On The Cover

University of South Florida (USF) nurse anesthesia faculty demonstrate an ultrasound guided brachial plexus blockade at the Center for Advanced Medical Learning and Simulation (CAMLS). The University of South Florida’s Center for Advanced Medical Learning and Simulation is one of the world’s largest, free-standing simulation facilities exclusively dedicated to training healthcare professionals. The USF Nurse Anesthesia Program is housed at CAMLS in Tampa, Florida. Pictured: John Maye, PhD, CRNA, CAPT(ret), NC, USN, and Alan Todd, DNP, CRNA, CHSE.

Articles

  • Wellness and Thriving in a Student Registered Nurse Anesthetist Population With the creation of its Wellness Program, the American Association of Nurse Anesthetists (AANA) has advocated for renewed emphasis in education, research, and practice on anesthesia provider wellness. This research was designed to explore the relationship between student registered nurse anesthetists’ perceived wellness and students’ thriving throughout their academic program. Within the variable, student academic achievement, overall wellness negatively correlated with the National Board of Certification & Recertification for Nurse Anesthetists’ Self-Evaluation Examination scores.
    Keywords: Academic achievement, salutogenic, self-efficacy, Student Registered Nurse Anesthetist, wellness.
    Version: 2017;85(5):325-330. Authors: Andrew Griffin, PhD, CRNA, APN Valerie Yancey, PhD, CHPN, HNC-A, RN Michael Dudley, PhD
  • Development of an Online, Evidence-Based CRNA Preceptor Training Tutorial (CPiTT): A Quality Improvement Project Certified Registered Nurse Anesthetists (CRNAs) who serve as clinical preceptors have the critical job of transferring high-quality patient care and patient safety skills to the student registered nurse anesthetists (SRNAs) they precept. The education of CRNAs in best precepting practices has the potential to enhance this transfer. However, most CRNAs do not receive formal instruction in how to precept SRNAs, which has the potential to limit the CRNA preceptors’ effectiveness in this critical educational role.
    Keywords: Clinical education, debriefing, nurse anesthesia preceptorship, online learning.
    Version: 2017;85(5): 331-339. Authors: Alexandria Easton, MSN, CRNA John M. O’Donnell, DrPH, MSN, CRNA Suzanne Morrison, DNP, MSN, CRNA Calvin Lutz
  • Refractory Hypotension in a Patient with a History of Anabolic Steroid Abuse Taking an Angiotensin-II Receptor Blocker: A Case Report This case report describes a unique case of refractory hypotension in a patient with a history of anabolic steroid abuse taking an angiotensin II receptor blocker. An understanding of the role of the RAAS in blood pressure regulation is essential for managing refractory hypotension.
    Keywords: Anabolic steroid abuse, anesthesia, angiotensin-receptor blockers, refractory hypotension.
    Version: 2017;85(5):340-344. Authors: Alyssa B. Jensen, MSN, CRNA Richard E. Haas, PhD, CRNA
  • Norwegian Nurse Anesthetist Perceptions of Professional Development and the Influence of Production Pressure Professional development is often connected with making improvements that affect patient experiences, needs, and safety. Competency maintenance, professional development, and updating skills and knowledge are demanded at workplaces, especially hospitals. The aim of this study was to examine Norwegian nurse anesthetists’ perceptions of professional development and research in the workplace.
    Keywords: Grounded theory, nurse anesthetists, perceptions, professional development and research.
    Version: 2017;85(5):345-351. Authors: Gertrud Averlid, RNA, MPH
  • Addition of Fentanyl to Ropivacaine Infusion in Continuous Thoracic Paravertebral Infusion Does Not Improve Its Analgesic Effect Following Modified Radical Mastectomy: A Randomized Controlled Trial A randomized controlled trial was conducted to evaluate pain scores in patients given continuous thoracic paravertebral (TPV) block with ropivacaine alone or with fentanyl in modified radical mastectomy (MRM). Forty female patients ASA classes 1 and 2, aged 18 to 60 years, undergoing MRM were recruited.
    Keywords: Fentanyl, ropivacaine, thoracic paravertebral block.
    Version: 2017;85(5):352-356. Authors: Hem Kumar Pushparajan, MD, Jyotsna Punj, MD, R. Pandey, MD, V. Darlong, MD, Anurag Srivastava, MD, R. K. Batra, MD, Anita Bhan, MD
  • Inadvertent Massive Overdose of Lidocaine in an Infant With Arthrogryposis Multiplex Congenita Treated Successfully With Lipid Emulsion Severe local anesthetic toxicity is potentially life threatening and is often refractory to standard resuscitative measures. Infants are a particularly susceptible population in this regard because of their unique physiologic features. We report a case of accidental life-threatening overdose of IV lidocaine (lignocaine) in an infant, which was successfully managed with 10% lipid emulsion.
    Keywords: Anesthetic overdose, complication, infant, intravenous lipid emulsion, local anesthetic.
    Version: 2017;85(5):357-360. Authors: Sapna Bathla, MD, Anju Gupta, MD, Medha Mittal, MD, Geeta Kamal, MD
  • The Future of Certified Registered Nurse Anesthetist Practice in South Korea: Fading Into the Sunset or Breaking of a New Dawn? The purpose of this study is to describe the practice of nurse anesthesia in the Republic of Korea and to identify trends, policy, and other factors that affect Certified Registered Nurse Anesthetists (CRNAs) as a profession.
    Keywords: Anesthesia registered nurse (ARN), Certified Registered Nurse Anesthetist, CRNA, job satisfaction, nurse anesthesia practice.
    Version: 2017;85(5):361-368. Authors: Michong Rayborn, DNP, CRNA, Gyeseon Jeong, PhD, CRNA, SatAnanda Hayden, PhD, MSN, RN, Sungu Park, MPH
  • Ketamine as Part of a Multimodal Approach to Postoperative Pain Management Some surgeries present increased challenges for adequate perioperative pain management, which require innovative methods to prevent development of chronic postsurgical pain (CPSP). Ketamine is an adjunct to traditional pain management methods and is an effective analgesic. The potent antihyperalgesic effects of ketamine represent an interesting option for those searching for multimodal approaches.
    Keywords: Chronic postsurgical pain, ketamine, postoperative pain management, sacral chordoma.
    Version: 2017;85(5):369-374. Authors: Denise Stuit, DNP, CRNA, Cormac O’Sullivan, PhD, CRNA, ARNP
  • Anesthesia Medicare Trend Analysis Shows Increased Utilization of CRNA Services Volume of anesthesia Medicare Part B services had an average increase of 3.1% per year from 2000 to 2014. In 2014, the top 25 anesthesia procedure codes accounted for 75% of all allowed Medicare services and $1.8 billion in Medicare payments. When more healthcare services are undergoing scrutiny to achieve cost-efficient, value-driven care, the increased use of the QZ modifier highlights a change in how the anesthesia workforce is used while aligning with federal and state regulations.
    Keywords: Billing modifiers, Medicare Part B, nurse anesthesia, reimbursement, trend analysis.
    Version: 2017;85(5):375-383. Authors: Jihan A. Quraishi, MS, BSN, AE-C, CCRC, Lorraine M. Jordan, PhD, CRNA, CAE, FAAN, Ruby Hoyem, PhD
  • AANA Journal Course: Update for Nurse Anesthetists-Part 4-An Overview of Anesthetic Management for the Brain-Dead Donor and Organ Recovery Transplantation of tissue is playing an increasing role in modern therapeutics. Survival of recipients and transplanted organs is excellent, making transplantation of many major organs a very successful therapeutic option. Evidence shows that a multidisciplinary approach to managing the brain-dead donor offers a better opportunity for successful organ survival after transplantation.
    Keywords: Anesthetic management, brain death, organ procurement.
    Version: 2017;85(5):385-392. Authors: Catherine Y. Morse, EdD, MSN, CRNA, APN