The Utility of BIS™ Monitoring in Anesthesia for Elderly Patients.

Aging leads to anatomic and physiologic changes in the brain, making it more sensitive to the depressant effects of anesthetic medications and increasing the risk of postoperative neurocognitive complications such as postoperative delirium and postoperative cognitive dysfunction. This article explores the implications of anesthesia on elderly patients' brain health, emphasizing the heightened risk of postoperative neurocognitive disorders, and describes the BIS™ Monitoring System as a neuromonitoring tool for anesthesia professionals to assess the depth of anesthesia. The integration of the BIS Monitoring System into clinical practice can contribute to a more tailored and patient-centered approach to anesthesia management, ultimately improving perioperative outcomes and safety.

Supporting CRNA Clinical Practice: A Review of New and Updated Professional Practice Documents.

The American Association of Nurse Anesthesiology (AANA) Practice Committee, in collaboration with AANA Professional Practice staff, advisory panels, and subject matter experts, annually applies a standardized evidence-based process to review, evaluate, and revise clinical resource documents found in the Professional Practice Manual for the CRNA (Certified Registered Nurse Anesthetist) and on the AANA website. This article highlights several revised and newly developed documents, which include topics such as diversity, equity, and inclusion, anesthesia and analgesia for obstetric patients, and safe injection guidelines.

Analysis of a Needs Assessment Survey to Develop an Online Resource Repository Supporting Nurse Anesthesia Educators.

BACKGROUND: Without highly qualified nurse anesthesia educators and administrators, the health care system will be threatened by the inadequate supply of certified registered nurse anesthetists (CRNAs). PURPOSE: American Association of Nurse Anesthesiologists' Faculty Stabilization Task Force (FSTF) analyzed reasons for high faculty turnover and developed recommendations to support nurse anesthesia faculty and administrators. METHODS: A survey evaluated participants' current role, leadership development opportunities, mentorship experiences, and resource needs. RESULTS: Of 109 respondents, 87 (80%) were program administrators or assistant administrators with less than 5 years of experience in their role. Despite academic experience, 51% felt adequately prepared for their role. CONCLUSIONS: The FSTF provided 2 recommendations: to create a robust faculty development program for all faculty at all levels of CRNA education and a repository of information needed for program administrators and faculty to oversee and educate students in a high-quality CRNA program.

Integrating the ASRA Pain Medicine Cannabis Consensus Guidelines into Certified Registered Nurse Anesthetist Clinical Practice.

The American Association of Nurse Anesthesiology Practice Committee and subject matter experts recently evaluated newly published cannabis guidelines titled "ASRA Pain Medicine Consensus Guidelines on the Management of the Perioperative Patient on Cannabis and Cannabinoids." A summative review of the evidence-based guidelines provides essential recommendations, which are directly applicable to certified registered nurse anesthetist clinical practice.

COVID-19 Preprocedure Testing Considerations.

The COVID-19 pandemic has presented significant patient and provider safety concerns, notably for clinicians involved in aerosol-generating procedures. Healthcare systems established new and innovative ways to function safely and maintain operations, including mandatory preoperative testing, changes to patient scheduling, infection control practices, staffing, surgical prioritization, environmental cleaning, and operating room processing. This article provides practice and policy considerations for preprocedure COVID-19 testing, taking into consideration the available evidence and variability in community prevalence, rate of vaccinations, and new COVID-19 variants.

Supporting the Foundation of Nurse Anesthesia Education: A Report of the Faculty Stabilization Taskforce.

Without highly qualified educators and educational program administrators, the ability to provide anesthesia and pain management services throughout the healthcare system will be threatened by the inadequate supply of Certified Registered Nurse Anesthetists (CRNAs). The average turnover rate between the years 2016-2020, for CRNA program administrators, was 15% with some programs changing leadership as often as every two to four years. In response, the American Association of Nurse Anesthesiology (AANA) and the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) created the Faculty Stabilization Taskforce (FSTF) to review reasons for the high turnover rate and to develop methods and tools to support program faculty and administrators in their role of educating the future CRNA workforce. The FSTF provided two recommendations: 1) to create a robust faculty development program for all faculty at all levels of CRNA education, and 2) to create a repository of information needed to administrate, and educate students, in a high-quality CRNA program. This article summarizes the report made to the AANA Board of Directors (BOD) which was unanimously accepted and is already being implemented by AANA and COA staff. The full text of the report can be found on the AANA's website at www.aana.com/FSTF.

A Review of New and Updated Professional Practice Documents.

The American Association of Nurse Anesthesiology (AANA) Practice Committee, in collaboration with AANA Professional Practice staff, advisory panels, and subject matter experts, applies a standardized evidence-based process to review, evaluate, and revise clinical resource documents found in the Professional Practice Manual for the CRNA (Certified Registered Nurse Anesthetist) and on the AANA website. This article highlights several revised and newly developed practice documents, which include topics such as the scope of nurse anesthesia practice, point of care ultrasound in anesthesia care, anesthesia for patients with substance use disorder, office-based dental anesthesia, workplace civility, and health disparities.

Point-of-Care Ultrasound in Anesthesia Care: New AANA Practice Document Adopted by AANA Board of Directors.

The American Association of Nurse Anesthetists recently released a practice considerations document titled, "Point-of-Care Ultrasound in Anesthesia Care," that clinicians, administrators, and other stakeholders are encouraged to download and read in their entirety, available at aana.com/PracticeManual.

A Review of New and Updated Professional Practice Documents.

The American Association of Nurse Anesthetists (AANA) Practice Committee, in collaboration with AANA Professional Practice staff, annually applies a standardized evidence-based process to review, evaluate, and revise clinical resource documents found in the Professional Practice Manual for the CRNA (Certified Registered Nurse Anesthetist). This article highlights several revised and newly developed documents, which include topics such as the standards for nurse anesthesia practice, office-based anesthesia practice, anesthesia for patients with substance use disorder, clinical privileges for CRNAs, ketamine infusion therapy, postanesthesia care, and medication-assisted therapy. The full versions of each document can be accessed at www.aana.com/PracticeManual.

Serotonin syndrome: fentanyl and selective serotonin reuptake inhibitor interactions.

Serotonin syndrome is a rare but potentially fatal adverse drug reaction associated with increased serotonergic activity in the central nervous system. It is characterized by a triad of symptoms, which include altered mental status, neuromuscular hyperactivity, and autonomic instability or hyperactivity. Due to the potential of rapid onset, it is important for clinicians to recognize the signs and symptoms of serotonin syndrome. Serotonin syndrome symptoms may resemble other conditions. Although this article focuses on serotonin syndrome as a result of an adverse interaction of selective serotonin reuptake inhibitors (SSRI) and fentanyl, it is important for not only anesthesia professionals, but all clinicians--such as those in emergency medicine and critical care--to be aware of this syndrome and its management. This article discusses the clinical manifestations of the serotonin syndrome and highlights reported cases of serotonin syndrome specifically related to an interaction between SSRIs and fentanyl, a commonly used opioid in anesthesia practice.

A closer look at the standards for nurse anesthesia practice.

As part of its ongoing work, the AANA's Practice Committee reviewed the Scope and Standards for Nurse Anesthesia Practice, particularly focusing on the Standards for Nurse Anesthesia Practice. Revisions and updates were made to the standards to ensure clarity and reflect current anesthesia practice. This article highlights several of the important revisions made to the Standards for Nurse Anesthesia Practice, specifically focusing on the importance of documentation, updates to Standard V-Patient Monitoring, and changes to other documents affected by the updates. This is not an exhaustive discussion of all changes made to the document. The updated Standards for Nurse Anesthesia Practice are presented in their entirety.

An update from the AANA practice committee: application of the evidence-based process.

The American Association of Nurse Anesthetists Practice Committee applies a standardized evidence-based process to the development and revision of practice-related documents and member resources. This article highlights recent Practice Committee work related to the revision and development of new materials for the Professional Practice Manual for the Certified Registered Nurse Anesthetist. Specific areas discussed include infection control, Certified Registered Nurse Anesthetists and the interprofessional team, safe practices for needle and syringe use, securing propofol, safe surgery and anesthesia, patient safety and fatigue, and the use of mobile devices.