Brother Norman Hipps: CRNAs deserve official designation in Pa.

This letter was published on TribLIVE on July 31, 2019

Pennsylvania is home to hundreds of student nurse anesthetists, yet Pennsylvania is one of just two states that fail to officially recognize CRNAs in some form. Because there is no “certified registered nurse anesthetist” title under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses, not as CRNAs.

This is the second consecutive legislative session that the measure passed the Senate, and the third time the full Senate has approved it. The House will have the opportunity to do the same when it returns to session this fall.

Certified registered nurse anesthetists are critical members of the health care team for everyone who faces the need for surgery. They provide an expert and assuring presence to patients in the moments before surgery begins and are the first to greet them when they awake.

Without formal designation, CRNAs have significant challenges.

Pennsylvania CRNAs who serve in the military must secure designation in another state to provide anesthesia in the armed services because we do not officially recognize CRNAs here. They cannot assist on rapid response teams in states affected by natural disasters because they lack formal credentials.

With 13 nurse anesthetist programs here, Pennsylvania ranks among the top draws nationally for CRNA students. But that could be at risk. Without an official CRNA designation, many graduating students wait as long as six months to get credentialed in out-of-state facilities, as state boards must verify that the students meet the requirements necessary to be classified appropriately there.

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists and plastic surgeons; pain management centers and more.

In Pennsylvania, education and clinical training for nurse anesthetists is extensive and requires national board certification. At the Excela Health School of Anesthesia, in partnership with Saint Vincent College in Latrobe, we ensure our graduates are eligible to sit for the national certification examination administered by the National Board on Certification and Recertification of Nurse Anesthetists .

We also provide mentoring and quality experiences that enhance the learning experience through clinical hours as well as simulation experiences that help students grow professionally. Our college currently has more than 20 clinical affiliation sites in the tristate area. We focus on providing students the knowledge and skills they need to develop as competent and safe quality anesthesia practitioners.

The nurse anesthetists we graduate are respected in the field as professionals who are well-prepared and ready to meet the challenges of modern health care.

Professional designation in Pennsylvania would help us achieve our shared mission of keeping patients safe, ensuring access to quality care. It is time to recognize CRNAs for the skills they have and the value they bring to our commonwealth.

Senate Unanimously Approves CRNA Designation Bill; Legislation Sent to House for Consideration

FOR IMMEDIATE RELEASE

CONTACT: Kurt Knaus, 717-724-2866

Senate Unanimously Approves CRNA Designation Bill;

Legislation Sent to House for Consideration

HARRISBURG (June 24, 2019) --- In the final days of legislative session before the General Assembly adjourns for summer, the state Senate today unanimously approved a measure (S.B. 325) that would formally recognize certified registered nurse anesthetists as “CRNAs” under Pennsylvania statute.

Pennsylvania remains one of just two states (New York is the other) that do not recognize CRNAs in some fashion. Under the state’s Professional Nursing Law, there is no official definition for “certified registered nurse anesthetist,” meaning these professionals are recognized only as registered nurses.

The measure, which is sponsored by state Sen. John R. Gordner (R-Columbia), now goes to the House, where Rep. Tarah Toohil is sponsoring a companion measure (H.B. 1064).

“We are so grateful to these legislative champions for all the work they are doing to advance the profession of nurse anesthetists and ensure these advanced practice nurses finally get the recognition they deserve,” said Derek Reckard, president of the Pennsylvania Association of Nurse Anesthetists, which represents more than 3,700 CRNAs and students in Pennsylvania.

These professional designation bills are simple, non-controversial title recognition measures, which is why similar measures have passed in previous legislative sessions. This is the second consecutive legislative session that Gordner’s measure passed the Senate, and the third time the full Senate has approved the measure. The Senate Consumer Protection and Professional Licensure Committee approved the bill June 12.

CRNAs operate safely in every setting where anesthesia is administered, including: hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; pain management centers and more.

The lack of professional designation brings logistical and financial challenges for CRNAs.

Pennsylvania CRNAs who serve in the military must secure designation in another state to serve as an armed forces anesthesia provider because the commonwealth does not recognize CRNAs. Pennsylvania-based military CRNAs pay more traveling out of state to obtain credits or meet other legal requirements to stay licensed and credentialed. They also pay more out-of-pocket expenses renewing multiple licenses.

Pennsylvania CRNAs also cannot assist on rapid response teams in states affected by natural disasters because they lack the formal credentials.

Moreover, with 13 nurse anesthetist programs here, Pennsylvania ranks among the top draws nationally for CRNA students. But that leadership position in education and training is at risk once students realize they face hurdles to getting credentialed after graduation.

After receiving training in Pennsylvania, many CRNAs relocate to states where they are fully recognized and credentialed for clinical practice, contributing to “brain drain.”

“The time is now to finally get this bill over the finish line,” Reckard said. “Every CRNA in Pennsylvania is committed to working with members of the House of Representatives to help them understand how important this bill is to keeping patients safe, ensuring access to quality care and reigning in rising health-care costs.”

Learn more about CRNAs in Pennsylvania at www.PANAforQualityCare.com. Additional details are available via Twitter at @PANACRNA and on Facebook at www.facebook.com/PANACRNA.

PANA Member Part of National Team Updating Anesthesia Practice Standards

PANA represents more than 3,700 certified registered nurse anesthetists and students in Pennsylvania, making it one of the largest state associations for CRNAs in the country. Many of PANA’s board members also play a role at the national level with the American Association of Nurse Anesthetists, meaning members here have enhanced representation.

The latest example is Jessica Poole, DNAP, MSN, CRNA. Jessica heads PANA’s Governance Committee, which is the association’s top post for engaging members and lawmakers on issues important to CRNAs, and for helping to coordinate efforts with other health-care partners.

Besides her work with PANA, Jessica also holds committee posts with AANA, where she is chair of the AANA Practice Committee, which comprises eight nurse anesthetists who work to ensure practice standards support the delivery of patient-centered, consistent, high-quality, and safe anesthesia care.

Jessica and her committee recently worked to release an updated version of the “Standards for Nurse Anesthesia Practice.” Revising the practice standards is a multi-year endeavor involving extensive reviews and several comment periods for stakeholder feedback. The comprehensive document sets standards that apply in all settings.

It’s an incredible undertaking --- and one more way both PANA and AANA are working to serve CRNAs in Pennsylvania and across the country.

Learn more about Jessica’s leadership and the updated standards by reading the full release below.

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Anesthesia Practice Standards Updated, Published by American Association of Nurse Anesthetists March 20, 2019

Park Ridge, Illinois—To ensure that patients continue receiving the highest quality anesthesia care possible, the American Association of Nurse Anesthetists (AANA) has published a comprehensive update to its Standards for Nurse Anesthesia Practice, the foundation of Certified Registered Nurse Anesthetist (CRNA) care delivery. The standards can be accessed at https://www.aana.com/standards.

As anesthesia experts with a 150+ year history, CRNAs are the hands-on providers of more than 45 million anesthetics each year in the United States, according to the AANA’s website (www.aana.com/crnafacts). The association represents approximately 53,000 CRNAs and student registered nurse anesthetists.

“The AANA’s practice standards support the delivery of patient-centered, consistent, high-quality, and safe anesthesia care and assist the public in understanding the CRNA’s role in patient care,” said Jessica Poole, DNAP, CRNA, chair of the AANA Practice Committee which is comprised of eight nurse anesthetists and supported by AANA staff. “The association routinely reviews and updates our profession’s practice standards, guidelines, and other critical documents based on the latest research to support CRNAs practicing at the peak of their knowledge and skills.”

This adherence to keeping current is one reason for CRNAs’ stellar safety record, according to AANA President Garry Brydges, DNP, MBA, CRNA. “No fewer than 10 major anesthesia safety studies published since 2000 have confirmed that CRNAs are the safest, most cost-effective anesthesia professionals in the United States,” he said.

With 7-8½ years of education and more than 9,000 hours of clinical training resulting in a graduate degree in their specialty, CRNAs are qualified to deliver anesthesia care for surgical, obstetrical, and emergency procedures, as well as provide chronic pain management services. They are the predominant anesthesia providers in rural and medically underserved areas of the country, to new moms in labor, and to U.S. military personnel around the world, especially on the front lines.

Poole said that “revising the practice standards was a multi-year endeavor involving an extensive literature review, multiple focus sessions, legal review, and a public comment period to obtain feedback from stakeholders across all practice settings.” The final document delineates each standard and includes links to more detailed resource documents containing the latest research to support the implementation of the standard.

“The standards apply in all practice settings, including operating rooms, nonoperating room anesthetizing areas, ambulatory surgical centers, and office-based practices,” Poole said. “As anesthesia care delivery continues to evolve at a rapid pace, the AANA and its members will continue to evolve right along with it. Our patients and employers expect nothing less.”

The essential elements of the standards include:

• Patients’ rights, which are prioritized as Standard 1 in the revised document;

• Preanesthesia patient assessment and evaluation;

• The anesthesia care plan;

• Informed consent;

• Documentation;

• Equipment;

• Anesthesia plan implementation and management;

• Monitoring and alarms;

• Infection control and prevention; and

• Transfer of care.

The revision also includes the addition of new standards on wellness and culture of safety.

“Patients can rest assured that when they receive their anesthesia from a Certified Registered Nurse Anesthetist they are in the care of a well-prepared, highly qualified provider whose sole focus is on their comfort and safety,” said Poole.