John Bojczuk
Title slide
“CRNAs Scope of Practice”
By: John Bojczuk
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Image 1 (Introduction)
Introduction
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Anesthesia and anesthesia-related care
represents those services that CRNAs
provide upon request and assignment
per the CRNA scope of practice.
Education, practice, and research within
nurse anesthesia promote competent
anesthesia care. CRNAs practice
according to expertise, state statutes
and regulations, and institutional
policies.
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(USF Health 2008)
Body Content
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There are many things CRNAs are
responsible for doing. According to the
American Association of Nurse Anesthetists,
CRNAs scope of practice includes:
Performing and documenting a preanesthetic assessment and evaluation of the
patient, developing and implementing an
anesthetic plan, initiating the anesthetic
technique, selecting, applying, and inserting
appropriate non-invasive and invasive
monitoring modalities, selecting, obtaining,
and administering the anesthetics, and
managing a patient’s airway and pulmonary
status.
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(Image of Surgery, 2009)
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CRNAs responsibilities also includes:
discharging the patient from post-anesthesia
care and providing post-anesthesia followup evaluation, implementing acute and
chronic pain management modalities,
responding to emergency situations by
providing airway management, and
administration of emergency fluids and
drugs.
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CRNAs main scope of practice seems
long and confusing but it can be broken
(Image of Surgery, 2009)
down simply. Pre-anesthetic assessment
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and evaluation includes requesting
consultations and diagnostic studies.
This includes selecting, obtaining,
ordering, and administering preanesthetic medications and fluids.
CRNAs must also obtain consent for the
anesthesia needed for the surgery.
Initiating anesthesia technique includes
general, regional, local, and sedation.
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(Image of Surgery, 2009)
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CRNAs have many individual
responsibilities which are just as
important as their main scope of
practice. The American Association of
Nurse Anesthetist says, “The additional
responsibilities include:
Administration/management, quality
assessment, educational teaching,
research, committee appointments,
interdepartmental liaison, and
clinical/administrative oversight of other
departments.”
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The individual responsibilities can also
be broken down simply. Scheduling,
material and supply management falls
under administration/management.
Data collection, reporting mechanism,
trending, compliance, committee
meetings, and reviews directly deal with
quality assessment. CRNA research has
to deal with the conduction and
participation in departmental/hospitalwide research projects. Finally,
respiratory therapy and pain clinics deal
with the clinical/administrative
oversight.
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(Dartmouth-Hitchcock Medical Center 2010)
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(Image of Surgery, 2009)
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There are other privileges that CRNAs
receive. According to the AANA
credentialing, core privileges, and core
clinical privileging can be achieved by a
qualified CRNA. Credentialing is the
recognition of professional and technical
competence to verify information and
evaluate an applicant requesting
privileges.
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Core privileges are the scope of
procedures and activities within a
specialty that CRNAs have the
experience, education, and competence
to perform. This process provides an
objective for initial application and
renewal of clinical privileges. “They are
based on education, experience, legal
qualifications, and an assessment of the
individual,” says the AANA.
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(Franciscan Skemp Healthcare 2005)
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(Duke University School of Nursing 2009)
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The strive for excellence is trying to be
achieved by setting such high standards
for CRNAs. They are active in many
other departments outside of
anesthesia.
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(Gannett Education 2010)
Conclusion
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The scope of practice for CRNAs is
extremely dynamic which requires them
to be very well rounded anesthesia
providers. Requirements will continue
to grow making the title of CRNA quite
an accomplishment if ever achieved.
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(UCLA Department of Anesthesiology 2010)
For More Information Please Visit:
http://www.aana.com/
Thank You
Sources
CRNA Scope of Practice.(2010). Retreived from the American Association of Nurse Anesthetists website.
Scope and Standards for Nurse Anesthesia Practice.(2007). Retrieved from the American Association of Nurse
Anesthetists website:
http://www.aana.com/uploadedFiles/Resources/Practice_Documents/scope_stds_nap07_2007.pdf
Recommended Reading
Principle and Practice of Nurse Anesthesia is a book about nurse anesthetists and their practice of
anesthesia.
Images
Image of Surgery. (2009). “Anesthesia Team.” Photo. http://www.imageofsurgery.com/Anesthesia_Team.htm.
Accessed November 7, 2010
USF Health. (2008). “USF Charter CRNA Students.” Photo. http://hscweb3.hsc.usf.edu/health/now/?p=3162 .
Accessed November 7, 2010
UCLA Department of Anesthesiology. (2010). “Nurse Anesthesia Education at UCLA”. Photo.
http://www.anes.ucla.edu/news.php?id=90. Accessed November 7, 2010
Dartmouth-Hitchcock Medical Center.(2010), “Consultation & Resources.” Photo.
http://www.dhmc.org/webpage.cfm?site_id=2&org_id=941&gsec_id=49478&sec_id=49478&item_id=49507.
Accessed November 7,2010
Franciscan Skemp Healthcare: School of Nurse Anesthesia.(2005). “Clinical Affiliations.” Photo.
http://www.uwlax.edu/biology/graduate/crna.htm. Accessed November 7, 2010
Duke University School of Nursing. (2009). “Nurse Anesthesia (CRNA) Specialty”. Photo.
http://nursing.duke.edu/modules/son_academic/index.php?id=103. Accessed November 7, 2010
Gannett Education. (2010). “Nurse Week.” Photo. http://nursing-ce-seminar-case-management-dallastx.eventbrite.com/. Accessed November 7, 2010