February 1993 AANA Journal

Table of Contents

Contents

Letters
Mivacurium: A replacement for succinylcholine
Print version: 1993;61(1):2.

Legal Briefs
By Gene A. Blumenreich, JD
Captain of the Ship
Print version: 1993;61(1):3-6.
Keywords: Captain of the Ship, negligence, vicarious liability.

Washington Scene
By Kathleen A. Michels, RN, JD, FAAN
HCFA issues 1993 CRNA Medicare conversion factors
Print version: 1993;61(1):7-11.
Keywords: Medicare conversion factors, monitored anesthesia care, Safe Harbor Rules.

Practice Issues
By Gayle Lee Ulshafer, CRNA, MSN
Managed care: Its impact upon CRNA practice
Print version: 1993;61(1):12-15.
Keywords: Health maintenance organizations (HMOs), preferred provider organizations (PPOs), independent practitioners associations (IPAs), managed care, managed care and CRNAs.

Book Reviews
Manual of Drug Interactions for Anesthesiology
Reviewer: Timothy O'Connor, MD
Print version: 1993;61(1):16.

Education News
By Betty Horton, CRNA, MA
Accreditation of regionalized and comprehensive nurse anesthesia programs
Print version: 1993;61(1):25-31.
Keywords: Anesthesia accreditation categories, clinical access, CRNA education, regionalized education.

Education News
By Lois Frels, RN, PhD
Writing the grant proposal
Print version: 1993;61(1):32-35.
Keywords: Federal funding, foundations, grants, grant writing, National Commission on Nurse Anesthesia Education.

Guest Editorial
By Gary P. Kraus, MBA, JD, DASHRM
Anesthesia Quality Plus: The quantification of competence
Print version: 1993;61(1):36-41.
Keywords: Anesthesia quality management, continuous quality improvement, risk management.

An anesthesia quality improvement program utilizing a computer database to effect change
By David DeMask, CRNA, MS
Fred C. Welke, CRNA, MEd
This article describes the perceived benefits of a quality improvement program, discussing the steps involved in the establishment of such a program and the implementation of a computer database for data collection and retrieval. The outcome of 4,500 anesthesia cases, representing 30 months of casework, is included.
Print version: 1993;61(1):42-47.
Keywords: Anesthesia mishaps, database, quality improvement, risk management in anesthesia.

The attrition rate of students in master's level nurse anesthesia programs
By Mary Ellen Mathis, CRNA, MAE
The purpose of this original research was to determine the dropout rate of students who did not complete their nurse anesthesia programs from 1985-1990. Also examined was whether students were more likely to leave because of clinical or academic difficulties or for personal reasons.
Print version: 1993;61(1):57-63.
Keywords: Attrition, dropout, nurse anesthesia education.

AANA Journal Course: Update for nurse anesthetists– Beyond the laryngoscope: Advanced techniques for difficult airway management
By Steven J. Somerson, CRNA, MS, CEN
Michael R. Sicilia, RN, BSN, CEN, EMT-P II
In this sixth chapter of the AANA Journal Update Course, the authors stress that proper management of a patient with a technically difficult airway commences with problem recognition. Reduction of airway-related morbidity and mortality is best achieved with an understanding of airway anatomy, common causes and prompt recognition of compromise, and alternative techniques of establishing patency and ventilation.
Print version: 1993;61(1):64-72.
Keywords: Airway management, airway patency, endoscopy, technically difficult airway, ventilation.

Epidural and intrathecal analgesia in a rural setting
By Margaret Anderson-Estill, RN, BSN, CCRN
Jack Neary, CRNA, ARNP
This article describes how a rural acute care facility initiated a program of epidural analgesia administered by the nursing staff under the direction of the anesthesia department utilizing AANA protocol.
Print version: 1993;61(1):73-80.
Keywords: Epidural analgesia, pain management, rural anesthesia providers.

A case report: The use of ketamine and midazolam intravenous sedation for a child undergoing radiotherapy
By Capt Jeffrey B. Worrell, CRNA, MSN, USAF, NC
Maj William J. McCune, MD, USAF, MC
The authors report on how the combination of ketamine hydrochloride and midazolam was used to successfully provide intravenous sedation for a child requiring daily radiation treatments.
Print version: 1993;61(1):99-102.
Keywords: Ketamine, midazolam, radiotherapy.

General and Subscription Information
Print version: 1993;61(1):2.

Council on Accreditation List of Programs to be Reviewed During Fiscal Year 1993
Print version: 1993;61(1):48.

Index to Advertisers
Print version: 1993;61(1):104.

February 1993 AANA Journal
Volume 61 , Number 1
ISSN 0094-6354
On the Cover: