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Nurse anesthetist

Wen-Tso Huang, Ping-Shun Chen, John J Liu, Yi-Ru Chen, Yen-Hsin Chen
Scheduling approaches for conventional surgery operating rooms in a hospital treat surgeons as bottleneck resources directly, but do not deal with stochastic medical resources, leading to an uneven human resource distribution in optimizing medical resource scheduling. Thus, this research focuses on the dynamic configuration scheduling problem for stochastic medical resources. In this paper, the surgical operating room is limited, and the arriving calls (i.e., number of patients) are dynamic. When a patient arrives, the nurse anesthetist and anesthesiologist are limited, but the medical service duration per patient is random...
March 13, 2018: Journal of Biomedical Informatics
Roberta Anderson, Elwood Armour, Courtney Beeckler, Valerie Briner, Amanda Choflet, Andrea Cox, Amanda N Fader, Marie N Hannah, Robert Hobbs, Ellen Huang, Marilyn Kiely, Junghoon Lee, Marc Morcos, Paige E McMillan, Dave Miller, Sook Kien Ng, Rashmi Prasad, Annette Souranis, Robert Thomsen, Theodore L DeWeese, Akila N Viswanathan
PURPOSE: As a core component of a new gynecologic cancer radiation program, we envisioned, structured, and implemented a novel Interventional Radiation Oncology (IRO) unit and magnetic resonance (MR)-brachytherapy environment in an existing MR simulator. METHODS AND MATERIALS: We describe the external and internal processes required over a 6-8 month time frame to develop a clinical and research program for gynecologic brachytherapy and to successfully convert an MR simulator into an IRO unit...
March 13, 2018: Brachytherapy
Peter Anders Christensen
Austere care of the wounded is challenging for all Western medical professionals-nurse, medic, or physician. There can be no doubt that working for the first time, either for a nongovernment organization or in the Special Forces, you will be taking care of wounded patients outside your training and experience. You must have the ability to adapt to and overcome lack of resources and equipment, and accept standards of treatment often very different and lower than that common in western hospitals. The International Committee of the Red Cross (ICRC) was asked to provide relief for the Pakistan Red Crescent in 1982 and set up the ICRC Hospital for Afghan War Wounded in Peshawar on the border to Afghanistan...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
M J Harris, R A Gabriel, R P Dutton, R D Urman
INTRODUCTION: Accurately predicting cesarean delivery case duration is an integral component of designing appropriate workflow protocols and ensuring adequate provider availability. Our primary objective was to describe the variability of case duration, based on factors that we hypothesized would be influential, such as hospital facility type, United States region, time of day, case volume, and patient and provider characteristics. METHODS: We analyzed hospital-, patient-, and provider-level variables from the National Anesthesia Clinical Outcomes Registry, a voluntary registry created to share anesthesia-related data and outcomes...
January 13, 2018: International Journal of Obstetric Anesthesia
N'Diris Barry, Joshua C Uffman, Dmitry Tumin, Joseph D Tobias
OBJECTIVES: Neuromuscular blocking agents (NMBAs) are administered to facilitate endotracheal intubation and provide skeletal muscle relaxation in surgical procedures. Sugammadex (Bridion) recently received approval by the United States Food and Drug Administration for reversal of rocuronium and vecuronium-induced neuromuscular blockade thereby providing an alternative to acetylcholinesterase inhibitors such as neostigmine. This quality improvement analysis sought to investigate the clinical reasons and common clinical perceptions for choosing sugammadex over neostigmine to reverse NMBAs...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Cristina López Muñoz, Andrés Sánchez Yagüe, Jose Carlos Canca Sánchez, José Antonio Reinaldo-Lapuerta, Ana Belén Moya Suárez
INTRODUCTION: research has shown that an endoscopist-nurse clinical team can perform sedation with propofol effectively, safely and efficiently. To do so, it is essential to provide specific and appropriate training in the necessary skills. The main aim of the present study was to evaluate the quality of the sedation procedure administered by non-anesthetists in a digestive endoscopy unit, one year after its introduction. METHODS: a prospective cohort study was performed in patients given propofol sedation by non-anesthetists...
February 21, 2018: Revista Española de Enfermedades Digestivas
Leopoldo López Rosés, Beatriz Álvarez, Abel González Ramírez, Alina López Baz, Alexia Fernández López, Sara Alonso, Andrés Dacal, Eva Martí, Gino Albines, Julieta Fernández Molina, Ángel Lancho
INTRODUCTION: there is a lot of controversy with regard to who should be responsible for sedation during digestive endoscopy, particularly in advanced procedures that require deep sedation such as enteroscopy. The aim of this study was to evaluate the endoscopist-directed sedation viability during single balloon enteroscopy. MATERIAL AND METHOD: this was a prospective, observational study of a series of consecutive enteroscopies. The clinical staff included an endoscopist, scrub nurse and a nurse in charge of monitoring and sedative administration...
February 21, 2018: Revista Española de Enfermedades Digestivas
Juan Duchesne, Chad Majoue, Marquinn Duke, Rosemarie Robledo, Chad Achord, Leslie McHale, Brandy Davis, Lusine Nahapetyan
A Trauma Certified Registered Nurse Anesthetists Team (TCT) was created and trained to provide trauma-focused anesthesia and resuscitation. The purpose of this study was to examine patient outcomes after implementation of TCT. We conducted retrospective analyses of trauma patients managed with surgical intervention from March to December 2015. During the first five months, patients managed before the development of TCT were grouped No-TCT, patients managed after were grouped TCT. To assess outcomes, we used hospital and intensive care unit length of stay, ventilator days, and a validated 10-point intraoperative Apgar score (IOAS)...
January 1, 2018: American Surgeon
Terri L Ares
PURPOSE: This study explored the transition of clinical nurse specialists into new roles after completion of their graduate education. DESIGN: A quantitative longitudinal survey was used to measure certification, employment, career commitment, and the imposter phenomenon. METHODS: An online survey was sent to 113 participants from a previous national study that agreed to follow-up. The Student Nurse Anesthetist Experience Questionnaire and Clance Imposter Phenomenon Scale instruments were used...
March 2018: Clinical Nurse Specialist CNS
Matthias Weigl, Jeannette Weber, Elyse Hallett, Michael Pfandler, Boris Schlenker, Armin Becker, Ken Catchpole
OBJECTIVE: To identify type and severity of surgical flow disruptions and to determine their impact on the perception of intraoperative teamwork. METHODS: 40 radical prostatectomy cases were studied in an academic department for urology. A standardized observational tool for identification of type and severity of flow disruptions was applied during real-time prostatectomy procedures. Additionally, all OR team members evaluated intra-operative teamwork immediately after the procedure...
January 22, 2018: Urology
Markus Forsberg, Catrine Björn, Maria Engström, Annika Nilsson
PURPOSE: The study aim was to describe nurse anesthetists' reflections on the provision of perioperative care to patients with previous substance dependence. DESIGN: A qualitative approach with a descriptive design. METHODS: Semistructured interviews based on clinical vignettes were conducted with 10 nurse anesthetists. FINDINGS: The perioperative care provided to patients with previous substance dependence was perceived as balancing between professionalism and preconceptions for this specific patient group...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Ann-Sofie Sundqvist, Agneta Anderzén-Carlsson, Ulrica Nilsson, Marie Holmefur
PURPOSE: To translate and adapt the Protective Nursing Advocacy Scale (PNAS) into a Swedish version (PNAS-Swe), evaluate its psychometric properties, and describe registered nurse anesthetists' (RNAs) advocacy beliefs and actions from a protective perspective. DESIGN: A cross-sectional design was used. METHODS: First, the PNAS was translated into Swedish. Next, the content and construct validity of the PNAS four subscales was evaluated. Finally, the PNAS-Swe was used to describe Swedish RNA beliefs and actions regarding protective nursing advocacy...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Rabie Soliman, Dalia Saad
OBJECTIVE: The aim of the study was to assess the effect of dexmedetomidine on the incidence of paradoxical hypertension in patients undergoing aortic coarctation repair. DESIGN: Randomized observational study. SETTING: University hospital and cardiac center. PATIENTS: The study included 108 pediatric patients with isolated aortic coarctation. METHODS: The patients were classified into two groups (each = 54): Group D: the patients received dexmedetomidine as a loading dose of 0...
January 2018: Annals of Cardiac Anaesthesia
Michael C Grant, Andrew Hanna, Andrew Benson, Deborah Hobson, Christopher L Wu, Christina T Yuan, Michael Rosen, Elizabeth C Wick
INTRODUCTION: To determine if the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery After Surgery (ERAS). ERAS programs involve the application of bundled best-practices to improve value of the perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. METHODS: Development of dedicated teams of anesthesia providers was a component of the ERAS implementation...
December 21, 2017: Journal of the American College of Surgeons
Umberto Barbero, Federico Ferraris, Milena Muro, Carlo Budano, Matteo Anselmino, Fiorenzo Gaita
: Supportive care for pain relief and back discomfort during electrophysiology interventions is usually needed in the electrophysiology lab, especially in long-lasting procedures like atrial fibrillation ablation. Although this is usually achieved with conventional pharmacologic anesthesia, hypnosis has recently aroused interest as a reliable tool to complement and possibly enhance conscious sedation. We collected five case of percutaneous arrhythmia ablation in which, after informed consent, hypnosis was performed by nurse anesthetists in the cath lab...
January 2018: Journal of Cardiovascular Medicine
Karin Aagaard, Erik Elgaard Sørensen, Bodil Steen Rasmussen, Birgitte Schantz Laursen
PURPOSE: To explore professional identity of registered nurse anesthetists (RNAs) and RNAs' expectations of their professional self and the expectations RNAs meet from interdisciplinary team members when preparing patients for general anesthesia. DESIGN: Focused ethnography was used for data collection. METHODS: Participant observations and interviews were conducted with patients scheduled for surgery and with RNAs in charge of the patients during the anesthetic procedures...
December 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Scott Feyereisen, Joseph P Broschak, Beth Goodrick
We further our understanding of jurisdictional disputes between established professional groups through a 10-year longitudinal analysis of the differential adoption by U.S. states of policies expanding Certified Registered Nurse Anesthetists' (CRNAs) autonomy. In the United States, CRNAs are trained to deliver anesthetics to patients in the same way as physician anesthesiologists but have more restrictions in practice. Following a 2001 federal decision regarding Medicare reimbursement, states were permitted but not required to allow CRNAs to practice without physician supervision, potentially reducing health care costs...
January 1, 2017: Medical Care Research and Review: MCRR
Milo Engoren, Lauryn R Rochlen, Matthew V Diehl, Sarah S Sherman, Elizabeth Jewell, Mary Golinski, Paul Begeman, John M Cavanaugh
BACKGROUND: While most Direct laryngoscopy leads to dental injury in 25-39% of cases. Dental injury occurs when the forces and impacts applied to the teeth exceed the ability of the structures to dissipate energy and stress. The purpose of this study was to measure strain, (which is the change produced in the length of the tooth by a force applied to the tooth) strain rate, and strain-time integral to the maxillary incisors and determine if they varied by experience, type of blade, or use of an alcohol protective pad (APP)...
November 7, 2017: BMC Anesthesiology
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 2017: Journal of Nursing Research: JNR
Johnson Dare Ogunlusi, Moruf Babatunde Yusuf, Popoola Sunday Ogunsuyi, Obafemi K Wuraola, Waheed O Babalola, Kehinde Sunday Oluwadiya, Oduwole Olayemi Ajogbasile
BACKGROUND: Surgical checklist was introduced by the World Health Organization to reduce the number of surgical deaths and complications. During a surgical conference on "safety in surgical practice," it was noticed that the awareness and the use of surgical checklist are poor in Nigerian hospitals. This study was aimed at determining the awareness and use of surgical checklist among the theater users in our hospital, factors militating against its implementation, and make recommendations...
July 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
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