A Confidential Questionnaire on Perioperative Critical Incidents as a Tool for Evaluating Anesthesia Safety Problems: a Pilot Study

There is a general agreement on the need to analyze critical incidents in the operating room (OR) in order to develop effective ways to predict associated fatal consequences, as well as to develop decision support cognitive tools that can be used in both routine and crisis situations.
Research objective. Developing and testing of a confidential questionnaire on perioperative critical incidents by anaesthesiologists and other intensivists, assessment of the initial results of the tool application including its possible relevance to further implementation in the Russian Federation health care
Materials and methods. The survey was conducted by anonymous questioning among doctors of large hospitals in St. Petersburg from 01.06.2024 to 31.12.2024 using an on-line form.
Results. Of the 32 questionnaires received, 27 (84.4%) were completed and contained complete information, which was systematized and analyzed. Respondents reported most often on critical incidents in male patients (15 patients, 55.6%), and in the age group of 45–59 years (8 cases, 29.6%). Most of the incidents occurred during minimally invasive video assisted surgery (18 cases, 66.7%). In 14 cases (51.8%), critical incidents were related to human error, and in 9 (33.3%) cases, they were related to unexpected complications in the perioperative period. Most of the respondents (20 out of 27, 74.1%) noted that the incidents could have been prevented with more accurate anesthesia monitoring and relying on more sophisticated and performant anesthetic equipment in the Intensive Care Unit. Doctors positively evaluated the trial version of the anonymous questionnaire (22 out of 27, 81.5%), noting its simplicity and usefulness in identifying problems. Several respondents suggested adding open-ended questions to provide a more detailed description of the incidents.
Conclusion. The study confirmed the usefulness of designing and implementing a national questionnaire on perioperative critical incidents in Russia. The data obtained demonstrate that such a tool, combined with improving the staff training, equipment upgrade, and standardization of protocols, can significantly contribute to enhancing patient safety in anesthesia. Ensuring the confidentiality of the provided data is crucial for obtaining statistically significant information. The development, implementation, and expansion of the proposed tool's database under the auspices of the Federation of Anesthesiologists and Resuscitation Specialists on a regular basis will undoubtedly contribute to improving the quality and safety of anesthesiology and resuscitation services in Russia.
Highlights
— 76.5% of respondents believe that incidents can be prevented by improving anesthesia control and OR anesthetic equipment.
— 81.5% of the surveyed specialists positively assessed the need for implementing the questionnaire, as well as its simplicity and anonymity.

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