Understanding Advanced Practice Nurses in Anesthesiology

Abstract

Purpose: Determine the practice authority and professional legitimacy of safe and competentanesthesia administration, particularly the necessity of physician anesthesiologist oversight of certified registered nurse anesthesiologists and anesthesiologist assistants, necessitating the exploration of the education and background experiences that establish the diverse expertise and competencies among these anesthesia professionals. Background: The medical and nursing professions operate in near equal numbers within the United States and provide more than 40 million anesthetics annually, with an established record of safe provision founded upon adequately trained physicians and nurse anesthesiologists. Understanding each profession’s background, education, and experience provides insight into these roles and how each contributes to the safe administration of anesthesia. Methods: This quality improvement project utilizes the Institute of Healthcare’s Model for Improvement plan to facilitate the successful implementation of proposed changes into clinical practice and integrate the Plan-Do-Study-Act (PDSA) cycle to support the development, implementation, evaluation, and necessary alterations to support the desired change. The project was designed for the Arizona Association of Nurse Anesthesiology leadership, who participated in an 18-minute virtual educational presentation followed by a post-pre-survey, quantifying increased knowledge, perceived self-value, and confidence directly attributable to the presentation. Results: Sixteen participants completed the post-pre-survey following the video presentation. Ten (10) survey questions were designed to identify any changes in knowledge and confidence as a direct result of the material in the presentation. Each of the ten (10) areas of confidence and knowledge growth received an average score with a 95% confidence interval above a score of three (3), which score would indicate neither a positive nor negative effect on their subject knowledge. Conclusions: This QI project indicates that there could be an improvement in the knowledge and confidence of anesthesia providers concerning the educational differences between the various anesthesia providers. Presenting this information to stakeholders could empower the current and future decision-making power regarding the safe and efficient practice of anesthesia. The knowledge resultant from this QI project is beneficial to the anesthesia profession and represents the potential for an increase in knowledge that could impact individual providers’ confidence