New Air Force Policy Recognizes Full Scope of Nurse Anesthetist Practice

For Immediate Release
January 30, 2012​

New Air Force Policy Recognizes Full Scope
 of Nurse Anesthetist Practice

AANA Commends USAF for Ensuring Access to Safe, Cost-Effective Anesthesia Care for Men and Women Serving Our Country and Their Dependents
Park Ridge, Ill.—A new U.S. Air Force (USAF) policy governing anesthesia delivery in USAF facilities worldwide recognizes the full scope of Certified Registered Nurse Anesthetists (CRNAs) practice, thereby ensuring military personnel and their dependents access to the safest, most cost-effective anesthesia care. The policy promotes patient safety by approving anesthesia delivery models common to other American military service branches with which the Air Force often operates jointly, and that are also widely used in civilian healthcare.
“Our military personnel and their dependents deserve the best anesthesia care, and CRNAs are privileged to provide it to them,” said Debra Malina, CRNA, MBA, DNSc, president of the American Association of Nurse Anesthetists (AANA).  “We commend the Air Force for making these policy improvements, which were developed collaboratively within the Air Force by CRNAs, nurses and physicians. Formal recognition of the outstanding care our military CRNAs provide, through an unencumbered scope of practice policy, is based on existing scientific evidence and current best practices.”

CRNAs provide the majority of anesthesia services to the U.S. armed forces at home and abroad, including the USAF.  They are often the only anesthesia professionals deployed in front-line military facilities. In 2011, 142 active duty CRNAs served in the Air Force.

The updated policy, Air Force Instruction 44-102, was publicly issued on January 20 by the Secretary of the Air Force and replaces regulations dating to 2006.  A collaborative process involving USAF physicians, nurse anesthetists, and other healthcare professionals led to the following important changes:
  • The USAF’s new Anesthesia Policy, Practice and Services demonstrates a commitment to professional collaboration among CRNAs and physician anesthesiologists in the interest of patient safety and access to care. Significantly, the policy states “Traditionally, ACT [anesthesia care team] referred to a CRNA working in a medical directed environment with an Anesthesiologist. However, in the [new policy], ACT refers to any combination of Anesthesiologist or CRNA working as a team…. The ACT concept is thus collaboration among anesthesia providers in the delivery of anesthesia and its related services.”

  • The new policy authorizes directors of USAF treatment facilities to name either a CRNA or anesthesiologist as chief of anesthesia.

  • The new policy closely mirrors similar policies in place in the U.S. Navy, promoting consistent patient care by advancing joint, common healthcare delivery and practice rules across military healthcare facilities worldwide.

Among the scientific evidence considered by the USAF was the landmark 2010 Institute of Medicine report titled “The Future of Nursing: Leading Change, Advancing Health,” and a 2010 research study published in the preeminent health policy journal Health Affairs titled “No Harm Found when Nurse Anesthetists Work Without Supervision by Physicians.” The publications underscored the patient safety, access to care, and cost-effectiveness benefits associated with policies promoting the use of CRNAs and other advanced practice registered nurses (APRNs) to their full scope of practice.
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