From the Operating Room to the Front Lines: Shared Experiences of Nurse Anesthetists During the Coronavirus Pandemic.

Coronavirus disease 2019 (COVID-19) has resulted in severe health, economic, social, political, and cultural consequences while thrusting Certified Registered Nurse Anesthetists (CRNAs) at the forefront of battling an often invisible enemy. A mixed-methods study was conducted to assess the impact of the COVID-19 pandemic on CRNA practice. The purpose of the qualitative component of the study, a focused ethnography, was to use personal and group interviews to determine the shared experiences of CRNAs who worked during the COVID-19 pandemic. Six themes were identified: (1) CRNAs are part of the solution, (2) doing whatever it takes, (3) CRNAs are valued contributors, (4) removal of barriers promotes positive change, (5) trying times, and (6) expertise revealed. The quantitative component of the study will be discussed in a separate article.

Adverse Events During Cosmetic Surgery: A Thematic Analysis of Closed Claims.

According to the American Society of Plastic Surgeons, there were approximately 1.8 million cosmetic and reconstructive surgeries performed in the United States in 2012. Very few anesthesia-related mortality statistics and detailed descriptions of adverse events during cosmetic/plastic surgery are found in existing literature. This article describes the use of thematic analysis, and subsequent findings, of a cosmetic closed-claim database generated by the American Association of Nurse Anesthetists (AANA) Foundation Closed Claim Research Team. From the most current dataset of 245 claim files provided by the insurance company (CNA), we isolated 25 claims regarding patients undergoing cosmetic and/or related plastic surgery procedures performed from 2003 to 2012. Three major themes emerged from the claims data: (1) normalization of deviance, (2) ineffective communication patterns, and (3) nonadherence to the AANA Standards for Nurse Anesthesia Practice. Detailed descriptions of the adverse events as they relate to the major themes are provided, and suggestions are offered for actions that may mitigate future adverse events in this subset of the population.

A Content and Thematic Analysis of Closed Claims Resulting in Death.

The analyses of malpractice closed claims conducted by the AANA Foundation Closed Claims Research Team are scientific studies of adverse anesthetic events where a Certified Registered Nurse Anesthetist was identified as potentially contributing to the outcome. From July 2013 to March 2014, the AANA Foundation Closed Claims Researchers evaluated 245 closed claims from the CNA Insurance Companies spanning from 2003 to 2012. An adverse event leading to death occurred in 87 of the claims. This article describes the use of content and thematic analysis in the evaluation of these closed claims. The purpose of the study was to establish themes that would provide unique insights into the events leading up to death with a focus on the role anesthesia may or may not have had in the outcome. Major themes identified include: (1) patient factors, (2) provider factors, (3) environmental factors, and (4) team/group factors.

Mobile Computing Devices in the Perioperative Environment: A Survey Exploring Uses and Experiences Among Certified Registered Nurse Anesthetists.

The use of mobile computing devices (MCDs) such as smartphones, tablet computers, and laptops among Certified Registered Nurse Anesthetists (CRNAs) in the clinical area may provide benefits as well as pose risks. Limited research is available on the use of MCDs in the practice of nurse anesthesia. The purpose of this study was to answer the following questions: (1) What are the clinical and nonclinical uses of mobile computing devices among Michigan CRNAs? and (2) What are the experiences of Michigan CRNAs with regard to the impact of using these devices on patient care? A descriptive survey design was used to answer the research questions. Findings from the study reveal that CRNAs believe there are many important benefits as well as major risks associated with using MCDs while providing direct patient care. In addition, some respondents either personally experienced or witnessed incidents of distraction, performance declines, or serious anesthesia events as the result of MCD use during patient care. This study elucidates the need for the development and adoption of policies that promote safe, appropriate, patient-centered use of MCDs for the specialty of nurse anesthesia.

The use of high-fidelity simulation in the admissions process: one nurse anesthesia program's experience.

Nurse anesthesia programs across the country are frequently in search of better selection criteria and more efficient evaluation systems. The goal is to select qualified applicants who will successfully complete the program and represent the profession of nurse anesthesia. The primary method of assessing the quality of candidates' noncognitive attributes at the Oakland University Beaumont Program of Nurse Anesthesia (Royal Oak, Michigan) was by face-to-face interviews. The admissions committee believed that high-fidelity simulation may be a valuable tool to improve the overall admission process. For the 2008 application interview process, high-fidelity simulation was used as a method of simultaneously evaluating candidates' cognitive and noncognitive attributes, in addition to the traditional face-to-face interview. On completion of the admission interview process, a retrospective research design was used to identify a possible correlation between high-fidelity simulation performance scores and other candidate characteristics. The findings of this pilot study revealed a positive correlation between simulation and face-to-face interview scores, suggesting that candidates who exhibited desirable noncognitive attributes in the face-to-face interview also performed well in the simulation environment. The use of high-fidelity simulation as an interview tool may provide an innovative adjunct for admission committees in assessment of candidates.