AANA journal最新文献_第10页

Educational Costs Expended and Career Incomes in Advanced Healthcare Professions. 高级医疗保健专业的教育成本支出和职业收入。

AANA journal Pub Date : 2024-02-01

Melissa M Brown, Gary C Brown, Meg R Smith

{"title":"Educational Costs Expended and Career Incomes in Advanced Healthcare Professions.","authors":"Melissa M Brown, Gary C Brown, Meg R Smith","doi":"","DOIUrl":"","url":null,"abstract":"The financial desirability of dollar/time investments in postbaccalaureate healthcare professional education is needed. We therefore compared postbaccalaureate educational costs and career earnings for nurse anesthetists, eight other advanced degree, nonphysician professions, and 14 physician specialties with internal rate of return (IRR) and net present value (NPV) analysis. The IRR and NPV integrated educational costs (tuition, finance charges, lost salary opportunity costs), and career earnings using U.S. Bureau of Labor and Medscape 2022 Physician Compensation Report data. Costs were discounted to 2022 U.S. real dollars using the 3.97% 50-year, U.S. average inflation rate. Annual IRRs for educational investment were 1) hospital CEOs = 48.8%; 2) managed care finance directors = 48.2%; 3) Doctors of Nurse Anesthesia Practice = 26.0%; 4) specialist physicians = 20.3%; 5) primary care physicians = 19.2%; 6) Doctors of Physical Therapy = 18.8%; 7) healthcare attorneys = 18.4%; 8) Doctors of Dental Surgery (dentists) = 18.1%; 9) Doctors of Pharmacy = 17.2%; and 10) Advanced Nurse Practitioners = 10.8%. Considering the educational money/time invested for career monetary returns, the financial desirability of nurse anesthetist and nonphysician, healthcare executive education exceeded that of physicians. Lifetime earnings for nurse anesthetists exceeded those of Doctors of Dental Surgery (Doctors of Dental Medicine), Doctors of Pharmacy, Doctors of Physical Therapy, managed care MBAs, biomedical engineers, healthcare attorneys, and Advanced Nurse Practitioners.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 1","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641424","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

Preliminary Investigation: Pilot Study of Program Directors' Perceptions of Wellness and Suicide Prevention for Student Registered Nurse Anesthetists. 初步调查：项目主任对注册麻醉师学生健康和自杀预防看法的试点研究。

AANA journal Pub Date : 2024-02-01

Charles A Griffis, Elizabeth Bamgbose, Maria Van Pelt, Holli DeVon, Holly Wilhalme, Kristen Choi

{"title":"Preliminary Investigation: Pilot Study of Program Directors' Perceptions of Wellness and Suicide Prevention for Student Registered Nurse Anesthetists.","authors":"Charles A Griffis, Elizabeth Bamgbose, Maria Van Pelt, Holli DeVon, Holly Wilhalme, Kristen Choi","doi":"","DOIUrl":"","url":null,"abstract":"The purpose of this pilot study was to investigate wellness and student suicidality in nurse anesthesia programs. Graduate students such as student registered nurse anesthetists (SRNAs) are at increased risk of suicide from environmental and educational stressors. Wellness interventions may help. An observational, anonymous online survey of all program directors (PDs) was conducted. Identical responses on a simultaneous pilot SRNA study were compared. Quantitative data were analyzed using Wilcoxon rank sum and Fisher's exact tests. Three PDs reported student suicides. Anxiety, depression, and emotional lability were warning signs. Student and PD responses to wellness program assessments were varied, with PD responses more positive and students more negative. PDs were as stressed as students and struggled to meet their own wellness needs. Most PDs reported no or insufficient training in suicide risk and prevention. Suggestions for improving wellness initiatives included to improve and standardize activities and make initiatives more accessible and seek innovative solutions to fit more content into an overcrowded curriculum. PDs and SRNAs need suicide prevention training and improved wellness efforts at local and national levels. Approaches are needed to counter stigma and reluctance to discuss mental health challenges. Suicide is multidimensional, but with proactive awareness, it may be preventable.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 1","pages":"17-26"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641426","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

Truncal Plane Blocks for Implantation of Cardiac Resynchronization Devices: A Systematic Review. 植入心脏再同步装置的顺行面阻滞：系统回顾

AANA journal Pub Date : 2024-02-01

Hannah Bridges, Duy Tran, Ruben A Lopez, Ashlee M Ericksen

{"title":"Truncal Plane Blocks for Implantation of Cardiac Resynchronization Devices: A Systematic Review.","authors":"Hannah Bridges, Duy Tran, Ruben A Lopez, Ashlee M Ericksen","doi":"","DOIUrl":"","url":null,"abstract":"Patients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) placement can experience significant perioperative pain. General anesthesia is traditionally used for S-ICD placement and is associated with increased risk. Truncal plane blocks (TPBs) and sedation offer an alternative for adequate analgesia while avoiding hemodynamic compromise related to general anesthesia. A comprehensive evidence search utilized PubMed, CINAHL, Google Scholar, EBSCOhost, US National Library of Medicine Clinical Trials, and Medline Complete databases and the evidence examined the efficacy of TPBs in S-ICD placement. The quality of evidence was assessed using the guidelines described in the Johns Hopkins Nursing Evidence-Based Practice Model. Three randomized-controlled trials, four nonrandomized experimental studies, two nonexperimental studies, and three case studies totaling 379 patients were reviewed. Ultrasound-guided TPBs with sedation demonstrated superior analgesic efficacy for S-ICD procedures. Hemodynamics marginally deviated from baseline values and were well tolerated by patients. The evidence suggests that TPBs provide adequate analgesia during intraoperative and postoperative periods. TPBs are effective in reducing pain scores and opioid consumption postoperatively. Although there were no significant changes in hemodynamic values, more research should be conducted to evaluate the effects on intraoperative hemodynamics.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 1","pages":"63-71"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641428","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

A Nurse Anesthesiology Mentorship Program: An Evidence-Based Project for Implementation. 麻醉学护士导师计划：以证据为基础的实施项目。

AANA journal Pub Date : 2024-02-01

Shelly Anderson

{"title":"A Nurse Anesthesiology Mentorship Program: An Evidence-Based Project for Implementation.","authors":"Shelly Anderson","doi":"","DOIUrl":"","url":null,"abstract":"Transitioning from the role of student to the professional certified registered nurse anesthetist (CRNA), as well as a CRNA transitioning to a new job can be very difficult because of uncertainty in the new environment when compounded by a lack of social support. A formal mentorship program was developed and organized by CRNA leadership to help retain and engage new employees and ensure that they assimilate to the new culture while effectively gaining institutional knowledge and clinical skills. The mentorship program consisted of structured meetings that included the newly hired cohort of CRNAs, matched mentors, and CRNA leadership at regular intervals to foster a sense of community and professional growth. The working definition of the mentorship process for this project was described as the following: a mentor, defined as an experienced CRNA, not a direct manager, meets with the mentee, a newly hired CRNA, on a regular basis following a predetermined timeline to assess and meet the mentee's goals, to provide resources, including networking, and to provide guidance for the mentee to make the best decisions for their professional and personal growth. The purpose of this project was to explain the potential benefits of implementing a formal mentorship program for recruiting, on-boarding, and retaining CRNAs.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 1","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641421","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

Anesthesia Management for Electroconvulsive Therapy. 电休克疗法的麻醉管理。

AANA journal Pub Date : 2024-02-01

Brian Czerwonka, Jake Johnston, Rachel Smith-Steinert

引用次数: 0

An Evaluation of Commercial Payer Reimbursement and Contracting Factors for Physician Anesthesiologists and Certified Registered Nurse Anesthetists for Services Performed in 2019. 对 2019 年内科医生麻醉师和注册护士麻醉师服务的商业支付方补偿和签约因素的评估。

AANA journal Pub Date : 2024-02-01

Jean Covillo, Maria Sallie Poepsel, Jeanie Skibiski

{"title":"An Evaluation of Commercial Payer Reimbursement and Contracting Factors for Physician Anesthesiologists and Certified Registered Nurse Anesthetists for Services Performed in 2019.","authors":"Jean Covillo, Maria Sallie Poepsel, Jeanie Skibiski","doi":"","DOIUrl":"","url":null,"abstract":"We sought to establish commercial rate benchmarks specific to certified registered nurse anesthetist (CRNA) anesthesia delivery models (QZ), quantify any payer disparities discovered between CRNAs and anesthesiologists, and determine payer alignment with nondiscrimination provisions of the Affordable Care Act (ACA). The Lewin Group administered the exploratory, descriptive study of QZ billing practices by surveying a targeted cross-section of 345 CRNAs known for QZ billing. Forty-one respondents reported information from 1,089 CRNAs and 351,920 cases with 127,888 commercial claims billed under 144 unique commercial contracts as performed in 2019. There was a 24% payer disparity in rates negotiated reported between anesthesia providers: CRNAs overall average of $58.62; $55.33-$64.57, compared with anesthesiologist average of $77.01 overall; $73.79-$80.76. Other findings included QZ payment adjustments, denials for reimbursement, and exclusion from plan participation. The study found disparities in rate and discriminatory payer practices specific to CRNA contracting and reimbursement, which suggests payer misalignment with nondiscrimination provisions of the ACA.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 1","pages":"41-48"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641422","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

Redefining Competencies for Nurse Anesthesia Education--Integrating Emotional Intelligence Assessment and Training into a Nurse Anesthesia DNP Program. 重新定义麻醉护士教育的能力--将情商评估和培训纳入麻醉护士DNP课程。

AANA journal Pub Date : 2024-02-01

Catherine S Daus, Kevin J Stein, Leah M Baecht

引用次数: 0

Lateral Femoral Cutaneous Nerve Cryoneurolysis for Meralgia Paresthetica: A Case Report. 股外侧皮神经冷冻神经溶解术治疗麻痹性肢痛症：病例报告。

AANA journal Pub Date : 2024-02-01

Lisa Pearson, Victoria Schmelzer, John Maye, Sarah Jingying Zhang

{"title":"Lateral Femoral Cutaneous Nerve Cryoneurolysis for Meralgia Paresthetica: A Case Report.","authors":"Lisa Pearson, Victoria Schmelzer, John Maye, Sarah Jingying Zhang","doi":"","DOIUrl":"","url":null,"abstract":"Meralgia paresthetica (MP) is a disorder of lateral femoral cutaneous nerve mononeuropathy caused by entrapment or compression of the nerve. It is characterized by numbing, tingling, and burning pain in the lateral aspect of the thigh. The current treatments for MP include conventional medical management, peripheral nerve blocks, and surgical interventions. Some patients who suffer from MP can experience intractable pain and medical management of MP is often inadequate to provide satisfactory pain control. Although regional anesthesia provides excellent pain relief, the analgesic effects of peripheral nerve block are short-lived. Emerging evidence suggests that cryoneurolysis has a low-risk safety profile and can provide prolonged pain relief of superficial nerves when administered appropriately. We present a successful case of a patient with intractable neuropathic pain resulting from MP treated with cryoneurolysis therapy. The patient demonstrated immediate pain relief by 100% after the procedure followed by 80% and 60% pain reduction at 1-month and 3-months follow-up, respectively. Cryoneurolysis may be an alternative modality for patients who fail at conventional medical treatments of neuropathic pain.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641425","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

Anesthetic Management of Patients Undergoing Electroconvulsive Therapy. 电休克治疗患者的麻醉管理。

AANA journal Pub Date : 2023-12-01

Sydna Sebastian

引用次数: 0

Assessing CRNA Knowledge of Local Anesthetic Systemic Toxicity Treatment. 评估局部麻醉系统毒性治疗的CRNA知识。

AANA journal Pub Date : 2023-10-01

Lapio Tkach, Laura Baillie, Jamison Newby, Crystal O'Guin, Carrie Bowman Dalley, Nancy Crowell, Ladan Eshkevari

{"title":"Assessing CRNA Knowledge of Local Anesthetic Systemic Toxicity Treatment.","authors":"Lapio Tkach, Laura Baillie, Jamison Newby, Crystal O'Guin, Carrie Bowman Dalley, Nancy Crowell, Ladan Eshkevari","doi":"","DOIUrl":"","url":null,"abstract":"Local anesthetic systemic toxicity (LAST) is a rare life-threatening adverse event. Due to the potential for devastating patient outcomes, it is crucial for anesthesia providers to understand appropriate LAST management. The primary aim of this study was to assess certified registered nurse anesthetist (CRNA) knowledge of the 2020 American Society of Regional Anesthesia and Pain Medicine (ASRA) LAST treatment guidelines. The secondary aim was to determine whether there was a relationship between the frequency of CRNAs' exposure to perioperative local anesthetic use and their knowledge level. A quantitative descriptive study and national American Association of Nurse Anesthetists electronic survey solicited practicing CRNAs. Survey findings revealed knowledge scores averaging 47.3% among 184 respondents. Almost all (97.8%) recognized the importance of early lipid emulsion administration. Over half (54.3%) were unaware of the recommended epinephrine dosing during LAST. No relationship was found between knowledge level and CRNAs' exposure to local anesthetics. Those who reported having immediate access to written or electronic guidelines in the event of LAST had significantly higher knowledge scores than those without access (P = .049). Implementing cognitive aids may help bridge knowledge gaps identified in this study and ensure critical steps are not missed. Further studies examining the use of cognitive aids to improve CRNA knowledge of LAST management may be beneficial in the future.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 5","pages":"385-390"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41110357","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