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https://www.readbyqxmd.com/read/28414657/death-by-propofol
#1
James H Diaz, Alan David Kaye
Since its introduction in 1986, propofol ( two, 6-diisopropylphenol) , an intravenous sedative-hypnotic agent, has been utilized for the induction and maintenance of general anesthesia and conscious sedation in over 80 percent of cases; largely replacing thiopental ( sodium pentothal) over a decade ago. Unrestricted as a controlled substance, propofol's abuse potential emerged quickly and was highlighted by the death of pop singer, Michael Jackson, in 2009. In order to assess the epidemiological features of fatal propofol abuse, a descriptive analysis of the scientific literature was conducted using Internet search engines...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28383331/the-path-to-advanced-practice-licensure-for-clinical-nurse-specialists-in-washington-state
#2
Heather Schoonover
PURPOSE: The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007...
May 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/28372645/anesthesiologists-perceptions-of-minimum-acceptable-work-habits-of-nurse-anesthetists
#3
Ilana I Logvinov, Franklin Dexter, Bradley J Hindman, Sorin J Brull
STUDY OBJECTIVE: Work habits are non-technical skills that are an important part of job performance. Although non-technical skills are usually evaluated on a relative basis (i.e., "grading on a curve"), validity of evaluation on an absolute basis (i.e., "minimum passing score") needs to be determined. DESIGN: Survey and observational study. PATIENTS: None. INTERVENTIONS: None. MEASUREMENTS: The theme of "work habits" was assessed using a modification of Dannefer et al...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28343638/patient-care-handoff-in-the-postanesthesia-care-unit-a-quality-improvement-project
#4
Gregory M Bruno, Mary Elizabeth Betsy Guimond
PURPOSE: The goal of this project was to improve the process of transferring patient information between certified registered nurse anesthetists and postanesthesia care unit registered nurses using an evidence-based handoff checklist and evaluate completeness and accuracy of transferred information. DESIGN: A convenience sample of 14 certified registered nurse anesthetists and 7 registered nurses working at a single regional health system was recruited. METHODS: The Handoff Accuracy Scoring Tool was developed to include a pre-/postinterventional design to compare scores of verbal handoffs conducted in the preintervention phase without checklist (n = 20) and postintervention phase with checklist (n = 20)...
April 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28343635/swedish-registered-nurse-anesthetists-evaluation-of-their-professional-self
#5
Christina Hedenskog, Ulrica Nilsson, Maria Jaensson
PURPOSE: This study aimed to explore how the nurse anesthetist values their professional self, compared with their peers, and also to explore whether professional self is affected by age, work experience, and/or gender. DESIGN: An explorative and prospective cross-sectional design. METHODS: During April 2011, a total of 108 registered nurse anesthetists from three different hospitals were surveyed using the Professional Self-Description Form with questions covering 21 items...
April 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28338157/-enhanced-recovery-after-surgery-in-the-west-china-problems-strategy-and-future
#6
Jingwang Ye, Baohua Liu, Weidong Tong
Enhanced recovery after surgery (ERAS) has been widely used in the world for near 20 years, which should be considered as the milestone of modern medicine advancement, changing the routine perioperative principle, accelerating the recovery speed following operation, minimizing the postoperative pain, and saving the medical resources. Despite the remarkable advance, the quality and application of ERAS in the west China needs further improvement if compared with international level or even some domestic hospitals...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28322646/operating-room-personnel-viewpoints-about-certified-registered-nurse-anesthetists
#7
Desiree Hensel, Rachel Cooper, Neil Craney
The purpose of this project was to explore what attitudes physicians, nurses, and operating room technicians had about working with Certified Registered Nurse Anesthetists (CRNAs) to better understand practice barriers and facilitators. This Q methodology study used a purposive sample of operating room personnel from four institutions in the Midwestern United States. Participants completed a -4 to +4 rank-ordering of their level of agreement with 34 attitude statements representing a wide range of beliefs about nurse anesthetists...
December 1, 2016: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28306580/comment-on-growth-in-an-anesthesiologist-and-nurse-anesthetist-supervised-sedation-nurse-program-using-propofol-and-dexmedetomidine
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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