Knowledge, attitudes, and practices of South African anaesthesiology registrars towards perioperative point-of-care viscoelastic testing

Abstract

Background: Perioperative bleeding contributes significantly to patient morbidity and mortality while the cost of blood products is substantial. Viscoelastic testing (VET) forms part of the armamentarium for perioperative patient blood management. To date, there is a lack of published literature on the knowledge, attitudes, and practices (KAP) of medical practitioners regarding VET. The objective of this study was to describe the KAP of South African anaesthesiology registrars concerning perioperative point-of-care (POC) VET.
Methods: A descriptive, cross-sectional study design was performed using a novel, electronic self-administered questionnaire as the data collection instrument. The study population consisted of South African anaesthesiology registrars who were part of the South African Society of Anaesthesiologists’ (SASA) electronic mailing list.
Results: A total of 71 completed questionnaires were received (response rate = 16.67%). Based on this, 69% of registrars were found to have adequate knowledge. Senior registrars were more likely to have adequate knowledge than junior registrars (p = 0.043). Of the registrars, 64.7% had a positive attitude score towards perioperative VET. All registrars felt they would benefit from a formal education platform on VET. The overall median self-rated confidence score for interpreting VET results was 6/10. Senior registrars had a higher median self-rated confidence score (6 vs 5) compared to junior registrars (p = 0.005). Registrars stated that a lack of VET consumables and trained technologists to administer the test was the greatest barrier to requesting VET for patients at their respective institutions.
Conclusion: Overall knowledge scores were encouraging, however, there is room for improvement, particularly at the junior registrar level. Targeted educational interventions should be implemented at both a local and national level. The lack of national guidelines should be addressed by a multidisciplinary team. Locally developed guidelines can serve as a tool for improving registrar knowledge on the subject of VET and can be used for improving uniformity in practices and standards across the various registrar training circuits in South Africa