AANA journal最新文献

Anesthetic Considerations for Maternal-Fetal Interventions. 母胎干预的麻醉考虑。

AANA journal Pub Date : 2025-06-01 DOI: 10.70278/AANAJ/.0000001019

Bridget Twohig, Callie Walter, Rachel Rachler, Marianne Cosgrove

{"title":"Anesthetic Considerations for Maternal-Fetal Interventions.","authors":"Bridget Twohig, Callie Walter, Rachel Rachler, Marianne Cosgrove","doi":"10.70278/AANAJ/.0000001019","DOIUrl":"https://doi.org/10.70278/AANAJ/.0000001019","url":null,"abstract":"Advances in diagnosing and managing fetal anomalies have enabled the rapid evolution of maternal-fetal surgery (MFS). These surgeries are broadly categorized as minimally invasive, open, or ex utero intrapartum treatment (EXIT) procedures. A multidisciplinary team is required for these techniques with the anesthesia provider playing a pivotal role. A unique aspect of MFS is the need to manage both mother and fetus. Successful delivery of anesthesia requires knowledge of the physiologic changes of pregnancy, fetal physiology, maintenance of uteroplacental blood flow, and mitigating risk of general anesthesia. Additionally, understanding the underlying condition of the fetus and its surgical correction can ensure optimal anesthetic care. Certified registered nurse anesthetists (CRNAs) may have limited experience with MFS, but knowledge of these considerations will enable safer delivery of anesthesia. The type of anesthesia for MFS is determined by the surgical procedure. Open surgeries and EXIT procedures commonly require general anesthesia with fetal immobility, management of uterine atony, and preparation for fetal resuscitation. Minimally invasive procedures are often performed with local anesthesia and maternal sedation. MFS is a growing subspecialty with specific anesthetic considerations that CRNAs should be familiar with. This journal course aims to increase knowledge to promote safe anesthetic care for MFS.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 3","pages":"223-232"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contributing Factors and Associated Outcomes of Burnout Among Certified Registered Nurse Anesthetists: An Integrative Review. 注册麻醉师护士职业倦怠的影响因素和相关结果：一项综合综述。

AANA journal Pub Date : 2025-06-01 DOI: 10.70278/AANAJ/.0000001016

Christina R Congdon, Donald R Boyd, Gregory L Alexander

{"title":"Contributing Factors and Associated Outcomes of Burnout Among Certified Registered Nurse Anesthetists: An Integrative Review.","authors":"Christina R Congdon, Donald R Boyd, Gregory L Alexander","doi":"10.70278/AANAJ/.0000001016","DOIUrl":"https://doi.org/10.70278/AANAJ/.0000001016","url":null,"abstract":"Certified registered nurse anesthetists (CRNAs) are essential providers of anesthesia in the United States, yet rates of burnout are alarmingly high. To further understand burnout among CRNAs, a current synthesis of the literature is warranted. The purpose of this integrative review was to identify and synthesize the prevalence, contributing factors, and associated outcomes of burnout among CRNAs. A systematic search of the PubMed, CINAHL, Scopus, and PsycINFO databases was performed. Quality appraisal was conducted using the Joanna Briggs Institute appraisal tools. A total of 15 studies were included in the review. Overall prevalence of burnout ranged from 12.5% to 72%. Significant contributing factors to burnout include lack of autonomy (n = 7), lack of leadership support (n = 4), moral distress (n = 3), and poor relations with physicians (n = 3). Intention to leave one's primary position (n = 3), decreased job satisfaction (n = 3), and fatigue (n = 1) were associated outcomes of burnout. CRNA burnout is found to have adverse individual and organizational outcomes. Contributing factors to be explored further in the CRNA population include poor CRNA-physician relations, poor CRNA-administration relations, and limited CRNA autonomy.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 3","pages":"169-176"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maternal Health Equity Toolkit for Anesthesia Providers: A Content Validity Study. 产妇保健公平工具包麻醉提供者：内容效度研究。

AANA journal Pub Date : 2025-06-01 DOI: 10.70278/AANAJ/.0000001012

Jennifer Fierros, Gordon Gillespie, Beth Ann Clayton

{"title":"Maternal Health Equity Toolkit for Anesthesia Providers: A Content Validity Study.","authors":"Jennifer Fierros, Gordon Gillespie, Beth Ann Clayton","doi":"10.70278/AANAJ/.0000001012","DOIUrl":"https://doi.org/10.70278/AANAJ/.0000001012","url":null,"abstract":"The purpose of this toolkit is to minimize maternal health disparities by supplying obstetric anesthesia providers with evidence-based recommendations and resources that empower the provision of equitable analgesia and anesthesia. Toolkit development was accomplished through an extensive literature review and summary of evidence. The toolkit was critiqued by obstetric care experts for its relevancy, simplicity, clarity, and ambiguity. These data points were evaluated using a content validity index (CVI) process, yielding an overall CVI of 0.94. Three recommendations for improvement in obstetric analgesia and anesthesia care were identified. Recommendation 1 highlighted the need to proactively seek growth and improvement of care delivery through provider education, tracking anesthesia-specific parturient outcomes, and assessing parturient delivery experience. Recommendation 2 identified the need to strengthen parturient-provider relationships with communication, shared decision-making, and diversifying the anesthesia workforce. Recommendation 3 focused on multidisciplinary parturient management through rapid-response teams, performance of emergency drills, and implementation of crisis management checklists to standardize care. Overall, this validated toolkit offers obstetric anesthesia providers evidence-based recommendations and resources to support fair and effective pain relief and anesthesia.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 3","pages":"191-198"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adopting Transesophageal Echocardiography by CRNAs in Noncardiac Surgery: A Prospective Cohort Observational Study. 在非心脏手术中采用经食管超声心动图：一项前瞻性队列观察研究。

AANA journal Pub Date : 2025-06-01 DOI: 10.70278/AANAJ/.0000001021

Barry Swerdlow, Lisa Osborne-Smith

{"title":"Adopting Transesophageal Echocardiography by CRNAs in Noncardiac Surgery: A Prospective Cohort Observational Study.","authors":"Barry Swerdlow, Lisa Osborne-Smith","doi":"10.70278/AANAJ/.0000001021","DOIUrl":"10.70278/AANAJ/.0000001021","url":null,"abstract":"This study considered a cohort of 15 practicing certified registered nurse anesthetists (CRNAs) who completed a 1-day didactic and simulation-based workshop on focused transesophageal echocardiography (TEE) for noncardiac surgery. Data were acquired by survey and knowledge-based testing immediately pre- and postworkshop, and after 3 months. The primary aims of the study were to determine the extent that workshop-trained CRNAs incorporated TEE into their noncardiac surgery practice soon after program completion and to identify perceived barriers to this process. The study also evaluated both initial acquisition and short-term retention of TEE knowledge. CRNA education in focused TEE to provide entry-level skills into practice via a 1-day workshop is feasible, acceptable, and has perceived utility. Preworkshop, 33% of the cohort utilized TEE during noncardiac surgery; 13% who had not previously utilized TEE incorporated it de novo into their practices within 3 months. The most common reason for failure to use TEE during noncardiac surgery postworkshop was lack of a TEE machine or an appropriate surgical patient. Other reasons included lack of a supervising anesthesiologist agreeable to doing so or lack of TEE privileges. As assessed by written evaluation, there was both significant knowledge acquisition and short-term retention associated with this workshop.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 3","pages":"203-210"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resources Utilized by Certified Registered Nurse Anesthetists to Acquire Employment Opportunities. 注册麻醉师护士获取就业机会所利用的资源。

AANA journal Pub Date : 2025-06-01 DOI: 10.70278/AANAJ/.0000001015

Heather Danke, Alliene Olson, Claire Yee, Molly Kraus

{"title":"Resources Utilized by Certified Registered Nurse Anesthetists to Acquire Employment Opportunities.","authors":"Heather Danke, Alliene Olson, Claire Yee, Molly Kraus","doi":"10.70278/AANAJ/.0000001015","DOIUrl":"https://doi.org/10.70278/AANAJ/.0000001015","url":null,"abstract":"The demand for anesthesia services continues to increase and the projected growth rate of this field may lead to increasing challenges in the future. Understanding how certified registered nurse anesthetists (CRNAs) acquire employment is important so practices can attract the CRNA workforce. It is unknown how CRNAs utilize resources to assess employment options. The aim of this survey was to determine how CRNAs acquire employment. A survey of a random sampling of 3,000 members of the American Association of Nurse Anesthesiology was conducted, 138 responses resulted in a response rate of 4.6%. Analyses were conducted using R version 4.2.2. Continuous variables were summarized using mean, standard deviation, and range. CRNAs seeking employment opportunities use on average 3.29 resources, with CRNA referrals (92.8%) and the professional association (74.6%) being most used. CRNAs ranked factors influencing employment decisions from most to least important, salary, location, and call. With the prevalence of social media use in the younger workforce, integration of this technology may become more common as an employment resource in years to come. Future research should focus on obtaining a larger sample size to ensure adequate generalizability to the CRNA population.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 3","pages":"185-189"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Editor's Desk: What Makes a Good Scholarly Article? 编辑台：怎样才能写出一篇好的学术文章？

AANA journal Pub Date : 2025-06-01

Edwin N Aroke

引用次数: 0

A Rare Event With High Acuity: A Case of Autonomic Dysreflexia. 高敏度罕见事件：自主神经反射障碍1例。

AANA journal Pub Date : 2025-06-01 DOI: 10.70278/AANAJ/.0000001002

Emily Sullivan, Ali Husseini, Laurie Easter

引用次数: 0

Evolution of Effectiveness of the Self-Evaluation Examination: A Mixed Methods Study of Predictive Validity and Perceived Utility. 自我评价考试有效性的演化：预测效度与感知效用的混合方法研究。

AANA journal Pub Date : 2025-06-01 DOI: 10.70278/AANAJ/.0000001018

Susan P McMullan, Timothy J Muckle, Kenneth A Wofford, Robyn C Ward, Janet Chan

{"title":"Evolution of Effectiveness of the Self-Evaluation Examination: A Mixed Methods Study of Predictive Validity and Perceived Utility.","authors":"Susan P McMullan, Timothy J Muckle, Kenneth A Wofford, Robyn C Ward, Janet Chan","doi":"10.70278/AANAJ/.0000001018","DOIUrl":"https://doi.org/10.70278/AANAJ/.0000001018","url":null,"abstract":"The Self-Evaluation Examination (SEE), an in-training examination administered by the National Board of Certification and Recertification of Nurse Anesthetists (NBCRNA), was reconfigured in 2016 to ensure fulfillment of its intended purposes, improve its utility, and augment predictive value toward a first-time pass on the National Certification Examination (NCE). The purpose of this mixed methods study was to reenvision the SEE to further enhance its value to stakeholders. A correlational quantitative analysis was conducted between the reconfigured SEE and NCE. A qualitative analysis of survey results was also performed; focus groups were undertaken among program administrators to assess utilization of the SEE. Final SEE results for 8,552 students from September 2016 through October 2023 were linked to first-time NCE results. Pearson's r correlations (r = 0.57; P < .01) represent a moderately strong positive correlation between SEE and NCE performance. Data from a survey of 107 program administrators indicated positive support for reconfigured SEE. Themes from three focus groups identified uses, best practices, and desired enhancements. Results were consistent with previously reported results, confirming the reconfigured SEE met intended goals. Future augmentations are being considered by NBCRNA to further enhance utility and value to nurse anesthesia educational programs.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 3","pages":"177-184"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emergency Surgical Front-of-Neck Airway Access: Effectiveness of a Didactic and Simulation-Based Training Intervention to Improve Performance and Self-Efficacy Among Resident Registered Nurse Anesthetists. 急诊外科颈前气道通路：以教学和模拟为基础的培训干预对提高住院注册麻醉师的表现和自我效能的有效性。

AANA journal Pub Date : 2025-06-01 DOI: 10.70278/AANAJ/.0000001020

David Allen, Hannah Bulick, Carrie Bowman Dalley, Nancy Crowell, Christina Miller, Megan McAuliffe

{"title":"Emergency Surgical Front-of-Neck Airway Access: Effectiveness of a Didactic and Simulation-Based Training Intervention to Improve Performance and Self-Efficacy Among Resident Registered Nurse Anesthetists.","authors":"David Allen, Hannah Bulick, Carrie Bowman Dalley, Nancy Crowell, Christina Miller, Megan McAuliffe","doi":"10.70278/AANAJ/.0000001020","DOIUrl":"https://doi.org/10.70278/AANAJ/.0000001020","url":null,"abstract":"Simulation is a valuable tool for developing technical skills and self-efficacy for high-risk, low-frequency events such as cannot intubate, cannot oxygenate (CICO) scenario. There is a deficiency of evidence regarding CICO events and emergency front of neck access training for resident registered nurse anesthetists (RRNAs). This study explored whether a low-fidelity simulation training utilizing a 3D-printed cricothyrotomy task trainer and educational intervention increased self-efficacy, improved performance measures (performance time, performance checklist scores), and increased expert performance levels (performance time, performance checklist score, completion of critical performance checklist steps) regarding scalpel-bougie-tube surgical cricothyrotomy (SBT-SC) among RRNAs. This pilot study utilized a quasiexperimental pretest-posttest design. Ten RRNAs participated in the study. Statistical analysis with paired t-tests demonstrated statistically significant improvement in mean self-efficacy scores (3.13 to 4.5 out of 5, P < .001), mean performance completion time (103.5 seconds (SD, 34.5) to 55.9 (SD, 17.9) seconds [P < .001]), mean performance checklist scores (5.5 to 9.1 out of 10, [P < .001]), and completion of critical checklist steps. Six participants completed the postintervention SBT-SC in under 60 seconds while completing all critical checklist steps. One participant met expert performance benchmark criteria following the intervention. This study supports low-fidelity simulation for SBT-SC education and training for RRNAs.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 3","pages":"213-220"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Role of Tranexamic Acid in Postpartum Hemorrhage in the High-Risk Obstetric Patient: A Retrospective Study. 氨甲环酸在高危产科患者产后出血中的作用：回顾性研究。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001008

Kaitlyn Colliton, Madeleine Schaefer, Megan McAuliffe, Nancy Crowell, Lauren Suszan, Mary Scott-Herring

引用次数: 0