: Not Applicable.