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https://www.readbyqxmd.com/read/28306580/comment-on-growth-in-an-anesthesiologist-and-nurse-anesthetist-supervised-sedation-nurse-program-using-propofol-and-dexmedetomidine
#1
Joseph P Cravero, Randall P Flick, Shobha V Malviya
No abstract text is available yet for this article.
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#2
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288089/complication-rates-for-fluoroscopic-guided-interlaminar-lumbar-epidural-steroid-injections-performed-by-certified-registered-nurse-anesthetists-in-diverse-practice-settings
#3
Donald E Beissel
STUDY QUESTION: What is the complication rate for Certified Registered Nurse Anesthetists (CRNAs) performing fluoroscopic guided lumbar epidural steroid injections (LESIs)? METHODS: CRNA pain practitioners responded to questionnaires regarding their education level, experience, and practice locations. Participants also collected data on number of fluoroscopic guided LESIs performed and each of 20 complications for a 6-month period, and answered a poll regarding satisfaction with the data collection process...
November 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28257319/contextual-challenges-to-safe-surgery-in-a-resource-limited-setting-a-multicenter-multiprofessional-qualitative-study
#4
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta A Mutabazi, William Austin Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVES: Safe surgery should be available to all patients, no matter the setting. The purpose of this study was to explore the contextual-specific challenges to safe surgical care encountered by surgeons and surgical teams in many in low- and middle-income countries (LMICs), and to understand the ways in which surgical teams overcome them. BACKGROUND: Optimal surgical performance is highly complex and requires providers to integrate and communicate information regarding the patient, task, team, and environment to coordinate team-based care that is timely, effective, and safe...
March 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28243888/assessing-the-impact-of-state-opt-out-policy-on-access-to-and-costs-of-surgeries-and-other-procedures-requiring-anesthesia-services
#5
John E Schneider, Robert Ohsfeldt, Pengxiang Li, Thomas R Miller, Cara Scheibling
In 2001, the U.S. government released a rule that allowed states to "opt-out" of the federal requirement that a physician supervise the administration of anesthesia by a nurse anesthetist. To date, 17 states have opted out. The majority of the opt-out states cited increased access to anesthesia care as the primary rationale for their decision. In this study, we assess the impact of state opt-out policy on access to and costs of surgeries and other procedures requiring anesthesia services. Our null hypothesis is that opt-out rule adoption had little or no effect on surgery access or costs...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28235524/awake-tracheal-intubation-in-anticipated-difficult-airways-lma-fastrach-vs-flexible-bronchoscope-a-pilot-study
#6
Sherine F Hanna, Marianne Mikat-Stevens, James Loo, Raj Uppal, W Scott Jellish, Matthew Adams
STUDY OBJECTIVE: To compare the use of LMA Fastrach intubating laryngeal mask airway (ILMA) to flexible bronchoscopy (FB) for awake intubation in patients with difficult airways. DESIGN: Randomized prospective study. SETTING: Large academic medical center. PATIENTS: Forty adult patients, American Society of Anesthesiologists I-IV, meeting the criteria for awake intubation based on history and physical examination. INTERVENTIONS: After sedation and airway topicalization, patients were randomized to either FB group, n=19, or ILMA group, n=21...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235177/aana-journal-course-update-for-nurse-anesthetists-part-5-use-of-tranexamic-acid-in-preventing-postpartum-hemorrhage
#7
Derrick C Glymph, Tito D Tubog, Mariya Vedenikina
Postpartum hemorrhage (PPH) continues to be a serious complication in both developed and underdeveloped countries. It remains the leading cause of maternal mortality in underdeveloped countries. Implementation of the World Health Organization guidelines of PPH treatment has reduced mortality. In addition, the prophylactic administration of tranexamic acid with uterotonic agents may contribute to the reduction of PPH. This evidence-based literature review of tranexamic acid will examine its mechanism of action as well as its effectiveness in prevention of PPH and blood loss reduction in elective surgery, obstetrics, and trauma...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235172/exploring-strategies-to-increase-and-sustain-membership-in-the-american-association-of-nurse-anesthetists
#8
Cynthia Ann Farina, Wanda Wilson, Kim FitzSimmons
The total numbers of Certified Registered Nurse Anesthetists (CRNAs) in the United States and members of the American Association of Nurse Anesthetists (AANA) have risen to an all-time high. However, the percentage of CRNAs who are AANA members has been slowly declining since 2006, particularly among newly certified nurse anesthetists. To develop new strategies to increase and sustain CRNA membership, the AANA conducted a translational research project that explored evidence-based determinants of individuals' decisions to join professional associations, current membership practices and patterns, results of a recent member needs survey, and socialization of student registered nurse anesthetists (SRNAs) into the AANA...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28230673/va-grants-most-aprns-full-practice-authority
#9
Dalia Sofer
But certified registered nurse anesthetists are excluded.
March 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28125964/effect-of-admission-fascia-iliaca-compartment-blocks-on-post-operative-abbreviated-mental-test-scores-in-elderly-fractured-neck-of-femur-patients-a-retrospective-cohort-study
#10
Peter M Odor, Irina Chis Ster, Iain Wilkinson, Frederic Sage
BACKGROUND: Post-operative cognitive impairment is common in elderly patients following surgery for hip fracture, with undertreated pain being an important etiological factor. Non-opioid based analgesic techniques, such as nerve blocks, may help reduce the risk of cognitive complications. The aim of this study was to investigate whether receiving a fascia iliaca compartment block (FICB) as part of a pre-operative analgesic regime increased the odds of high post-operative abbreviated mental test scores (AMTS) when compared with conventional analgesia without a nerve block...
January 5, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28106610/-opt-out-and-access-to-anesthesia-care-for-elective-and-urgent-surgeries-among-u-s-medicare-beneficiaries
#11
Eric C Sun, Franklin Dexter, Thomas R Miller, Laurence C Baker
BACKGROUND: In 2001, the Centers for Medicare and Medicaid Services issued a rule allowing U.S. states to "opt out" of the regulations requiring physician supervision of nurse anesthetists in an effort to increase access to anesthesia care. Whether "opt out" has successfully achieved this goal remains unknown. METHODS: Using Medicare administrative claims data, we examined whether "opt out" reduced the distance traveled by patients, a common measure of access, for patients undergoing total knee arthroplasty, total hip arthroplasty, cataract surgery, colonoscopy/sigmoidoscopy, esophagogastroduodenoscopy, appendectomy, or hip fracture repair...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28098571/operating-room-anesthesia-subspecialization-is-not-associated-with-significantly-greater-quality-of-supervision-of-anesthesia-residents-and-nurse-anesthetists
#12
Franklin Dexter, Johannes Ledolter, Richard H Epstein, Bradley J Hindman
BACKGROUND: Supervision of anesthesia residents and nurse anesthetists is a major responsibility of faculty anesthesiologists. The quality of their supervision can be assessed quantitatively by the anesthesia residents and nurse anesthetists. Supervision scores are an independent measure of the contribution of the anesthesiologist to patient care. We evaluated the association between quality of supervision and level of specialization of anesthesiologists. METHODS: We used two 6-month periods, one with no feedback to anesthesiologists of the residents' and nurse anesthetists' evaluations, and the other with feedback...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#13
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
March 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28091758/-deaths-from-propofol-abuse-survey-of-institutes-of-forensic-medicine-in-germany-austria-and-switzerland
#14
C Maier, J Iwunna, M Tsokos, F Mußhoff
Previous references suggesting a high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in Germany, Austria and Switzerland concerning the number of autopsies carried out between 2002-2112 on medical personnel with the suspicion of abuse of propofol or other analgesics. The response rate was 67%. In 16 out of the 32 responding departments 39 deaths (27 males) were observed with previous connections to anesthesiology, intensive care or emergency departments of which 22 were physicians, 13 nurses, 2 other personnel and 2 were unknown...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28045884/a-study-of-interpersonal-conflict-among-operating-room-nurses
#15
Tsui-Fen Chang, Chung-Kuang Chen, Ming-Jia Chen
BACKGROUND: Team collaboration is an important factor that affects the performance of the operating room (OR). Therefore, the ability of OR nurses to adapt to and manage interpersonal conflict incidents properly is very important. PURPOSE: The aims of this study were to investigate the interpersonal conflict management capabilities of OR nursing staffs and to find the relationships among the demographics of OR nurses and the following: work-related variables, interpersonal conflict management style, and target of interpersonal conflict...
December 29, 2016: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28034412/does-adoption-of-electronic-health-records-improve-organizational-performances-of-hospital-surgical-units-results-from-the-french-e-si-preps-sips-study
#16
Morgane Plantier, Nathalie Havet, Thierry Durand, Nicolas Caquot, Camille Amaz, Irène Philip, Pierre Biron, Lionel Perrier
BACKGROUND: Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances...
February 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28009594/assessing-the-psychometric-properties-of-alternative-items-for-certification
#17
COMPARATIVE STUDY
Mary Anne Krogh, Timothy Muckle
Alternative items were added as scored items to the National Certification Examination for Nurse Anesthetists (NCE) in 2010. A common concern related to the new items has been their measurement attributes. This study was undertaken to evaluate the psychometric impact of adding these items to the examination. Candidates had a significantly higher ability estimate in alternative items than in multiple choice questions and 6.7 percent of test candidates performed significantly differently in alternative item formats...
2016: Journal of Applied Measurement
https://www.readbyqxmd.com/read/28001018/advanced-practice-registered-nurses-final-rule-with-comment-period
#18
(no author information available yet)
The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three roles of VA advanced practice registered nurses (APRN) when they are acting within the scope of their VA employment. Certified Registered Nurse Anesthetists (CRNA) will not be included in VA's full practice authority under this final rule, but comment is requested on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking...
December 14, 2016: Federal Register
https://www.readbyqxmd.com/read/27935778/anesthesia-involvement-in-palliative-care
#19
Amanda C Faircloth
Palliative care teams require multidisciplinary support. While this is an emerging area in anesthesia practice, there are many avenues for certified registered nurse anesthetists (CRNAs) to share their unrivaled clinical knowledge. CRNAs may become involved with or consult on palliative sedation, medical management, interventional pain management, terminal wean/extubation, and organ donation. Additionally, CRNAs need to understand the unique needs of this patient population so that they can appropriately care for palliative care patients presenting to the operating room for palliative surgery...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27935772/anesthetic-implications-of-obesity-and-obstructive-sleep-apnea
#20
Jennifer Greenwood
The incidence of morbid obesity has tripled within the past 25 years in developed countries, with the highest rate of growth noted among people with body mass index (BMI) greater than 50. The physiologic derangements that accompany obesity affect almost every organ system leading to a vast array of comorbid conditions including obstructive sleep apnea (OSA). This review focuses on the unique perioperative management considerations that the nurse anesthetist must address when caring for these patients as well as the impact of obesity and OSA on postoperative complications and mortality rates...
January 2017: Annual Review of Nursing Research
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