Hospital Administrators’ Knowledge of the CRNA Role and Scope of Practice

Abstract

Certified Registered Nurse Anesthetists (CRNAs) are advanced practice registered nurses that have been providing anesthesia care for over 150 years; in all 50 states, all branches of the military, from the neonate to the centenarian and in all surgical settings. The safety and cost effectiveness of anesthesia care delivered by CRNAs has been well documented in several studies, yet their scope of practice continues to be determined by state laws and hospital bylaws. Hospital administrators are often at the forefront of making decisions regarding healthcare costs and finding high quality, cost-effective care. The purpose of this study was to determine hospital administrators’ knowledge regarding the Arizona CRNA and scope of practice. Nonaka’s Theory of Organizational Knowledge Creation explains how hospital administrators process information as they adapt to an ever-changing healthcare environment currently focused on value-based purchasing. Engaging stakeholders in areas unfamiliar to them, such as the CRNA role, was accomplished by using the Participatory, Evidence-Based, Patient-Focused Process for Advanced Practice Nursing (PEPPA) framework to promote increased knowledge. A pre and post survey was implemented to determine lack of knowledge and if the educational tools provided to the participants were able to fill any knowledge gaps regarding the Arizona CRNA. Results from the pre-survey (n=4) found that 25% of hospital administrators are not fully aware of the extent of the CRNA scope of practice and how this affects CRNA practice. Results from the post-survey (n=2), found that 100% of hospital administrators gained knowledge in all areas after reviewing the educational tools provided to them. This project proves there are knowledge gaps about the CRNA role and responsibilities. It is important for CRNAs to increase awareness to stakeholders responsible for making healthcare decisions regarding anesthesia care and policy.