Academic literature on the topic 'Nurse Anesthetists'

Background: Acute postoperative pain can develop into chronic pain if not managed well. Nurse anesthetists consider many factors when developing an anesthetic plan to provide optimal postoperative pain management. Multimodal pain management is recommended for managing pain in the perioperative period and this may include administering medications such as intravenous (IV) acetaminophen and IV non-steroidal anti-inflammatory drugs (NSAIDs) to the patients if not contraindicated. Even though these are valuable and daily considerations for nurse anesthetists, there is not a standard of care for addressing postoperative pain management in adult abdominal surgical procedures. Objective: The purpose of the project is to determine the perspectives of nurse anesthetists for developing postoperative pain management in adult patients having abdominal surgical procedures. Design: This is a descriptive study designed to determine if current nurse anesthetist practices are being guided by evidence-based practices and if the findings can be used to develop a standard of care. Participants: Nurse anesthetists from a local Tucson, AZ health care facility Measurements: Nurse anesthetists were interviewed in-person. They were asked six semi-structured questions and the answers were recorded and transcribed into the program NVivo. Each answer was then coded and compared for emerging common themes. Results: Five out of eleven nurse anesthetists participated in this project. Thirty-five themes were discovered and three main categories developed: 1. Nurse anesthetists consider multimodal pain management an integral part of the anesthetic plan. IV acetaminophen and IV NSAIDs are considered for every surgical patient if they are not contraindicated; 2. IV acetaminophen is used more frequently for abdominal procedures compared to IV NSAIDs because of risks for bleeding associated with IV NSAIDs; and 3. Each anesthetic plan is individualized to safely address both the patient and surgical factors. Conclusion: A multi-center study should be considered for a future project to determine if these common themes would be found consistently across health care facilities. Eventually, this information could be used to develop a standard of care for managing postoperative pain in adults having abdominal surgery. Other methods for addressing multimodal pain management such as regional blocks should be considered for future studies as well.

For several decades, the field of nursing has focused on the integration of cultural competence content into its prelicensure educational programs. Despite this focus, little is known about the cultural competence of nurses extending their education past initial licensure into an advanced practice nursing specialty, such as nurse anesthesia. Researchers in other fields have found that provider race and previous cultural competence training are associated with higher levels of cultural competence. This research, guided by the culture care diversity and universality theory, sought to determine the relationship between the two subscales, Cultural Awareness and Sensitivity (CAS) and the Cultural Competence Behavior (CCB) of the Cultural Competence Assessment (CCA) tool, and describe the relationships that exist between selected demographic variables and the total cultural competence scores for nurse anesthetists. One hundred and fifty-eight members of the American Association of Nurse Anesthetists participated in the study. The total CCA score for the population was 4.98 out of a potential total score of 7 (SD = .79). Mean scores were 5.64 (SD = .73) and 4.38 (SD = 1.19) for the CAS and CCB subscales, respectively. Hierarchical multiple regression analysis confirmed a positive relationship between post graduate diversity training and total CCA score (B = .28, p < .05). Identifying the cultural competence of this population and the characteristics that are associated with high levels of cultural competence could lead to better provider awareness of their own interactions and perceptions of patients and improved patient-centered care for patients in minority populations who are served by certified registered nurse anesthetists, resulting in positive social change.

Thesis advisor: Patricia Tabloski<br>Fatigue is a factor in human error particularly on tasks requiring sustained attention (Dinges, 1995). Work-hour studies of staff nurses have demonstrated that the risks of making an error increased when nurses worked longer shifts (Rogers, Hwang, Scott, Aiken, and Dinges, 2004. Workload in anesthesia care can vary widely with diverse cognitive and physical demands (Gaba and Lee, 1990; Weinger, Herndon, Zornow, Paulus, Gaba, and Dallen, 1994; Weinger, Reddy, and Slagle, 2004; Weinger and Slagle 2001). The purpose of the study was to examine the influence of work hours and workload on fatigue in certified registered nurse anesthetists (CRNAs). A predictive, correlational design was employed and utilized an electronic survey of 10,000 active certified and active recertified CRNAs. A total of 928 CRNAs completed the survey which included a self-report of work hours. Workload was measured by the NASA Task Load Index and fatigue by the Checklist Individual Strength (CIS-20). Hierarchical multiple regression analysis was applied to the data to test the hypotheses that 1) after controlling for demographic variables, the number of work hours and workload will positively influence post-shift fatigue in nurse anesthetists and 2) after controlling for demographic variables, there will be an interaction between work hours and workload in nurse anesthetists. Work hours and workload explained 19 % of the variance in fatigue in nurse anesthetists with the greatest contribution being from the number of work hours and the workload dimension of performance satisfaction. The study findings suggest that increasing hours of anesthesia time and increasing workload, particularly dissatisfaction with meeting the goals of the anesthetic (performance dimension) increase fatigue in nurse anesthetists. The implications for practice, policy, and research are discussed<br>Thesis (PhD) — Boston College, 2013<br>Submitted to: Boston College. Connell School of Nursing<br>Discipline: Nursing

ABSTRACT PREDICTORS OF SITUATION AWARENESS IN GRADUATE STUDENT REGISTERED NURSE ANESTHETISTS Suzanne M. Wright, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2009 Major Director: J. James Cotter, Ph.D. Situation awareness (SA) is defined as one’s perception of the elements of the environment, the comprehension of their meaning, and the projection of their status in the near future. Stated more simply, SA is knowing what is going on around you. The concept of SA is well known in the field of aviation which is characterized by complexity and dynamism. The discipline of anesthesia shares these same characteristics, yet the study of SA in this setting is in its infancy. Human error has been implicated in nearly 80% of all preventable medical errors. It is well documented that lack of SA frequently contributes to human error. Although the discipline of anesthesia has led the medical field in patient safety through rigorous study of human error and adverse events in the operating room, crises in anesthesia still exist. Nurse anesthetists should possess the ability to acquire and maintain SA at all times during clinical situations in the operating room, yet there are no studies examining SA in this population. Guided by Endsley’s theory of situation awareness, the purpose of this study was to provide nurse anesthesia educators with a best evidence predictor model of SA in GSRNAs for curricular implementation. The study objectives are to determine: a) the extent to which memory, cognition, and automaticity are related to situation awareness, b) the extent to which any relationship amongst memory, cognition, and automaticity mediates their relationship with situation awareness, and c) the extent to which Endsley’s theory of situation awareness is supported in the GSRNA population. After IRB approval, 71 GSRNAs were randomly selected from each of three universities chosen for this study. A non-experimental, correlational design was used to measure the relationship between memory, cognition, and automaticity and SA. Situation awareness was measured by the WOMBAT-CS, a computer-based assessment tool for evaluating SA in complex-system operators such as pilots, air traffic controllers, and anesthetists. A stepwise multiple regression was performed between the GSRNA attributes and SA scores. Beta-weights were used to identify the magnitude each relationship. Findings from this study revealed that cognition best predicts SA in the population of Graduate Student Registered Nurse Anesthetists, with the addition of memory and automaticity contributing no additional predictive value to the model. The results of this study have the potential to make a positive impact on the education and training of GSRNAs. Additionally, this study may provide foundational support for further research directed at assessing the effectiveness of high-fidelity simulated operating room environments in promoting SA in GSRNAs.

Walden University College of Health Sciences This is to certify that the doctoral study by Rickey King has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Marisa Wilson, Committee Chairperson, Health Services Faculty Dr. Murielle Beene, Committee Member, Health Services Faculty Dr. Deborah Lewis, University Reviewer, Health Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 Abstract Development of Emotional Intelligence Training for Certified Registered Nurse Anesthetists by Rickey King MSNA, Gooding Institute of Nurse Anesthesia, 2006 BSN, Jacksonville University, 2003 ASN, Oklahoma State University, 1988 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2016 The operating room is a high stress, high stakes, emotionally charged area with an interdisciplinary team that must work cohesively for the benefit of all. If an operating room staff does not understand those emotions, such a deficit can lead to decreased effective communication and an ineffectual response to problems. Emotional intelligence is a conceptual framework encompassing the ability to identify, assess, perceive, and manage emotions. The research question for this project is aimed at understanding how an educational intervention could help to improve the emotional intelligence of anesthetists and their ability to communicate with other operation room staff to produce effective problem solving. The purpose of this scholarly project was to design a 5-week evidence-based, educational intervention that will be implemented for 16 nurse anesthetists practicing in 3 rural hospitals in Southern Kentucky. The Emotional and Social Competency Inventory - University Edition will be offered to the nurse anesthetists prior to the educational intervention and 6 weeks post implementation to determine impact on the 12 core concepts of emotional intelligence which are categorized under self-awareness, social awareness, self-management, and relationship management. It is hoped that this project will improve emotional intelligence, which directly impacts interdisciplinary communication and produces effective problem solving and improved patient outcomes. The positive social change lies in the ability of the interdisciplinary participants to address stressful events benefitting patients, operating room personnel, and the anesthetist by decreasing negative outcomes and horizontal violence in the operating room.

<p> The purpose of this exploratory qualitative study was to identify experiences or barriers that arise during the first year as Certified Registered Nurse Anesthetists (CRNAs) transition into management and; if these shared experiences can prepare future CRNA managers by providing insight into what knowledge, skills, and abilities are necessary to ensure a smooth and successful career transition. </p><p> A representative sample by email and Facebook (FB) elicited 18 phone interviews of current and past Certified Registered Nurse Anesthetist (CRNA) managers. One interviewer asked 16 questions: seven demographic and nine open-ended. Survey information was (1) transcribed, (2) reviewed and de-identified, and (3) coded for content and classical analysis by two experienced independent coders. A coding tree was developed by coders after independent and random assessment of codes with an IRR (0.93). NVivo 11 software was used to assist with analysis of codes. </p><p> CRNA participants (66%) had less than five years of CRNA management experience, and 61% had no previous management experience or education before accepting their first role as a CRNA manager. An incidental finding, 83% of participants were reluctant managers and 76% of CRNA managers devoted greater than 50% of their time to performing clinical duties over managerial duties. Two resources that CRNA participants agreed were helpful resources during transition included: mentors (83%) and previous education or experiences (44%), especially in business, finance, or management. The skills CRNA participants believed were important during transition included people skills (56%), financial knowledge (33%), and communication (28%). </p><p> CRNA managers are more likely to be reluctant managers that may be relatively new in the role, and with no previous management experience or education. Recommendations for new CRNA managers during transition included; mastering &ldquo;people skills,&rdquo; either through relationship management or communication skills. Derailment may be avoided if new managers consider the results of this investigation.</p><p>