RESOURCES

Numerous medical studies show there is no statistical difference in patient outcomes when a nurse anesthetist provides treatment, even for rare and difficult procedures.

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AANA: From the OR to the Front lines: Shared Experiences of CRNAs during the COVID-19 Pandemic

The American Association of Nurse Anesthesiology (AANA) found that removing scope of practice barriers for nurse anesthetists results in increased access to patient care and eliminated unnecessary layers of supervision. When the World Health Organization declared the COVID-19 outbreak a pandemic one year ago, Certified Registered Nurse Anesthetists (CRNAs) were deployed across the country to care for patients infected with the virus. CRNAs stepped into leadership roles, providing expertise in triage, airway and ventilation management, emergency care, ground and air patient evacuation, physical and psychosocial support and recovery, and disaster management—making CRNAs a highly sought-after healthcare provider. According to study researchers, the majority of CRNAs found themselves front and center of the crisis educating, developing protocols, acting as consultants and intensivists, manning incident command centers, and innovatively solving problems. They adapted to every situation they were confronted with, which one CRNA identified as fulfilling “right size roles.” Findings of the study confirmed that CRNAs are adept at meeting challenges and leading during a crisis. Details of the survey are available in the April edition of the AANA Journal, the association's official scholarly journal.

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CMS: Nurse Anesthetists Among Most Utilized Healthcare Providers

A new report from the Centers for Medicare & Medicaid Services provides data that indicate Certified Registered Nurse Anesthetists (CRNAs) are among the most utilized healthcare providers in the nation. According to this data, CRNAs were among the top 20 specialties that served the most beneficiaries in non-telehealth care between March 2020 and June 2020—the height of the COVID-19 public health emergency. In its report, "Putting Patients First: The Centers for Medicare & Medicaid Services' Record of Accomplishments from 2017-2020," CMS also cites that its action to waive the physician supervision requirement of CRNAs is among its notable accomplishments in healthcare between 2017 and 2020.

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Anesthesiology: “Anesthesia Care Team Composition and Surgical Outcomes”

New research published online in the journal Anesthesiology confirms the quality and safety of anesthesia provided by Certified Registered Nurse Anesthetists (CRNAs) while raising questions about the role and value of anesthesiologist assistants (AAs) in patient care. The study, titled “Anesthesia Care Team Composition and Surgical Outcomes,” was funded by the American Society of Anesthesiologists. CRNAs are not required by state or federal laws or regulations to be supervised by --- or to even work with --- an anesthesiologist, while AAs can only work under the supervision of an anesthesiologist. An AA functions as an assistant to an anesthesiologist and is dependent upon the anesthesiologist’s supervision and direction. When an anesthesiologist supervises multiple CRNAs, however, it is typical for the anesthesiologist to rarely be present in the operating room, or not present at all, because CRNAs are capable of working safely and effectively without anesthesiologists and do so all the time.

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Reforming America’s Healthcare System Through Choice and Competition

Reforming America's Healthcare System Through Choice and Competition Summary (pp. 30-36): The U.S. Department of Health and Human Services, in collaboration with the U.S. Department of Treasury, the U.S. Department of Labor, the Federal Trade Commission, and several offices within the White House, issued a report as part of a Trump Administration directive to ensure quality health care at affordable prices by promoting choice and competition. Among its findings is that states should change their scope of practice statutes to allow all health-care providers to practice to the top of their licensure. States also should consider eliminating rigid collaborative practice and supervision agreements that are not justified by legitimate health and safety concerns.

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The Cochrane Collaboration: No Differences in Care Provided by CRNAs and Anesthesiologists

Summary: Researchers studying anesthesia safety found no differences in care between nurse anesthetists and physician anesthesiologists based on an exhaustive analysis of research literature published in the United States and around the world. Based on the collaboration’s findings, the greater utilization of CRNAs to the fullest extent of their scope of practice and skills promotes patient access to safe, cost-effective anesthesia care, especially now when it is desperately needed.

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Policy Perspectives: Competition and the Regulation of Advanced Practice Nurses

Summary: The Federal Trade Commission (FTC) recently urged state legislators and policymakers to be mindful when evaluating proposals that limit access to care provided by advanced practice registered nurses such as CRNAs. The FTC reports that “[r]estrictive physician supervision requirements exacerbate well-documented provider shortages, that “[e]xcessive supervision requirements may increase health care costs and prices,” and that “[f]ixed supervision requirements may constrain innovation in health care delivery models.”

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Cost-Effectiveness Analysis of Anesthesia Providers

Summary: The LewinGroup, a nationally recognized health-care policy and research organization, issued a report --- "Cost Effectiveness Analysis of Anesthesia Providers"-- that found CRNAs provide high-quality, efficacious anesthesia care, even for rare and difficult procedures; and that as demand for health care continues to grow, increasing the number of CRNAs will be a key to containing costs while maintaining quality care.

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No Harm Found When Nurse Anesthetists Work Without Supervision by Physicians

Summary: Health Affairs published a report --- “No Harm Found When Nurse Anesthetists Work Without Supervision by Physicians” --- that recommends the Centers for Medicare & Medicaid Services (CMS) allow certified registered nurse anesthetists in every state to work without the supervision of a surgeon or anesthesiologist. The cooperative nature of nurses working with physicians determines the best health care for a patient.

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The Future of Nursing: Leading Change, Advancing Health

Summary: A study from the Institute of Medicine of the National Academies shows that expanding the role of nurses in the U.S. health-care system will help meet the growing demand for medical services. That study ---  “The Future of Nursing: Leading Change, Advancing Health” --- makes clear that nurses will play a fundamental role in transforming health care, if policies exist to enable them to practice to the full extent of their education and training.

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MedPage Today: Can CRNAs Work Alone?

Summary: Sedation for outpatient endoscopy procedures had similar outcomes when certified registered nurse anesthetists (CRNAs) managed the protocol with or without anesthesiologist supervision, a review of more than 100,000 patient records showed. Overall adverse event rates were low, and none of the most common or serious adverse events occurred more often when CRNAs handled sedation by themselves or with an anesthesiologist.