On The Cover

The credential CRNA (Certified Registered Nurse Anesthetist) came into existence in 1956 but nurse anesthetists have been providing anesthesia care to patients in the United States for more than 150 years. CRNAs are anesthesia professionals who safely administer more than 34 million anesthetics to patients each year in the United States. In some states, CRNAs are the sole anesthesia providers in nearly 100% of rural hospitals.

Articles

  • Perioperative Glucose Monitoring and Treatment of Patients Undergoing Vascular Surgery in a Community Hospital Setting This article discusses the glucose monitoring and treatment practices of a small community hospital and aims to determine how these practices relate to postoperative complications in patients undergoing vascular surgery. A retrospective analysis of 101 patients who underwent vascular surgery was performed.
    Keywords: Hyperglycemia, outcomes, perioperative, vascular.
    Version: 2014;82(6):427-430. Authors: Suzanne Morrison, CRNA, MSN, DNP, John O’Donnell, CRNA, MSN, DrPH, Dianxu Ren, MD, PhD, Richard Henker, CRNA, PhD, FAAN
  • Anesthetic Management and Implications of Pediatric Patients With a Diagnosis of Anti-N-Methyl-D-Aspartate Receptor Encephalitis: Two Case Reports This article discusses the anesthetic management and implications of 2 pediatric patients with a diagnosis of anti-N-methyl-d-aspartate (NMDA) receptor encephalitis. Anesthesia providers must incorporate an understanding of the administered anesthetic agent’s potential pharmacologic effect on the affected NMDA receptor when formulating the patient’s anesthetic plan.
    Keywords: Anesthesia, anti-NMDA receptor encephalitis, pediatric.
    Version: 2014;82(6):431-436. Authors:
  • Workplace Incivility Affecting CRNAs: A Study of Prevalence, Severity, and Consequences With Proposed Interventions Incivility in healthcare settings has potentially detrimental effects on healthcare providers and patient safety. This study examines the prevalence of incivility and the influence of workplace incivility on burnout among Certified Registered Nurse Anesthetists in Michigan. It proposes interventions to prevent and manage incivility.
    Keywords: Burnout, CRNA, incivility.
    Version: 2014;82(6):437-445. Authors: Ray Elmblad, CRNA, DrAP, Gergana Kodjebacheva, PhD, Lynn Lebeck, CRNA, PhD
  • Psychometric Testing of the Pecka Grading Rubric for Evaluating Higher-Order Thinking in Distance Learning This article describes development of the Pecka Grading Rubric (PGR) as a strategy to facilitate and evaluate students’ higher-order thinking in discussion boards. The purpose of this study was to describe psychometric properties of the PGR. Beginning evidence indicates a valid and reliable instrument that measures higher-order thinking in the student registered nurse anesthetist.
    Keywords: Distance learning, grading rubric, higherorder thinking, reliability, validity.
    Version: 2014;82(6):449-456. Authors: Shannon Pecka, CRNA, MSN Kendra Schmid, PhD Bunny Pozehl, PhD, APRN-NP, FAHA, FAAN
  • Securing the Endotracheal Tube With Adhesive Tape: An Integrative Literature Review The practice of securing the endotracheal tube with adhesive tape appears to be benign. However, evidence-based research suggests it is a high-risk practice. Researchers found that adhesive tape outside its original packaging became contaminated with pathogens.
    Keywords: Anesthesia, anesthesia equipment, contamination, disinfection, hand hygiene.
    Version: 2014;82(6):457-464. Authors: Lois Krug, CRNA, ARNP, MBA, Melissa Machan, CRNA, ARNP, DNP, Jose Villalba, MD
  • AANA Journal Course: Update for Nurse Anesthetists—Part 5—Medication Administration in the Operating Room: New Standards and Recommendations Anesthesia is one of the few areas in healthcare with no secondary verification of medication administration, yet it also has the highest number of administered medications, most of which are high-alert medications. The Anesthesia Patient Safety Foundation recommends implementing standardizations, barcode medication administration, and the use of prefilled or premixed syringes to assist in the safe delivery of anesthesia.
    Keywords: Barcode medication administration, medication administration safety, prefilled syringes, premixed syringes.
    Version: 2014;82(6):465-469. Authors: Lindsay Bree Brown, CRNA, MSN