Shared Experiences of Nurse Anesthesiology Faculty During the COVID-19 Pandemic.

The COVID-19 pandemic impacted all aspects of healthcare, including the education of certified registered nurse anesthesiologists. While the literature contains reports of the impact of COVID-19 on physician anesthesiologist faculty, there was no research identified describing the impact on nurse anesthesiologist faculty. The purpose of this study was therefore to describe and explore the impact of the COVID-19 pandemic on nurse anesthesiology faculty. This qualitative ethnographic study used small focus groups and semistructured and probing questions to examine the phenomenon of interest. Through thematic analysis of the narrative, five overarching themes were identified: 1) ability to adapt to adversity, 2) disruption leads to change, 3) perceived positive outcomes, 4) previously untapped resources, and 5) curricular innovation and integrity.

Opportunities and Obstacles: The Impact of COVID-19 on Student Registered Nurse Anesthetists.

In March of 2020, the World Health Organization declared COVID-19 a pandemic. The pandemic had unprecedented impacts on nurse anesthesia education delivery. The aim of this mixed methods study was to describe and quantify the personal and educational impacts of the COVID-19 pandemic on student registered nurse anesthetists (SRNAs). Three themes emerged from the qualitative arm of the study: 1) COVID-19 caused feelings of isolation, anxiety, and stress; 2) COVID-19 was a financial silver lining; and 3) COVID-19 changed nurse anesthesia education delivery and learning for SRNAs. The quantitative arm of the study revealed that SRNAs experienced anxiety, social isolation, and a sense of being overwhelmed. Almost half of the participants received federal stimulus money. Most participants reported an increase in distance education delivery and virtual simulation. This study summarizes the impact of the COVID-19 pandemic on SRNAs and how nurse anesthesia education was altered.

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.

The Flipped Classroom With Case-Based Learning in Graduate Nurse Anesthesia Education.

A pilot study was conducted to compare student academic performance and course satisfaction with the flipped classroom (a type of blended learning) and casebased learning in a graduate nurse anesthesia program. Quiz, test, and student satisfaction survey scores from a neuroanesthesia principles course were compared between 2 first-year nurse anesthesia student cohorts taught in a flipped classroom with case-based learning (n=17) vs traditional lecture-based classroom (n=19). Mean preclass and postclass quiz scores (SD) improved significantly in both the flipped classroom (8.41 [0.870] vs 8.94 [0.243], P=.03, α =.05) and traditional classroom (8.68 [0.58], P=.03, α .05). Between cohorts, no significant differences were found on mean preclass (8.41 vs 8.68, P=.34, α <.05) and postclass quizzes (8.94 vs 9.0, P=.32, α <.05) or examination scores (29.41 [2.00]; 28.31 [2.14]; P=.12, α <.05). Student satisfaction scores were favorable but not significantly different between cohorts. Based on noninferior outcomes in student academic performance and satisfaction, the flipped classroom with case-based learning may be a suitable alternative to the traditional lecture-based classroom in graduate nurse anesthesia education.

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.

Relationship Between Emotional Intelligence and Occupational Stress Levels Among Certified Registered Nurse Anesthetists.

Certified Registered Nurse Anesthetists (CRNAs) are exposed to multiple job-related stressors and therefore experience high levels of occupational stress and job burnout. In healthcare systems, job burnout from occupational stress may lead to poor patient care and safety outcomes. Prior research findings suggest nurses who reported higher levels of emotional intelligence (EI) had significantly lower work-related stress and less job burnout than nurses who reported lower levels of EI. To date, the relationship between EI and occupational stress among CRNAs has not been studied. The purpose of this study was to determine if a relationship exists between EI levels and workplace stress levels among CRNAs. A descriptive survey design was used to answer the research question. Findings from the study reveal a significant relationship between the levels of EI and levels of stress in the CRNA population surveyed (r = -0.20, P = .01). CRNAs who reported higher levels of EI experienced less workplace stress than CRNAs who reported lower levels of EI. Additional findings suggest that CRNAs who have higher levels of EI are better able to cope with occupational stressors. Developing and implementing strategies to increase EI among CRNAs may be key to decreasing work-related stress and burnout.

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.

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.

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.