AANA journalPub Date : 2026-04-01DOI: 10.70278/AANAJ/.0000001047
Heather Lenzmeier, Emily Funk, Kristin Schroeder, Brian Jones, Brett Morgan, Denise H Tola, Erick Moses Muyunga, Ally Munir Akrabi, Jane Blood-Siegfried, Benjamin Smallheer
{"title":"Evaluating the Safety of a Ketamine Sedation Protocol In a Pediatric Oncology Population in Tanzania: A Quality Improvement Project.","authors":"Heather Lenzmeier, Emily Funk, Kristin Schroeder, Brian Jones, Brett Morgan, Denise H Tola, Erick Moses Muyunga, Ally Munir Akrabi, Jane Blood-Siegfried, Benjamin Smallheer","doi":"10.70278/AANAJ/.0000001047","DOIUrl":"10.70278/AANAJ/.0000001047","url":null,"abstract":"<p><p>This project aimed to reintroduce and evaluate a pediatric ketamine sedation protocol at a Zonal Referral Center in Mwanza, Tanzania, where nonanesthesia clinicians provide sedation when trained anesthesia personnel are unavailable. The objectives were to assess knowledge retention, confidence, and protocol compliance. The study design used a pre- and postintervention design. Nonanesthesia clinicians at a > 1,000-bed hospital were surveyed to assess their knowledge and confidence about ketamine sedation. Over 10 days, 50 clinicians received training that included lectures and cognitive aid resources in English and Swahili (the local language). Knowledge and confidence were measured using paired surveys. Clinicians were observed for compliance, skill demonstration, and feedback during postimplementation sedation encounters. Results showed significant improvements in knowledge (M = 6.93-8.77; <i>P</i> = .001) and confidence (M = 5.94-8.98; <i>P</i> = .001). Seven sedation encounters were observed over a 7-day period, and compliance with the presedation assessment was 100% for last food or drink intake, allergy history, and medication history. Reintroducing this protocol in a low-resource setting led to improvements in knowledge, confidence, and skills among nonanesthesia clinicians.</p>","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 2","pages":"107-114"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637662","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}
AANA journalPub Date : 2026-04-01DOI: 10.70278/AANAJ/.0000001089
Edwin N Aroke
{"title":"The Editor's Desk: From Assignment to Publication: Transforming DNP/DNAP Projects into Scholarly Contributions.","authors":"Edwin N Aroke","doi":"10.70278/AANAJ/.0000001089","DOIUrl":"https://doi.org/10.70278/AANAJ/.0000001089","url":null,"abstract":"","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 2","pages":"87-88"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637664","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}
AANA journalPub Date : 2026-04-01DOI: 10.70278/AANAJ/.0000001058
Allan Lovern, May Watson, Alecia Hollis, Lindsay M Quinlan, Yuhua Su
{"title":"Using a Nature-Based Mindfulness Intervention to Improve Mental Health in Nurse Anesthesia Students: A Pilot Study.","authors":"Allan Lovern, May Watson, Alecia Hollis, Lindsay M Quinlan, Yuhua Su","doi":"10.70278/AANAJ/.0000001058","DOIUrl":"10.70278/AANAJ/.0000001058","url":null,"abstract":"<p><p>Resident registered nurse anesthetists (RRNAs) face high levels of depression, anxiety, and stress (DAS) due to the academic, clinical, and financial demands of graduate anesthesia education. Nature-based mindfulness, which integrates nature exposure with mindfulness practices, has shown promise in reducing psychological distress but remains underexplored among RRNAs. This single-arm pilot, pre-/posttest study evaluated the effectiveness of a nature-based mindfulness intervention (NBMI) on DAS in a cohort of third-year RRNAs in the southeastern United States. The 8-week intervention included guided nature walks, box breathing exercises, and gratitude journaling. Depression, anxiety, and stress were measured pre- and postintervention using DASS-21. Focus groups explored participants' experiences postintervention. Quantitative analysis revealed a statistically significant reduction in anxiety levels (P = .039). Stress and depression scores decreased but did not reach statistical significance. Qualitative findings reflected improved mental clarity, emotional well-being, and peer connection. Findings suggest that NBMI is an effective, feasible, low-cost strategy to enhance well-being in RRNAs. Larger, randomized studies are warranted to examine the broader applicability of NBMI in nurse anesthesia education.</p>","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 2","pages":"133-138"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637613","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}
AANA journalPub Date : 2026-04-01DOI: 10.70278/AANAJ/.0000001078
Jiale Hu, Rebekah Chung, Ryshona Odeneal, Sarah Jingying Zhang
{"title":"<i>AANA Journal</i> Course-The Gut-Brain Axis and Chronic Pain: The Emerging Role of Microbiota.","authors":"Jiale Hu, Rebekah Chung, Ryshona Odeneal, Sarah Jingying Zhang","doi":"10.70278/AANAJ/.0000001078","DOIUrl":"10.70278/AANAJ/.0000001078","url":null,"abstract":"<p><p>Chronic pain is a complex and disabling condition that significantly impairs quality of life. It often arises from central sensitization, an amplified response to pain stimuli driven by neuroinflammatory changes in both the peripheral and central nervous systems. Emerging evidence highlights the gut microbiome's crucial role in the process because it modulates inflammation, immune function, and neurotransmitter production via the gut-brain axis. An imbalance in gut flora, known as dysbiosis, can exacerbate neuroinflammation by altering intestinal barrier integrity, facilitating the release of pro-inflammatory mediators, and activating microglia within the central nervous system. These changes contribute to increased pain sensitivity and the progression of chronic pain states. Consequently, strategies promoting a healthy gut microbiome, such as targeted dietary measures and microbiota-focused therapies, represent promising adjuncts to conventional chronic pain management. This journal course evaluates current research on the connection between the gut microbiome and chronic pain, offering a novel perspective on holistic, microbiome-centered interventions for alleviating pain disorders. As certified registered nurse anesthetists increasingly participate in pain management, understanding this emerging approach is vital for improving patient outcomes in chronic pain conditions.</p>","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 2","pages":"141-151"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637673","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}
AANA journalPub Date : 2026-04-01DOI: 10.70278/AANAJ/.0000001053
Zachary Petterson, Sarah Cook, Hayden Johnston, Olivia Caldwell, Sadeeka Al-Majid, Cyril Rakovski, Mark H Gabot
{"title":"Identifying Risk Factors and Creating a Point-Based Risk Calculator for Postoperative Pneumonia in Thoracic Surgery Patients.","authors":"Zachary Petterson, Sarah Cook, Hayden Johnston, Olivia Caldwell, Sadeeka Al-Majid, Cyril Rakovski, Mark H Gabot","doi":"10.70278/AANAJ/.0000001053","DOIUrl":"10.70278/AANAJ/.0000001053","url":null,"abstract":"<p><p>This secondary data analysis used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), logistic regression (Method 1), Xtreme Gradient Boosting (Method 2), and a 12-member expert panel (Method 3) to develop and validate a predictive model to identify patients undergoing thoracic surgery at risk for postoperative pneumonia (POP). Twenty-three covariates associated with POP were selected from the 2013-2022 ACS NSQIP dataset filtered for thoracic surgeries. Method 1 and Method 2 were assessed through area under the receiver operating characteristic curve (AUC ROC) using 10-fold cross-validation. Method 3 evaluated the 23 covariates for relevance to POP and relevant predictors were assessed through AUC ROC. Method 1 identified nine significant predictors (<i>P</i> < .05) with a 10-fold cross-validated AUC ROC = .72 (fair classifier). The significant preoperative predictors and their effect size were, sepsis (1.43), systemic inflammatory response syndrome (1.04), male gender (.77), bleeding disorder (.57), current smoker within 1 year (0.39), disseminated cancer (.39), hypoalbuminemia (.33), history of severe chronic obstructive pulmonary disease (.31), and anemia (.05). Method 2 achieved a 10-fold cross-validation AUC ROC = .75 (fair classifier). Method 3 had an AUC ROC = .6 (poor classifier). The nine significant predictors from Method 1 were used to develop a risk-based calculator.</p>","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 2","pages":"115-122"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637595","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}
AANA journalPub Date : 2026-04-01DOI: 10.70278/AANAJ/.0000001075
Callie Dolan, Kelly Gallant, Maria van Pelt, Nelson Aquino
{"title":"An Inclusive Approach to the Preanesthetic Interview: Consensus Development of the Perioperative Gender-Diverse Assessment Tool (PGDAT).","authors":"Callie Dolan, Kelly Gallant, Maria van Pelt, Nelson Aquino","doi":"10.70278/AANAJ/.0000001075","DOIUrl":"10.70278/AANAJ/.0000001075","url":null,"abstract":"<p><p>This study aimed to develop an evidence-based perioperative assessment tool for anesthesiology professionals to supplement standard preoperative assessments, targeting the unique health needs of transgender and gender-diverse (TGD) patients to enhance the perioperative experience. Many TGD patients express dissatisfaction with their care, while numerous healthcare professionals report feeling inadequately prepared to care for this population effectively. Using a modified Delphi design, a consensus-based Perioperative Gender-Diverse Assessment Tool (PGDAT) was developed to assist anesthesiology professionals in sensitively engaging with TGD patients and creating evidence-informed, patient-focused anesthetic plans. Fourteen expert panelists from the United States appraised the quality and clinical readiness of the PGDAT through iterative online surveys. Consensus was defined as 0.8 agreement among raters, and a thematic analysis was conducted following Braun and Clarke, with three core themes emerging. The interrater reliability was 0.75707 and 0.83977 using Gwet's AC2. The 0.8 consensus threshold was achieved after two survey rounds, which content-validated the PGDAT and established an evidence-based resource that future research opportunities can use to bring about systemic changes that promote safe and inclusive healthcare environments for all.</p>","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 2","pages":"123-131"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637632","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}
{"title":"Estimating the Usefulness of Inferior Vena Cava Collapsibility Index as a Predictor for Post-Spinal Hypotension in Orthopedic Patients Undergoing Elective Surgery in a Tertiary Care Hospital.","authors":"Sitara Raghavan Nandyal, Shweta Sinha, Arun Kumar Hd, Suvajit Podder, Deepali Shetty, Shaji Mathew","doi":"10.70278/AANAJ/.0000001055","DOIUrl":"10.70278/AANAJ/.0000001055","url":null,"abstract":"<p><p>Subarachnoid block, colloquially referred to as spinal anesthesia, is a commonly employed method of anesthesia for most of the lower limb orthopedic procedures. Patients in preoperative hypovolemic states are more prone to post-spinal anesthesia hypotension (PSAH). Most orthopedic patients present in a preoperative fluid deficit state, thus, its recognition and appropriate correction are prudent. Ultrasonographic measurement of the inferior vena cava collapsibility index (IVCCI) is a tool to detect and correct hypotension secondary to hypovolemia. We hypothesized that pre-spinal IVCCI measurement is a reliable predictor of PSAH in patients undergoing elective lower limb orthopedic procedures. Ninety-nine participants, ASA grade I and II, aged 18-60 years, undergoing elective lower limb orthopedic surgeries were enrolled. Preoperative ultrasound inferior vena cava evaluation was performed and IVCCI was calculated. Preloading was done with intravenous crystalloid and subarachnoid block was administered in lateral position. Participants were placed supine and thereafter, level of sensory block was ascertained, and noninvasive blood pressure was measured every 2.5 min for 30 min. One hundred patients were screened and one was excluded due to failure of block. Mean IVCCI was 47.33 ± 9.62%. The receiver operating characteristic curve showed IVCCI has satisfactory predictive validity for predicting hypotension with AUC of 0.829 and <i>P</i> < 0.001. The sensitivity and specificity of IVCCI was found to be 87.36% and 83.3% at a cut-off value of 51.67%. Preoperative ultrasound evaluation of IVCCI is a reliable predictor for PSAH at a value of 51.67%.</p>","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 2","pages":"99-106"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637640","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}
AANA journalPub Date : 2026-04-01DOI: 10.70278/AANAJ/.0000001054
Michong Kong Rayborn, Gyeseon Jeong, Hui Ju Yang, Yunsuk Jeon
{"title":"Comparative Study of Nurse Anesthetist Competency in Finland, South Korea, Taiwan, and the United States.","authors":"Michong Kong Rayborn, Gyeseon Jeong, Hui Ju Yang, Yunsuk Jeon","doi":"10.70278/AANAJ/.0000001054","DOIUrl":"10.70278/AANAJ/.0000001054","url":null,"abstract":"<p><p>The aim of this study was to identify and assess factors associated with nurse anesthetist competency in Finland, South Korea, Taiwan, and the United States. A cross-sectional design was used. The Anesthesia Nursing Competence Scale consisting of seven competencies was utilized: ethics, patient risk management, technological skills, collaboration, medication, optimizing anesthesia care, and anesthesia knowledge (0 = not competent at all, 10 = excellent competence). The data were collected via an online survey (N = 582) in 2024. Data analysis included correlation tests, t-tests, and linear regression analysis. The highest-rated competencies varied by country: collaboration in Finland (9.31 ± 0.68), medication in Taiwan (9.01 ± 1.19), and ethics in the United States (9.58 ± 0.84). However, anesthesia knowledge was the lowest-rated competency across all countries. Age, educational level, and work experience showed a positive correlation with competency and education level was identified as the most important factor influencing anesthesia nursing competency. Assessing these competencies as outcomes of nursing education in an international context remains crucial for promoting global standards in the education and practice of nurse anesthetists. Strengthening international collaboration in anesthesia nursing education and establishing standardized competency assessments could further promote high quality practices and ensure quality patient care.</p>","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 2","pages":"89-97"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637635","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}
AANA journalPub Date : 2026-02-01DOI: 10.70278/AANAJ/.0000001045
Yolanda Perez Duncan, Margaret A Gettis
{"title":"Effect of Using Virtual Reality Technology on Preoperative Anxiety in Pediatrics: An Evidence-Based Practice Initiative.","authors":"Yolanda Perez Duncan, Margaret A Gettis","doi":"10.70278/AANAJ/.0000001045","DOIUrl":"10.70278/AANAJ/.0000001045","url":null,"abstract":"<p><p>Anxiety is a common preoperative occurrence in children having surgery, and it can compromise surgical results, have long-term psychological effects, and lead to future healthcare challenges. In the surgical setting, preoperative anxiety is frequently treated with a combination of pharmaceutical and nonpharmacological interventions. One nonpharmacological approach is the use of virtual reality (VR), a computer-generated environment accessed by headset or goggles. This evidence-based practice initiative utilized VR goggles to address the question: to what degree would previous research on virtual reality distraction in the preoperative area and in the operating room impact preoperative anxiety levels among pediatric patients undergoing surgery at an outpatient surgery center? A preoperative registered nurse assessed and scored the patient for preoperative anxiety utilizing the modified Yale preoperative anxiety scale (mYPAS) tool while a certified registered nurse anesthetist intraoperatively obtained a second mYPAS score. The findings demonstrated how VR goggles utilized preoperatively and intraoperatively improved patients' anxiety with innovative technology indicating that results were clinically and statistically significant.</p>","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 1","pages":"36-41"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111688","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}
AANA journalPub Date : 2026-02-01DOI: 10.70278/AANAJ/.0000001082
Edwin N Aroke
{"title":"The Editor's Desk: AI in Nurse Anesthesiology: A Mandate for Rigor, Reproducibility, and Transparency.","authors":"Edwin N Aroke","doi":"10.70278/AANAJ/.0000001082","DOIUrl":"https://doi.org/10.70278/AANAJ/.0000001082","url":null,"abstract":"","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 1","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111741","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}