Michael Ingersoll, RN, BSN (left), performs an awake fiberoptic airway examination under the guidance of Peter Kallio, CRNA, MSN, APNP, at Clement J. Zablocki VA, Milwaukee, Wisconsin. Ingersoll, now a CRNA, was a student at Rosaline Franklin University of Medicine and Science, Nurse Anesthesia Program, North Chicago, Illinois, at the time this photo was taken. Kallio is clinical director of the Preanesthesia Clinic at Clement J. Zablocki VA, and an instructor at Rosalind Franklin. The preanesthesia clinic was developed by Kallio in response to a need for improved and consistent preoperative evaluation of the high risk anesthesia patient.
Accuracy of Fingerbreadth Measurements for Thyromental Distance Estimates: A Brief ReportThere have been many contradicting studies as to how well preoperative airway assessments predict difficult intubation. This study assessed anesthesia providers’ estimated and actual fingerbreadth measurements to determine the effectiveness of the practice of using fingerbreadths as a measuring tool for thyromental distance. The authors found a statistically significant difference between estimated and actual fingerbreadth measurement for the index finger but not for the combinations of fingers.
CRNA Prescribing Practices: The Washington State Experience One year after implementation of a 2005 Washington State law that granted Certified Registered Nurse Anesthetists (CRNAs) authority to prescribe schedule II through IV controlled substances, only 30% of CRNAs held prescriptive authority. The purpose of this study was to describe Washington State CRNA prescribing practices and workforce and practice characteristics. A secondary purpose was to analyze factors related to Washington State CRNAs’ adoption of prescriptive authority for controlled substances II through IV.
Neuroimmune Activation and Chronic PainChronic pain is an extremely debilitating disease syndrome for which current treatment modalities are largely ineffective. This review article presents the recently proposed contributions of neuroimmune activation to the maintenance of chronic pain. Literature generated by the emerging field of central nervous system glial cell research, including genetic therapies, was reviewed to provide empirical support for this pathway. The clinical implications of neuroimmune activation to improved treatment of chronic pain states are discussed.
Moral Distress in Certified Registered Nurse Anesthetists: Implications for Nursing Practice The purpose of this exploratory, descriptive study was to determine if Certified Registered Nurse Anesthetists (CRNAs) experience moral distress in their nursing practice. The author stated that although a small number of nurse anesthetists experienced high levels of moral distress, CRNAs generally experienced moderate levels of moral distress. The author concluded that strategies must be developed to assist CRNAs dealing with ethical issues and in decreasing the occurrence of moral distress.
Keywords: CRNAs, moral distress, nurses.
Version: 2011;79(1):39-45. Authors: Linda Clerici Radzvin, RN, PhD, CRNP
Polyuria With Sevoflurane Administration: A Case ReportThe purpose of this exploratory, descriptive study was to determine if Certified Registered Nurse Anesthetists (CRNAs) experience moral distress in their nursing practice. The author stated that although a small number of nurse anesthetists experienced high levels of moral distress, CRNAs generally experienced moderate levels of moral distress. The author concluded that strategies must be developed to assist CRNAs dealing with ethical issues and in decreasing the occurrence of moral distress.
Keywords: CRNAs, moral distress, nurses.
Version: 2011;79(1):39-45.Authors: Linda Clerici Radzvin, RN, PhD, CRNP
The Influence of Perioperative Care andTreatment on the 4-Month Outcome in Elderly PatientsWith Hip FractureThe purpose of this study was to investigate if factors such as prolonged waiting time before surgery, anesthetic technique, perioperative hypoxemia, hypotension, and anemia are associated with outcome in terms of mortality, postoperative confusion, in-hospital complications, and length of hospital stay in elderly patients with hip fracture. The results of the study indicate the great importance of perioperative optimization of the patient’s oxygen saturation and hemoglobin level and a reduction of fasting and waiting time for surgery in order to minimize postoperative morbidity and mortality.
Work Climate Related to Job Satisfaction Among Dutch Nurse AnesthetistsThis study investigates the relationship between work climate and job satisfaction among Dutch nurse anesthetists. To achieve a higher level of job satisfaction among nurse anesthetists, the authors said it is necessary to improve some essential work climate characteristics, such as making the nurse anesthetist feel an important part of the organization’s mission statement, discussing progress at work, giving recognition for delivered work, encouraging development, and providing sufficient opportunities to learn and to grow.
Keywords: Job satisfaction, nurse anesthetist, work climate.
Version: 2011;79(1):63-70Authors: Vera C. H. Meeusen, RNA, PhD, MA
Karen van Dam, PhD
Chris Brown-Mahoney, PhD
Andre A. J. van Zundert, MD, PhD, FRCA
Hans T. A. Knape, MD, PhD, FRCA