Barriers and Enablers to Using a Mobile App–Based Clinical Decision Support System in Managing Perioperative Adverse Events Among Anesthesia Providers: Cross-Sectional Survey in China

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Publicat a:Journal of Medical Internet Research vol. 27 (2025), p. e60304
Autor principal: Feng, Xixia
Altres autors: Li, Peiyi, Zhao, Renjie, Li, Weimin, Zhu, Tao, Hao, Xuechao, Chen, Guo
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Gunther Eysenbach MD MPH, Associate Professor
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Accés en línia:Citation/Abstract
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022 |a 1438-8871 
024 7 |a 10.2196/60304  |2 doi 
035 |a 3222368076 
045 2 |b d20250101  |b d20251231 
100 1 |a Feng, Xixia 
245 1 |a Barriers and Enablers to Using a Mobile App–Based Clinical Decision Support System in Managing Perioperative Adverse Events Among Anesthesia Providers: Cross-Sectional Survey in China 
260 |b Gunther Eysenbach MD MPH, Associate Professor  |c 2025 
513 |a Journal Article 
520 3 |a Background:Perioperative adverse events (PAEs) pose a substantial global health burden, contributing to elevated morbidity, mortality, and health care expenditures. The adoption of clinical decision support systems (CDSS), particularly mobile-based solutions, offers a promising avenue to address these challenges. However, successful implementation hinges on understanding anesthesia providers’ knowledge, attitudes, and willingness to embrace such technologies.Objective:This study aimed to evaluate the knowledge, attitudes, and willingness of Chinese anesthesia professionals to adopt a mobile CDSS for PAE management, and to identify key factors influencing its implementation.Methods:A nationwide cross-sectional survey was conducted among anesthesia providers in China from September 5 to December 31, 2023. Participants included anesthesiologists and nurse anesthetists, who play pivotal roles in perioperative care. A 51-item questionnaire, structured around the Knowledge-Attitude-Practice (KAP) framework, was distributed via WeChat through professional anesthesia associations. The questionnaire covered four domains: (1) demographic characteristics, (2) knowledge assessment, (3) attitude evaluation, and (4) practice willingness. Multivariable regression analyses identified predictors of KAP outcomes, with sensitivity analyses focusing on nurse anesthetists.Results:The study included 2440 anesthesia professionals (2226 anesthesiologists and 214 nurse anesthetists). Overall, 87.3% (2130/2440) expressed willingness to adopt the CDSS, with 87.5% (1947/2226) of anesthesiologists and 85.5% (183/214) of nurse anesthetists showing readiness. However, only 39.2% (956/2440) were satisfied with existing incident management systems. Key findings indicated that higher knowledge scores were associated with female gender (coefficient=0.19, P=.003), advanced education, and lack of previous informatics experience (coefficient=0.29, P<.001). Nurse anesthetists scored lower than anesthesiologists (coefficient=–0.76, P<.001). Negative attitudes were more prevalent among older practitioners (coefficient=–0.13, P<.001), females (coefficient=–0.66, P<.001), nurse anesthetists (coefficient=–1.12, P=.003), and those without prior PAE exposure (coefficient=–0.97, P<.001). Higher willingness was observed among practitioners in Southwest China (coefficient=0.10, P=.048), those with positive attitudes (coefficient=0.06, P<.001), and those dissatisfied (coefficient=0.32, P<.001) or neutral (coefficient=0.11, P=.02) towards existing systems. Infrequent departmental incident discussions would reduce practice willingness (coefficient=–0.08, P=.01).Conclusions:This national study highlights a strong readiness among Chinese anesthesia professionals to adopt mobile CDSS for PAE management. However, critical barriers, including role-specific knowledge disparities and ineffective organizational communication, must be addressed to ensure successful implementation. Collaborative efforts among local authorities, health care facilities, anesthesia departments, and technology developers are essential to design and implement tailored strategies. Key recommendations include interdisciplinary training programs to enhance nurse anesthetists’ competencies, institution-level incentives to promote incident reporting, and user-centered CDSS designs that prioritize seamless integration into clinical workflows. These measures are vital for improving perioperative incident reporting systems and ultimately advancing the safety and outcomes of surgical patients. 
610 4 |a WeChat 
651 4 |a China 
653 |a Morbidity 
653 |a Discriminant analysis 
653 |a Health care expenditures 
653 |a Mortality 
653 |a Local authorities 
653 |a Medical personnel 
653 |a Questionnaires 
653 |a Anesthesia 
653 |a Likert scale 
653 |a Automation 
653 |a Global health 
653 |a Patients 
653 |a Anesthesiology 
653 |a Clinical outcomes 
653 |a Validity 
653 |a Internet access 
653 |a Clinical decision making 
653 |a Attitudes 
653 |a Perioperative care 
653 |a Health care 
653 |a Implementation 
653 |a Demography 
653 |a Hospitals 
653 |a Critical incidents 
653 |a Interdisciplinary aspects 
653 |a Professionals 
653 |a Willingness 
653 |a Polls & surveys 
653 |a Anesthetists 
653 |a Decision support systems 
653 |a Knowledge 
653 |a Management 
653 |a Support networks 
653 |a Computer mediated communication 
653 |a Nurses 
653 |a Adoption of innovations 
653 |a Health services 
653 |a Software 
653 |a Organizational communication 
653 |a Medical decision making 
653 |a Educational programs 
653 |a Females 
700 1 |a Li, Peiyi 
700 1 |a Zhao, Renjie 
700 1 |a Li, Weimin 
700 1 |a Zhu, Tao 
700 1 |a Hao, Xuechao 
700 1 |a Chen, Guo 
773 0 |t Journal of Medical Internet Research  |g vol. 27 (2025), p. e60304 
786 0 |d ProQuest  |t Library Science Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3222368076/abstract/embedded/L8HZQI7Z43R0LA5T?source=fedsrch 
856 4 0 |3 Full Text + Graphics  |u https://www.proquest.com/docview/3222368076/fulltextwithgraphics/embedded/L8HZQI7Z43R0LA5T?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3222368076/fulltextPDF/embedded/L8HZQI7Z43R0LA5T?source=fedsrch