A Mixed-Methods Exploration of Competencies and Professional Development Needs Among Chief Certified Registered Nurse Anesthetists
AANA J. 2024 Apr;92(2):105-113.ABSTRACTThis project sought to explore the experiences, self-perceived preparation, professional development needs, and preferred learning methods of certified registered nurse anesthetists (CRNAs) in a management role. A sample of 10 current chief CRNAs responded to a demographics survey and participated in one-on-one interviews using a 14-question, semi-structured interview framework modified from a previous study. Interview responses were deidentified and qualitatively analyzed for common themes by two content experts and one qualitative analysis expert. Results suggest that CRNAs entering...
Source: AANA Journal - April 2, 2024 Category: Anesthesiology Authors: Austin L Cole Virginia C Simmons Barbara S Turner Robert Whitehurst Denise H Tola Source Type: research
A New Distal Pharyngeal Airway Device Associated with a Reduced Need for Chin-Lift and Jaw-Thrust Maneuvers in Sedated Patients
AANA J. 2024 Apr;92(2):115-120.ABSTRACTOropharyngeal airways (OPA) or nasopharyngeal airways (NPA) sometimes require chin-lift or jaw-thrust (CLJT) maneuvers to relieve airway obstruction which creates the burden of continuous hands-on care by the anesthesia provider. A new distal pharyngeal airway device (DPA) was used on 63 successive ambulatory surgery patients to assess the frequency of patients requiring manual CLJT maneuvers to prevent airway obstruction. Results were then compared with a contemporaneous group of patients who had used OPA or NPA devices for similar procedures. Patients using the DPA had a 38.5% lower...
Source: AANA Journal - April 2, 2024 Category: Anesthesiology Authors: Carol Daniel Monika Feeney Leah Gordon Source Type: research
Improving CRNAs' Confidence and Perceived Knowledge of Endosurgical Patients Who Use Marijuana: A Quality Improvement Project
AANA J. 2024 Apr;92(2):121-130.ABSTRACTAlthough some researchers have reported health-related benefits of marijuana, others have reported adverse side effects in nearly every organ system. Patterns of marijuana use are evolving, as is researchers' understanding of marijuana use for healthcare. Despite these findings and developments, nurse anesthetists are inadequately educated about marijuana's perioperative effects on endosurgical patients. As a result, many nurse anesthetists lack confidence in and knowledge of the perioperative care of endosurgical patients under the influence of marijuana. This lack of confidence and ...
Source: AANA Journal - April 2, 2024 Category: Anesthesiology Authors: Janice Cain Teri Lindgren Alexandra Duke Source Type: research
Challenges for Nurse Anesthetists Reentering Practice Following Substance Use Disorder Treatment
AANA J. 2024 Apr;92(2):131-138.ABSTRACTSubstance use disorder (SUD) is a persistent, relapsing condition that is present in approximately 10% of anesthesia providers, who, compared with other healthcare providers, face a greater risk of developing an SUD by virtue of constant access to medications. The ability of certified registered nurse anesthesiologists (CRNAs) to obtain or maintain employment after treatment for SUD treatment is not well documented. The purpose of this qualitative study was to explore challenges encountered by CRNAs in recovery as they attempt to reenter practice following SUD treatment. The phenomeno...
Source: AANA Journal - April 2, 2024 Category: Anesthesiology Authors: T'Anya Carter Nancy Wingo Susan McMullan Gwen Childs Bernadette Roche Lisa J Merlo Karen Heaton Source Type: research
Quantitative Neuromuscular Monitoring Permits Early Diagnosis of Abnormal Butyrylcholinestrase: Two Case Studies Demonstrating Prevention of Awareness from Premature Awakening
We present two patients with abnormal BChE gene variants. In the first case, quantitative monitoring was applied too late to prevent awareness, but allowed diagnosis and prevented admission to the intensive care unit. In the second case, monitoring was applied prior to NMB, which enabled early diagnosis and prevented premature awakening from anesthesia. These cases illustrate the importance of quantitative NMM, even in short cases and with short-acting depolarizing agents such as succinylcholine. The clinical implications of this report include a more consistent use of NMM to identify and manage patients with undiagnosed a...
Source: AANA Journal - April 2, 2024 Category: Anesthesiology Authors: Erica M Harris Emily M Funk Daniel Plezia Judson Elliott Ryland Elliott Jessica Szydlowski Pitman Stuart A Grant Source Type: research
Implementation of a Spaced Learning Program for Educating CRNAs on a Scalpel-Bougie Cricothyrotomy Procedure for Emergency Front of Neck Access
AANA J. 2024 Apr;92(2):145-152.ABSTRACTCertified registered nurse anesthetists (CRNAs) who are responsible for airway management, may lack adequate continuing education for emergency front of neck access (EFONA), an advanced skill necessary in situations when a patient cannot be intubated and cannot be oxygenated (CICO). The purpose of this study was to improve CRNA knowledge and confidence when performing a scalpel-bougie cricothyrotomy for EFONA in a CICO event through the implementation of a spaced learning intervention. Thirteen CRNAs at a 160-bed community hospital participated in a 3-week educational intervention. We...
Source: AANA Journal - April 2, 2024 Category: Anesthesiology Authors: Antoinette T Padula Joy Elwell Maria Madonick Michael Wilhelm Don Boyd Source Type: research
Educational Costs Expended and Career Incomes in Advanced Healthcare Professions
AANA J. 2024 Feb;92(1):7-16.ABSTRACTThe financial desirability of dollar/time investments in postbaccalaureate healthcare professional education is needed. We therefore compared postbaccalaureate educational costs and career earnings for nurse anesthetists, eight other advanced degree, nonphysician professions, and 14 physician specialties with internal rate of return (IRR) and net present value (NPV) analysis. The IRR and NPV integrated educational costs (tuition, finance charges, lost salary opportunity costs), and career earnings using U.S. Bureau of Labor and Medscape 2022 Physician Compensation Report data. Costs were...
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Melissa M Brown Gary C Brown Meg R Smith Source Type: research
Preliminary Investigation: Pilot Study of Program Directors' Perceptions of Wellness and Suicide Prevention for Student Registered Nurse Anesthetists
AANA J. 2024 Feb;92(1):17-26.ABSTRACTThe purpose of this pilot study was to investigate wellness and student suicidality in nurse anesthesia programs. Graduate students such as student registered nurse anesthetists (SRNAs) are at increased risk of suicide from environmental and educational stressors. Wellness interventions may help. An observational, anonymous online survey of all program directors (PDs) was conducted. Identical responses on a simultaneous pilot SRNA study were compared. Quantitative data were analyzed using Wilcoxon rank sum and Fisher's exact tests. Three PDs reported student suicides. Anxiety, depressio...
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Charles A Griffis Elizabeth Bamgbose Maria Van Pelt Holli DeVon Holly Wilhalme Kristen Choi Source Type: research
Redefining Competencies for Nurse Anesthesia Education--Integrating Emotional Intelligence Assessment and Training into a Nurse Anesthesia DNP Program
We present an overview of best practices for integrating emotional intelligence into a nurse anesthesia educational program. We first cover a brief history of the importance of emotional intelligence to the healthcare, nursing, and nurse anesthesia fields and then present the processes we undertook to integrate emotional intelligence holistically into our curriculum.PMID:38289684 (Source: AANA Journal)
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Catherine S Daus Kevin J Stein Leah M Baecht Source Type: research
Lateral Femoral Cutaneous Nerve Cryoneurolysis for Meralgia Paresthetica: A Case Report
We present a successful case of a patient with intractable neuropathic pain resulting from MP treated with cryoneurolysis therapy. The patient demonstrated immediate pain relief by 100% after the procedure followed by 80% and 60% pain reduction at 1-month and 3-months follow-up, respectively. Cryoneurolysis may be an alternative modality for patients who fail at conventional medical treatments of neuropathic pain.PMID:38289685 (Source: AANA Journal)
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Lisa Pearson Victoria Schmelzer John Maye Sarah Jingying Zhang Source Type: research
An Evaluation of Commercial Payer Reimbursement and Contracting Factors for Physician Anesthesiologists and Certified Registered Nurse Anesthetists for Services Performed in 2019
AANA J. 2024 Feb;92(1):41-48.ABSTRACTWe sought to establish commercial rate benchmarks specific to certified registered nurse anesthetist (CRNA) anesthesia delivery models (QZ), quantify any payer disparities discovered between CRNAs and anesthesiologists, and determine payer alignment with nondiscrimination provisions of the Affordable Care Act (ACA). The Lewin Group administered the exploratory, descriptive study of QZ billing practices by surveying a targeted cross-section of 345 CRNAs known for QZ billing. Forty-one respondents reported information from 1,089 CRNAs and 351,920 cases with 127,888 commercial claims bille...
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Jean Covillo Maria Sallie Poepsel Jeanie Skibiski Source Type: research
Anesthesia Management for Electroconvulsive Therapy
AANA J. 2024 Feb;92(1):51-56.ABSTRACTElectroconvulsive therapy (ECT) was first introduced in the late 1930s. In 2016, 1.4 million people worldwide were treated with ECT, a procedure that differs from any other. Indications for ECT include schizophrenia, schizoaffective disorder, catatonia, neuroleptic malignant syndrome, and bipolar disorder. Additionally, ECT can be beneficial for patients with autism spectrum disorder, specifically those with self-injurious behaviors and severe behaviors related to agitated or excited catatonia. As indications for ECT have grown, the results of therapy have proven beneficial. The anesthe...
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Brian Czerwonka Jake Johnston Rachel Smith-Steinert Source Type: research
A Nurse Anesthesiology Mentorship Program: An Evidence-Based Project for Implementation
AANA J. 2024 Feb;92(1):57-62.ABSTRACTTransitioning from the role of student to the professional certified registered nurse anesthetist (CRNA), as well as a CRNA transitioning to a new job can be very difficult because of uncertainty in the new environment when compounded by a lack of social support. A formal mentorship program was developed and organized by CRNA leadership to help retain and engage new employees and ensure that they assimilate to the new culture while effectively gaining institutional knowledge and clinical skills. The mentorship program consisted of structured meetings that included the newly hired cohort...
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Shelly Anderson Source Type: research
Truncal Plane Blocks for Implantation of Cardiac Resynchronization Devices: A Systematic Review
AANA J. 2024 Feb;92(1):63-71.ABSTRACTPatients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) placement can experience significant perioperative pain. General anesthesia is traditionally used for S-ICD placement and is associated with increased risk. Truncal plane blocks (TPBs) and sedation offer an alternative for adequate analgesia while avoiding hemodynamic compromise related to general anesthesia. A comprehensive evidence search utilized PubMed, CINAHL, Google Scholar, EBSCOhost, US National Library of Medicine Clinical Trials, and Medline Complete databases and the evidence examined the efficacy...
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Hannah Bridges Duy Tran Ruben A Lopez Ashlee M Ericksen Source Type: research
Educational Costs Expended and Career Incomes in Advanced Healthcare Professions
AANA J. 2024 Feb;92(1):7-16.ABSTRACTThe financial desirability of dollar/time investments in postbaccalaureate healthcare professional education is needed. We therefore compared postbaccalaureate educational costs and career earnings for nurse anesthetists, eight other advanced degree, nonphysician professions, and 14 physician specialties with internal rate of return (IRR) and net present value (NPV) analysis. The IRR and NPV integrated educational costs (tuition, finance charges, lost salary opportunity costs), and career earnings using U.S. Bureau of Labor and Medscape 2022 Physician Compensation Report data. Costs were...
Source: AANA Journal - January 30, 2024 Category: Anesthesiology Authors: Melissa M Brown Gary C Brown Meg R Smith Source Type: research
