AANA Anesthesia E-ssential

Anesthesia E-ssential January 15, 2015

AANA Anestehsia E-ssential 
Anesthesia E-ssential

January 15, 2015


Board Update

Coming Soon: First-Ever Online Video Chat with the AANA President
On Jan. 22, AANA President Sharon Pearce, CRNA, MSN, will present the first-ever “30 Minutes with the President,” the AANA’s 21st Century answer to Franklin Delano Roosevelt’s “Fireside Chats.” A maximum of 300 participants will be able to access the online video chat session at http://join.onstreammedia.com/go/aana@aana.com/syqgq0g at 7 p.m. CST.
Participants will have the opportunity to ask President Pearce questions via email.  She will answer as many as possible during and after the chat.
The AANA plans to offer “30 Minutes” sessions periodically as a vehicle for effective two-way communication between the president and members, as well as an opportunity to try out new communication technology for the future. The association expects the “30 Minutes” sessions to evolve over time and looks forward to hearing member feedback.

Vital Signs

CPC Stakeholder Task Force
During its December conference call, the AANA Board of Directors approved the development of a CPC Stakeholder Task Force. The following AANA members will comprise the CPC Stakeholder Task Force:
  • Chair - Linda Williams, CRNA, JD, AANA past president
  • Danette Plautz, CRNA, MSN, Continuing Education Committee chair
  • Randall Moore, CRNA, DNP, AANA Board representative
  • Sandra Ouellette, CRNA, MEd, FAAN, educator and CE vendor
  • Gerald Hogan, CRNA, DNSc, educator and state leader
  • NBCRNA representatives – Steve Wooden, CRNA, DNP, and Chuck Vacchiano, CRNA, PhD, FAAN (two members selected by NBCRNA’s board)
  • Bruce Schoneboom, CRNA, PhD, FAAN, AANA senior director of education and professional development
The task force charges set by the Board were the following:
  • Examine the components of the CPC program and, with input from stakeholders, identify opportunities to strengthen the program.
  • The task force will report to the AANA Board of Directors by the Mid-Year Assembly in April.
Following the report to the AANA Board, the task force report will be made available to the members of the AANA. The AANA BOD strongly supports the task force representatives and looks forward to the next steps. 


The Pulse

  • CRNA Week Celebration Focuses on Anesthesia's Future
  • Jan. 15 Deadline for Nominations to the "Daniel D. Vigness Federal Political Director Award"
  • Jan. 30 Deadline for CRNA and Student Registered Nurse Anesthetist Nominations for Service on the 2015-16 CRNA-PAC
  • Greetings from the Chair of the AANA Foundation
  • Register Today for Fun in the French Quarter
  • Awards Deadline
  • Donor Spotlight
  • Early Registration Now Open for Mid-Year Assembly
  • Business of Anesthesia--Save the Date
  • New Year, New 114th Congress for CRNAs to Get to Know
  • VHA Nursing Handbook Update Process Affirmed, Nurse Workforce Funding Boosted, in 2015 Budget Package OK’d by Congress
  • ASA-backed Rural Pass-through Proposal would Boost Costs, Not Quality, Says AANA
  • In Discussions with AANA, NGS Medicare Clarifies Coverage for CRNA Pain Management Services
  • Medicare Publishes Guidance on 2015 Colonoscopy Anesthesia Coverage
  • To Protect and Advance CRNA Practice, the CRNA-PAC will Soon Begin its 2015 Development Campaign
  • Medicare Issues Surveyor Worksheets for Assessing Compliance with Hospital Conditions of Participation, Including Infection Control
  • HRSA Invites CRNA Educational Programs to Apply for Nurse Workforce Development and Nurse Anesthetist Traineeship Funding
  • Feds Issue Five-Year Health Information Technology Strategic Plan for Public Comment
  • CRNA-PAC Publishes 2014 Election Report with Thanks to PAC Contributors
  • Amendments

Healthcare Headlines

Healthcare Headlines is for informational purposes, and its content should not be interpreted as endorsements, standards of care, or position statements of the American Association of Nurse Anesthetists.

Inside the Association
CRNA Week Celebration Focuses on Anesthesia's Future
It’s not often you can predict the future. But, during National CRNA Week, Jan. 25-31, 2015, CRNAs will be touting this year’s theme, “CRNAs: The Future of Anesthesia Care Today,” which provides a platform for CRNAs to promote the value of nurse anesthesia and the critical role that CRNAs play in today’s—and tomorrow’s—healthcare system. Promotional items specific to CRNA Week are available until Jan. 20. Orders will be available online only at www.aana.com/crnaweek. Be sure to check out all the possibilities! (Note: phone, fax, and mail orders will not be accepted.)
Jan. 15 Deadline for Nominations to the “Daniel D. Vigness Federal Political Director Award”
Is your state’s Federal Political Director (FPD) awesome? Then nominate him or her for the “Daniel D. Vigness Federal Political Director Award,” which is presented during AANA Mid-Year Assembly in April 2015.
Named for the late Dan Vigness, CRNA, of South Dakota, the first AANA FPD of the Year, this honor recognizes a CRNA who has been involved in federal political campaigns, developed close working relationships with federal officials, led successful CRNA advocacy efforts, helped contribute and raise funds for the CRNA-PAC, and helped recruit CRNAs to participate in political campaigns.
Jan. 30 Deadline for CRNA and Student Registered Nurse Anesthetist Nominations for Service on the 2015-16 CRNA-PAC
If you or a colleague would like to serve on the CRNA-PAC Committee, Jan. 30 is the deadline for submitting an application online.
In September 2015, the nine-member committee will have two CRNA vacancies, each for three-year terms. One student registered nurse anesthetist vacancy will also open for a one-year term. Two members of the AANA Board of Directors serve on the CRNA-PAC Committee, each for a one-year term that may be renewed for one additional year while the member also serves on the Board. To submit a CRNA nomination, please click here (AANA login required). To submit a student nomination please click here (AANA login required) and see the additional requirements here (AANA login required).

Greetings from the Chair of the AANA Foundation
On behalf of everyone at the AANA Foundation, I would like to extend our warmest wishes for a safe, happy and prosperous New Year.
With your help and support, in FY14 the AANA Foundation:
  • Supported more than 217 CRNAs and students
  • Educated more than 100 CRNAs at Foundation-supported workshops
  • Funded two new health services research studies focused on CRNA scope of practice and quality
  • Funded and coordinated a malpractice closed-claim study by a team of CRNA researchers to identify potentially avoidable anesthesia adverse events and provide mitigation strategies to improve anesthesia quality and patient safety
  • Arranged for 140 poster presentations at AANA Annual Congress – including four international poster presentations
    Awarded over $450,000 to program recipients through scholarships, fellowships, research grants, and poster presentations
  • Recognized: Ladan Eshkevari, CRNA, PhD,LAc as the John F. Garde Researcher of the Year;
    Kathleen Thibeault, CRNA, MSN, State of Florida Advocate as the Advocate of the Year
    Gina M. Mason, CRNA, U.S. Army Reserve, (Ret.) as the Rita LeBlanc Philanthropist of the Year; and
    Erin M. Cushing, CRNA, MS with the Janice Drake CRNA Humanitarian Award.
I am deeply grateful for the continued dedication and commitment of the entire Foundation team, as well as friends, families, colleagues and donors who continue to support the Foundation’s efforts.  We are now poised for another eventful year in 2015.
Wishing you all the very best in the New Year.
Wilma K. Gillis, CRNA, BSN, APNP
AANA Foundation, Chair
Register Today for Fun in the French Quarter
If you’re planning to attend the AANA Assembly of School Faculty meeting, you won’t want to miss the AANA Foundation’s Fun in the French Quarter event to be held at Acme Oyster House in New Orleans. Click here to learn more and register for this event. We hope to see you there!
Awards Deadline
Each year, the AANA Foundation presents awards at the Nurse Anesthesia Annual Congress to individuals who have made a difference in the nurse anesthetist community. The deadline for award nominations is Feb. 1, 2015. Please take the time today to recognize someone you know. It is truly an honor to be nominated.
Click here to access the nomination/application forms for:
  • Advocate of the Year
    Presented to an advocate committed to supporting the AANA Foundation and  encouraging others to do the same.
  • John F. Garde Researcher of the Year
    Presented to an individual who has made a significant contribution to the practice  of anesthesia through clinical research.
  • Rita L. LeBlanc Philanthropist of the Year
    Presented to an individual who has donated time, talent, and direct financial    support to the AANA Foundation and other deserving organizations.
  • Janice Drake CRNA Humanitarian Award
    Presented to a CRNA who wishes to volunteer and provide anesthesia,   education and training in needy areas.
Forward the completed form to the AANA Foundation—email foundation@aana.com or mail to 222 S. Prospect Avenue, Park Ridge, IL, 60068.
Thank you in advance for recognizing a member of the nurse anesthesia community. If you have any questions, please contact the AANA Foundation at (847) 655-1170 or foundation@aana.com.

Donor Spotlight: Peter Pollachek, CRNA, APN, FAAPM
Peter has been a CRNA for over 25 years and is a generous AANA Foundation supporter. Click here to read more about Peter in his own words. Thank you, Peter, for your generous support!

Early Registration Open Now for the Mid-Year Assembly
April 18-22, 2015
The Mid-Year Assembly, to be held this spring in Arlington, Va., is for all CRNAs and student registered nurse anesthetists interested in issues, trends, and influences related to practice and professional advocacy. Registration open now: click here to learn more.
Save the Date—Business of Anesthesia Conference
The Business of Anesthesia Conference will be held June 26-27, 2015, at the Grant Hotel in San Diego, Calif.  Mark your calendars and don’t miss this conference, which will offer practical, fundamental continuing education related to the business aspects of anesthesia practice. Check the AANA website at www.aana.com/meetings for further information.

New Year, New 114th Congress for CRNAs to Get to Know
The new 114th Congress was sworn in Tuesday, Jan. 6, and members of the AANA’s Washington staff were on Capitol Hill meeting new members of the House and Senate and their staffs and reconnecting with CRNAs’ friends in Congress.
This Congress will differ substantially from the Congress that just adjourned in December. With 58 new members, the new 435-member House will have a 246-188 Republican majority, the largest for the GOP since the 1920s. While the previous Senate had a Democratic majority, the new 100-member Senate will have 13 new Senators and a 54-46 Republican majority, with Republicans chairing all committees and subcommittees. As of Jan. 5, one House member has already resigned: Rep. Michael Grimm (R-NY), following a guilty plea for federal tax evasion. His Staten Island district will have special primary and general elections later this year to fill the vacancy. Notably for CRNAs, Grimm had prominently opposed Veterans Health Administration (VHA) recognition of APRNs to their full practice authority.
Several deadlines drive Congress’ early 2015 agenda. The president’s 2016 budget is due to be released in February. On the last day of March, relief from Medicare “sustainable growth rate” cuts expires, hammering CRNAs and other healthcare providers with Part B payment cuts exceeding 20 percent unless Congress enacts temporary or permanent relief in time. Uncle Sam’s statutory debt limit is reached later in the spring, prompting another reckoning over paying government bills that Congress has already obligated.
See new members of Congress at http://thehill.com/new-members-guide-2014. See all members of the 114th Congress at http://www.c-span.org/congress/members/.
VHA Nursing Handbook Update Process Affirmed, Nurse Workforce Funding Boosted, in 2015 Budget Package OK’d by
Language affirming the Veterans Health Administration (VHA) process for updating its Nursing Handbook to recognize APRNs to their full practice authority, along with an increase in Title 8 nurse workforce funding, was included in a huge end-of-session budget package cleared by Congress on bipartisan votes and signed into law by the president Dec. 19.
General language in H.R. 83, the Consolidated Appropriations Act for 2015, affirms provisions previously adopted in appropriations bills regarding the VHA Nursing Handbook. As previously reported, that language states (from H.R. 4486, H. Rpt. 113-416):
“The Committee understands that the VHA Nursing Handbook is currently under review. The Committee encourages the VHA to seek input from internal VA program offices and external professional stakeholders, prior to possible regulatory action and submission to the Under Secretary for Health for final approval. The Committee believes all possible outreach efforts should be used to communicate the proposed changes, to gather public comment, and to collaborate with Congress, stakeholders, VA nursing staff, and external organizations. Finally, the Committee requests that the VHA ensure that any changes to handbooks within the VHA do not conflict with other handbooks already in place within the VHA.”
A 3.5 percent boost was provided to Title 8 nurse workforce development programs, to $231.6 million for 2015, which was sought by AANA and nursing groups. From those funds, HRSA customarily issues between $3-5 million annually to CRNA programs in the form of competitive grants to expand educational opportunities, often through distance learning or simulator technology, and for nurse anesthetist traineeship grants.
See how your U.S. Representative voted at https://www.govtrack.us/congress/votes/113-2014/h563 and how your U.S. Senators voted at https://www.govtrack.us/congress/votes/113-2014/s354.
ASA-backed Rural Pass-through Proposal would Boost Costs, Not Quality, Says AANA
An ASA-backed provision included in draft Medicare hospital legislation in the House would increase rural healthcare costs without improving quality, according to a letter sent to Congress Dec. 15 by the AANA.
The draft bill, issued by Rep. Kevin Brady (R-TX) in his role as chair of the House Ways and Means Subcommittee on Health, includes the text of the provision previously introduced as H.R. 4781 by Rep. Lynn Jenkins (R-KS), a member of the panel. The “Hospital Improvements for Payment Act of 2014” notes that Jenkins’ provision at Sec. 211 “(e)stablishes parity between anesthesiologists and certified registered nurse anesthetists (CRNAs) by allowing anesthesiologists to receive pass-through payments in the same fashion CRNAs receive pass-through payments.”
But in a letter signed by AANA President Sharon Pearce, CRNA, MSN, the AANA said, “As proposed, Sec. 211 will increase the overall cost of anesthesia delivery in rural America without improving outcomes or access for rural Americans, placing additional financial burdens upon rural hospitals already facing financial challenges.”
See the AANA’s letter (requires AANA member login and password) and the committee’s section-by-section review of the draft legislation. The rural anesthesiologist provision is Sec. 211. See the current Medicare policy on page 5 of this document: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/CritAccessHospfctsht.pdf.
In Discussions with AANA, NGS Medicare Clarifies Coverage for CRNA Pain Management Services
The AANA recently had a conference call with the contractor medical directors from National Government Services (NGS) Medicare to clarify the provider qualification requirements specified in three pain management local coverage determinations (LCDs), which become effective for services beginning Tues., Dec. 16.
NGS clarified that CRNAs certified and recertified to practice by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) meet these LCDs’ provider qualifications requirements. Such CRNA services may be covered insofar as they are providing Medicare services within their state scope of practice. Further, those CRNAs possessing the new optional Nonsurgical Pain Management (NSPM) credential promulgated by NBCRNA also meet the requirement and may also have their Medicare services covered. The LCDs affect services provided in the following states: Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont, and Wisconsin. An open issue remains in Illinois over Medicare coverage of CRNA pain management services with fluoroscopy; the imaging service is the subject of restrictive state language.
Read the final LCDs as follows: Pain Management, Epidural, and Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy. The AANA’s comments this past summer were as follows: Pain Management, Epidural Injections, and Facet Joint Injections.
Medicare Publishes Guidance on 2015 Colonoscopy Anesthesia Coverage
Medicare has published additional guidance on preventive and screening services, which includes information important to CRNAs submitting claims for anesthesia associated with screening colonoscopies.
According to Medicare, “Effective January 1, 2015, anesthesia professionals who furnish a separately payable anesthesia service in conjunction with a screening colonoscopy shall include the following on the claim for the services that qualify for the waiver of coinsurance and deductible: Modifier 33 – Preventive Services: when the primary purpose of the service is the delivery of an evidence-based service in accordance with a USPSTF A or B rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure. For separately reported services specifically identified as preventive, the modifier should not be used.”
In addition, also effective Jan. 1, 2015, Medicare says that “beneficiary coinsurance and deductible do not apply to the following anesthesia claim lines when furnished in conjunction with screening colonoscopy services and when billed with Modifier 33: 00810: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum.”
To Protect and Advance CRNA Practice, the CRNA-PAC will Soon Begin its 2015 Development Campaign
Led by CRNA-PAC Chair Rick Jueneman, CRNA, the CRNA-PAC is wasting no time in getting its 2015 development campaign under way as the New Year begins. State association leaders have already received information packets to start the process rolling.
Focused on building member engagement to protect and advance CRNA practice through federal advocacy, the CRNA-PAC will undertake its 2015 campaign in four major phases. With the theme of “#MyCRNACause,” the first phase involves educating AANA members about the role and benefits of the CRNA-PAC to the nurse anesthesia profession and to CRNAs, particularly in a time of major health policy and industry change. The second phase will reach out to members via email, mail, and telephone to ask for their support. Third, the CRNA-PAC will undertake a new peer-to-peer Ambassador Program initiative to raise funds for both the CRNA-PAC and state PACs in 10 selected states. The campaign will conclude with “Great Moments in Time,” the CRNA-PAC gala event being held Sunday, April 22, in Washington, D.C., at the Newseum.
Learn more about the CRNA-PAC or make a contribution at www.crna-pac.org (requires AANA member login and password). For more information please contact AANA Associate Director Political Affairs Kate Fry at kfry@aanadc.com.
Medicare Issues Surveyor Worksheets for Assessing Compliance with Hospital Conditions of Participation, Including Infection Control
Infection control practices are under the microscope for CRNAs and all other hospital healthcare professionals as Medicare has issued new worksheets that state survey agencies will use to assess hospital compliance with Medicare regulations.
The infection control worksheet contains several elements relevant to CRNA practice, including hand hygiene, injection practices, personal protective equipment, single-use devices, central venous catheters, spinal injection procedures, among others. To promote patient safety and to ensure compliance, CRNAs should familiarize themselves with the AANA Infection Control Guide for Certified Registered Nurse Anesthetists and should be aware of the hospital infection control worksheet. The AANA also has several infection control-related materials on the Professional Practice portion of the AANA website.
HRSA Invites CRNA Educational Programs to Apply for Nurse Workforce Development and Nurse Anesthetist Traineeship Funding
The Health Resources and Services Administration (HRSA) has posted invitations for nurse anesthesia educational programs to apply for nurse anesthetist traineeships and advanced education nursing program funding for FY2015.
The Nurse Anesthetist Traineeship (NAT) grant program application deadline is Feb. 26, 2015, and the announcement is posted here: http://www.grants.gov/view-opportunity.html?oppId=270393. HRSA expects to award approximately 85 grants totaling $2.25 million.
The Advanced Education Nursing (AEN) grant program application deadline is Feb. 13, 2015, and the announcement is posted here: http://www.grants.gov/view-opportunity.html?oppId=270149.
Feds Issue Five-Year Health Information Technology Strategic Plan for Public Comment
For CRNAs interested in developments in health information technology (health IT), the federal government has issued its draft five-year health IT strategic plan for review and comment. The AANA is reviewing the proposal.
Released by the Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC), the draft 2015-2020 Federal Health IT Strategic Plan intends to expand adoption of health information technology, advance interoperability, and strengthen care delivery by expanding the adoption of health IT across the care continuum. This plan identifies the federal government’s health IT priorities, including working toward more widespread adoption of health IT. The first two goals of this plan prioritize increasing the electronic collection and sharing of health information while protecting individual privacy. The final three goals focus on federal efforts to create an environment where interoperable information is used by healthcare providers, public health entities, researchers, and individuals to improve health and healthcare, and to reduce costs.
The AANA is currently reviewing this strategic plan for possible comments, which are due to the agency on Feb 6, 2015. View the Federal Health IT Strategic Plan 2015-2020 at http://www.healthit.gov/sites/default/files/federal-healthIT-strategic-plan-2014.pdf.
CRNA-PAC Publishes 2014 Election Report with Thanks to PAC Contributors
How did the AANA fare in the 2014 midterm elections? As noted in an email alert to all AANA members, the CRNA-PAC has published and circulated an analysis outlining how candidates backed by CRNA-PAC fared in the Nov. 4 midterm elections.
According to an analysis by the National Association of Business Political Action Committees, the CRNA-PAC ranked 19th of all membership association PACs in the United States in terms of its impact on the 2014 elections. This accomplishment came as a result of thousands of AANA member contributions large and small to our CRNA-PAC, which is the only PAC in America devoted solely to CRNA interests and issues in Washington.
To read the CRNA-PAC 2014 Election Report, follow this link (AANA login and password required) and click on the first bullet item.
The following is an FEC required legal notification for CRNA-PAC: Gifts to political action committees are not tax deductible. Contributions to CRNA-PAC are for political purposes. All contributions to CRNA-PAC are voluntary. You may refuse to contribute without reprisal. The guidelines are merely suggestions. You are free to contribute more or less than the guidelines suggest and the association will not favor or disadvantage you by reason of the amount contributed or the decision not to contribute. Federal law requires CRNA-PAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. Each contributor must be a US Citizen.


Panel Cites Need for Individualized, Patient-Centered Approach to Treat and Monitor Chronic Pain
An independent panel convened by the National Institutes of Health concluded that individualized, patient-centered care is needed to treat and monitor the estimated 100 million Americans living with chronic pain. To achieve this aim, the panel recommends more research and development around the evidence-based, multidisciplinary approaches needed to balance patient perspectives, desired outcomes, and safety. Chronic pain is often treated with prescription opioids, but the panel noted widespread concern with this practice. Although some patients benefit from such treatment, there are no long-term studies on the effectiveness of opioids related to pain, function, or quality of life. There is not enough research on the long-term safety of opioid use. However, there are well-documented potential adverse outcomes, including substantial side effects, physical dependence, and overdose. The panel identified several barriers to implementing evidence-based, patient-centered care, including the fact that some insurance plans do not offer effective non-opioid drugs as first-line treatment for chronic pain.

From "Panel Cites Need for Individualized, Patient-Centered Approach to Treat and Monitor Chronic Pain"
NIH News (01/12/15)


Drug Switch May Delay Executions in Ohio
The state of Ohio said Thursday that it may delay several executions as it changes its lethal-drug protocol after a convicted man choked, gasped, and clenched his fists for more than 20 minutes during his execution last year. The state will discontinue its use of the two drugs—midazolam and hydromorphone—used to execute Dennis McGuire last January. The state will switch to pentobarbital or sodium thiopental, both previously used for executions. A law approved by the state Legislature that goes into effect in March would allow the state to purchase drugs used for lethal injections made in compounding pharmacies, which could allow the state to resume executions before the end of spring.

From "Drug Switch May Delay Executions in Ohio"
New York Times (01/09/15) Williams, Timothy


Northwestern Study Finds Music Alleviates Pain After Pediatric Surgery
A team of researchers from Northwestern Medicine has found that children who undergo major surgery may experience less pain if they listen to songs or audiobooks 30 minutes after the procedure. In a study published in the Journal of Pediatric Surgery, the researchers had 60 children, aged nine to 14, listen to audiobooks and different music genres of their choice. The children were divided into three different groups: one group that listened to music for 30 minutes, one group that listened to audiobooks for 30 minutes, and one group that listened to 30 minutes of silence with noise-canceling headphones. The group that listened to silence reported no change in pain, but the other two groups reported significantly less pain, regardless of their initial pain score. This may be the "first randomized study to evaluate and demonstrate the use of patient-preferred audio therapy as a promising strategy to control post-surgical pain in children," Northwestern University said in a news release.

From "Northwestern Study Finds Music Alleviates Pain After Pediatric Surgery"
Daily Northwestern (01/09/15) Alfaro, Mariana


Helping Newborns Manage Pain
Members of the Mayday Fellowships, run by the Mayday Fund to help improve the treatment of pain, are working to develop better pain-management methods for babies. Dr. Marsha Campbell-Yeo, an assistant professor at Dalhousie University in Nova Scotia who specializes in newborn pain, recently released a YouTube video to provide parents with strategies to manage pain in their newborns. "For a long time people didn't think babies even felt or remembered pain, so we didn't treat it very well," Campbell-Yeo noted. Methods to reduce pain in newborns may be as simple as holding a baby, skin-to-skin, during a procedure such as a vaccination or a blood test. A study in Cochrane Review also demonstrated that this "kangaroo care" can safely and effectively reduce pain.

From "Helping Newborns Manage Pain"
Dalhousie University (Canada) (01/07/15) Skagen, Emma
Survey: Addiction and Drug Abuse Concerns Prompting PCPs to Prescribe Fewer Opioids
The escalation of the prescription painkiller problem in America has moved primary care physicians (PCPs) to scale down their use of the drugs to treat chronic pain. In a new nationwide survey, 45 percent of respondents reported that they were less likely to prescribe opioids than they were a year earlier. Additional results indicated that 90 percent of the poll-takers characterized prescription drug abuse as a "big" or "moderate" problem in their communities; 85 percent agreed that opioids are used too frequently in clinical practice; and many expressed concern about potential adverse patient outcomes, including addiction and death. "Our findings suggest that primary care providers have become aware of the scope of the prescription opioid crisis and are responding in ways that are important, including reducing their overreliance on these medicines," remarked lead study author G. Caleb Alexander, MD, MS, of Johns Hopkins University. "The health care community has long been part of the problem and now they appear to be part of the solution to this complex epidemic." Alexander's team from the Bloomberg School of Public Health sent the poll to 1,000 PCPs, with a 58 percent response rate.

From "Survey: Addiction and Drug Abuse Concerns Prompting PCPs to Prescribe Fewer Opioids"
Anesthesiology News (01/06/15)

Study Finds Certification May Impact Surgical Patients
A study published in the AORN Journal reveals that specialty nursing certification may help improve surgical patient outcomes. The research was conducted by the National Database of Nursing Quality Indicators (NDNQI) and the University of Kansas, and sponsored by the Competency & Credentialing Institute. Researchers considered the impact of four types of certifications frequently held by perioperative nurses—certified ambulatory perianesthesia nurse (CAPA), certified postanesthesia nurse (CPAN), certified nurse operating room (CNOR), and certified RN first assistant (CRNFA). The results indicated that higher rates of CPAN and CNOR/CRNFA certification in perioperative units were significantly associated with lower rates of central-line associated bloodstream infections in surgical intensive care units. The researchers also examined secondary data from the NDNQI to "ensure the research could be generalized to more facilities," says James Stobinski, one of the study authors.

From "Study Finds Certification May Impact Surgical Patients"
Infection Control Today (01/06/15)

Success of Spinal Anesthesia Lower for Preterm Parturients
According to a study out of Duke University, spinal anesthesia during C-section is much more likely to fail in pregnant women who deliver early than in those who have reached their ninth month. The researchers analyzed records for 3,404 term patients and 1,637 preterm patients who underwent cesarean delivery under spinal or combined spinal-epidural anesthesia between 2003 and 2012. They found that failed spinal anesthetics occurred more frequently in preterm women, particularly those who were 30 weeks or fewer into their pregnancy. "Our thoughts behind this are that pregnant patients are known to need higher doses of local anesthetic to create the same block heights," remarked lead researcher Lisa Einhorn, MD. "So it's possible that these early preterm patients may not fully undergo the anatomic and physiologic changes that lead to increased spinal spread in pregnancy. Therefore, an increased spinal dose may be necessary to fully anesthetize these patients for surgical anesthesia for cesarean delivery."

From "Success of Spinal Anesthesia Lower for Preterm Parturients"
Anesthesiology News (01/01/15) Vol. 41, No. 1 Vlessides, Michael


GOP Relaunches Push to Ban Late-Term Abortions
The issue of fetal pain and abortion is back before Congress, with House Republicans reintroducing the Pain Capable Unborn Child Protection Act on the first day of the new session. The proposed law would prevent abortions from taking place after the first 20 weeks of pregnancy, based on the theory that fetuses can experience pain at that point. The measure was previously approved by House lawmakers in June 2013; but with the GOP now controlling both chambers of Congress, it is likely to receive a vote this term in the Senate as well. Reps. Trent Franks (R-Ariz.) and Marsha Blackburn (R-Tenn.) are sponsoring the legislation in the House, and Sen. Lindsey Graham (R-S.C.) is expected to reintroduce his companion bill soon.

From "GOP Relaunches Push to Ban Late-Term Abortions"
The Hill (01/06/15) Viebeck, Elise
Anesthesia Providers Play Critical Role in Managing Ebola Virus Disease
Anesthesia providers perform a number of invasive procedures—from intubation and mechanical ventilation to venous catheter placement—and, thus, are critically positioned to manage Ebola patients and prevent transmission of the virus to themselves and others. "Anesthesia departments should educate, train, and prepare their providers immediately" on safety protocols for when they respond to a known or suspected case of Ebola infection, University of Miami researchers write in Anesthesia & Analgesia. While there is little direct evidence on the anesthetic management of the disease, the team led by Dr. Andres Missair base their fundamental recommendations on an analysis of animal research involving Ebola as well as human trials. They cite strict compliance with guidelines for personal protective equipment, since anesthesia providers are at high risk for direct exposure to contaminated body fluids or injuries from needles, scalpels, and other "sharps." They also also point to consideration of peripheral nerve block or other alternatives to general anesthesia; properly disposing of tainted equipment; and taking additional precautionary steps when conducting medical procedures involving inhaled aerosol particles.

From "Anesthesia Providers Play Critical Role in Managing Ebola Virus Disease"
Infection Control Today (01/05/15)

Helping Children Push Past the Pain
More than 30 U.S. teaching hospitals have established in the past few years pediatric pain clinics that help children manage pain with exercise facilities, biofeedback training, acupuncture, and sleep specialists. Only four programs, such as the Mayo Family Pediatric Pain Rehabilitation Center in Waltham, Mass., offer a more extensive outpatient program with therapists who focus on conditions such as chronic migraines, fibromyalgia, or pain from an infection or injury. The team consists of a physician, physical therapist, psychologist, and occupational therapist. The program takes on about five or six children at one time, usually for three weeks, but sometimes for five or six weeks. Children at the outpatient facility go through a simulated school day, including playing in a gym class and walking through a crowded hallway, to learn how to deal with pain they may experience and use sensory-based coping strategies. While most children still experience some pain after the program, most of them see a gradual reduction in pain and can return to normal activities. Chronic, unexplained pain is becoming more widely recognized in children. At least 8 percent of kids deal with regular abdominal pain, and 14 percent say they deal with back pain, researchers recently reported in the medical journal Pain.

From "Helping Children Push Past the Pain"
Boston Globe (12/29/14) Kotz, Deborah

Highmark Drops Anesthesia Ban
Rather than restricting the use of certain drugs in colorectal cancer screening, health insurer Highmark Inc. has instead decided to follow Medicare's lead on the issue. Highmark had planned to limit payment for administering propofol to high-risk patients, but it backed away from the decision in May as it continued discussions with organizations such as the Pennsylvania Medical Society, the Pennsylvania Society of Gastroenterology, and the Pennsylvania Society of Anesthesiologists. In a move to encourage screening for colorectal cancer, Medicare will waive co-insurance and deductibles for anesthesia or sedation services furnished in conjunction with screening colonoscopies, starting Jan. 1. Highmark will adopt Medicare's policy on the use of anesthetics during endoscopy procedures.

From "Highmark Drops Anesthesia Ban"
Pittsburgh Business Times (12/22/14) Mamula, Kris B.

United States Anesthesia Drugs Market & Forecast
The overall U.S. market for anesthesia drugs is estimated to be worth more than $3 billion by 2018, according to ResearchandMarkets.com's latest report. General intravenous anesthesia drugs dominate this market. Propofol and benzodiazepines class (diazepam and midazolam) are the top contributors to intravenous anesthetic drugs, while in the local anesthesia drugs market, Lidocaine holds the largest market share. Baxter International, Endo Health Solutions, and Abbott Laboratories are the three main players, the report said.

From "United States Anesthesia Drugs Market & Forecast"
PR Newswire (12/14/14)

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