AANA journal最新文献_第7页

Managing Simulated Anesthesia Emergencies with the Use of Clinical Decision Support Systems in a Rural Hospital Setting. 在农村医院使用临床决策支持系统管理模拟麻醉紧急情况。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001010

David Good, Sharon Schaaf

{"title":"Managing Simulated Anesthesia Emergencies with the Use of Clinical Decision Support Systems in a Rural Hospital Setting.","authors":"David Good, Sharon Schaaf","doi":"10.70278/AANAJ/.0000001010","DOIUrl":"10.70278/AANAJ/.0000001010","url":null,"abstract":"Certified registered nurse anesthetists (CRNAs) regularly encounter stressful emergency situations that demand critical thinking and quick intervention; these scenarios often result in task saturation and compromised mental acuity. An intervention utilizing a clinical decision support system (CDSS) with anesthesia emergency checklists built into the electronic health record (EHR) at a rural hospital in New Mexico was tested in a simulated environment. The simulation compared CRNA performance and adherence to evidence-based protocols with and without the checklists. The purpose of this study was to determine whether a CDSS built into the existing EHR could improve both CRNAs' adherence to evidence-based protocols and their documentation during an acute malignant hyperthermia (MH) emergency. Quantitative methods were used in the analysis of the data. Descriptive statistics and a paired t test were used to analyze MH evaluation tool data. Measures of central tendency were used to identify trends in the data. The study showed significant improvement (P < .05) in CRNA performance while using a CDSS during a simulated MH emergency and dramatic increases in documentation completeness.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 2","pages":"105-115"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708067","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

Barriers To Point-Of-Care Ultrasound Use In Nurse Anesthesiologists: A Preliminary Survey. 护士麻醉师在护理点使用超声的障碍：初步调查。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001007

Morgan Morrow, Angela Burgess, Janet Vaughn, Charlotte Bolch

引用次数: 0

Postoperative Recovery Time After Knee Arthroscopic Surgery Using Low Dose Mepivacaine Spinal Anesthesia Versus General Anesthesia: A Retrospective Propensity Score Matched Cohort Study. 低剂量甲哌卡因脊柱麻醉与全身麻醉的膝关节镜手术术后恢复时间：回顾性倾向评分匹配队列研究

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001011

Cheng Lin, Grace Xu, Rohan Dadak, Hesham Youssef, Kamal Kumar

{"title":"Postoperative Recovery Time After Knee Arthroscopic Surgery Using Low Dose Mepivacaine Spinal Anesthesia Versus General Anesthesia: A Retrospective Propensity Score Matched Cohort Study.","authors":"Cheng Lin, Grace Xu, Rohan Dadak, Hesham Youssef, Kamal Kumar","doi":"10.70278/AANAJ/.0000001011","DOIUrl":"10.70278/AANAJ/.0000001011","url":null,"abstract":"General anesthesia (GA) is the preferred technique in ambulatory surgery because GA is associated with a predictable recovery time. However, it carries higher risk of postoperative nausea and vomiting and drowsiness when compared with spinal anesthesia (SA). This study aimed to determine whether the recovery time in mepivacaine of 30 mg SA is noninferior when compared with GA. Our single-center retrospective study used a multivariable logistic regression to model anesthetic modality as a function of age, sex, body mass index, and American Society of Anesthesiologists physical status to generate a propensity score for each patient for matching. After screening 455 patients, 111 patients in each group were matched. SA was associated with 23.0 minutes (95% CI, -∞ to 31.0; P < .0001) longer recovery time, shorter operating room time (-8.0 minutes, 95% CI -13.0 to -3.0), more likely to bypass phase 1 recovery (OR, 2.77; 95% CI, 1.20 to 6.88) and less opioid use (-0.5 mg; 95% CI, -3.7 to -0.0001) but no difference in length of stay (LOS). Spinal anesthesia was correlated with inferior recovery time. The associated phase 1 bypass and similar LOS suggest SA as a viable alternative to GA.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 2","pages":"138-142"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708069","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

Prevention and Management of Hypoxemia During Anesthesia Induction In the Neonate and Small Infant. 新生儿和小婴儿麻醉诱导时低氧血症的预防和处理。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001006

Laura McDonald, Shelley Barenklau, Brittany Hollabaugh

引用次数: 0

Relationship Between Emotional Intelligence and Burnout Among Anesthesia Providers. 麻醉人员情绪智力与倦怠的关系

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001003

Julia Trainor, Kayla Nandlall, Nancy Crowell, Ladan Eshkevari, Avi Leibowitz, Mary Scott-Herring

{"title":"Relationship Between Emotional Intelligence and Burnout Among Anesthesia Providers.","authors":"Julia Trainor, Kayla Nandlall, Nancy Crowell, Ladan Eshkevari, Avi Leibowitz, Mary Scott-Herring","doi":"10.70278/AANAJ/.0000001003","DOIUrl":"10.70278/AANAJ/.0000001003","url":null,"abstract":"Previous studies have shown that higher emotional intelligence (EI) leads to lower incidence of burnout in clinical healthcare workers. However, there are currently no published studies that explore this relationship in anesthesia providers. This study aimed to investigate 1) whether anesthesia providers with higher EI were less likely to meet burnout criteria, and 2) whether demographic factors played a role in likelihood of burnout. In this study, 21 certified registered nurse anesthesiologists, 23 physician anesthesiologists, and six anesthesiologist assistants completed the 16-item Wong and Law Emotional Intelligence Score and the 16-item Oldenburg Burnout Inventory. T-test analysis was used for data interpretation to answer the emotional intelligence and burnout relationship proposed by the study. A statistically significant correlation was found between higher EI and lower incidence of burnout (P = .022). No statistically significant relationships were found between demographic variables and rates of burnout. Burnout is a tremendous issue among anesthesia providers, and further exploration into the influence of emotional intelligence on burnout may be instrumental to decreasing burnout incidence.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"55-60"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405019","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 Narrative, Qualitative Research Study of CRNA Perspectives of Practice Within the Anesthesia Care Team Model. 麻醉护理团队模式中CRNA实践视角的叙述性定性研究。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001027

Cindi Dabney, Michael Carter, Michael Herr, Todd Monroe, James Moore, Nina Sublette

{"title":"A Narrative, Qualitative Research Study of CRNA Perspectives of Practice Within the Anesthesia Care Team Model.","authors":"Cindi Dabney, Michael Carter, Michael Herr, Todd Monroe, James Moore, Nina Sublette","doi":"10.70278/AANAJ/.0000001027","DOIUrl":"10.70278/AANAJ/.0000001027","url":null,"abstract":"This research focused on the perspectives of certified registered nurse anesthetists on practice within the anesthesia care team (ACT) model. This narrative, qualitative study examined participants' perspectives on the strengths, challenges, conflict resolutions, and any other information they provided about working in the ACT model. The participants drew sharp distinctions between the supervision requirement of the ACT and that of collaboration with a team approach. The participants reported that they enjoyed and supported collaboration and found that the team approach led to efficient patient care while having extra hands to help and minds to problem-solve complicated patient scenarios. They did not believe physician supervision over their practice was necessary and proved burdensome. They further reported that they often relied on collaboration, accommodation, or compromise to resolve decision-making conflicts when they practiced within the ACT. However, several reported avoiding or leaving the ACT care model for independent practice. Participants who left ACTs reported that they were much happier with their profession and would never return to the ACT model. The recommendations from this study include discontinuing supervision of their practice while strengthening collaboration, a change in payment structure for anesthesia services, and reformed hospital credentialing. They believe that these recommendations would facilitate the full scope of practice and work independently to deliver the high-quality anesthesia care they trained for.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405129","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

Exploring Safety Culture, Production Pressure, Occupational Burnout, and Patient Safety in Anesthesia. 探讨麻醉中的安全文化、生产压力、职业倦怠和患者安全。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001029

Bryan Wilbanks, Edwin Aroke, Marjorie Everson, Beth Ann Clayton, Peng Li

{"title":"Exploring Safety Culture, Production Pressure, Occupational Burnout, and Patient Safety in Anesthesia.","authors":"Bryan Wilbanks, Edwin Aroke, Marjorie Everson, Beth Ann Clayton, Peng Li","doi":"10.70278/AANAJ/.0000001029","DOIUrl":"10.70278/AANAJ/.0000001029","url":null,"abstract":"Anesthesia-related studies have found that many adverse events are related to human factors including occupational burnout, safety culture, and production pressure. The purpose of this study was to explore the relationships between those factors to identify potential interventions to improve patient safety and anesthesia practice. This exploratory study used a cross-sectional design with a survey administered via e-mail to nurse anesthetists. The survey consisted of the Survey on Patient Safety, Maslach's Burnout Inventory, and the NASA task-load-index. Data analysis included linear mixed regression models, Spearman correlations, and Cronbach's alpha. Covariates included age, years of clinical experience, zip codes, and gender. We found that the best predictors of patient safety are hospitals' culture of safety and staffing patterns. Adequate staffing had the largest impact on reducing occupational burnout and nurse anesthetists' intentions to leave their jobs. Less experienced nurse anesthetists reported lower patient safety scores. Successful interventions to improve institutional factors need to be implemented and supported by management with an emphasis on open communication among all team members to elicit lasting changes. Additionally, interventions should focus on appropriate staffing, team training, and resilience training because these have the greatest impact.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405005","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 Novel Device for Training and Evaluating Ultrasound-Guided Procedures in Anesthesia. 一种用于训练和评估超声引导麻醉过程的新装置。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001004

Shayne D Hauglum, Karina Gattamorta, Martin Hossbach, Pezhman Foroughi, Alican Demir, Purnima Rajan

{"title":"A Novel Device for Training and Evaluating Ultrasound-Guided Procedures in Anesthesia.","authors":"Shayne D Hauglum, Karina Gattamorta, Martin Hossbach, Pezhman Foroughi, Alican Demir, Purnima Rajan","doi":"10.70278/AANAJ/.0000001004","DOIUrl":"10.70278/AANAJ/.0000001004","url":null,"abstract":"To improve dynamic needle-tip visualization, nurse anesthesiology students were evaluated during simulated ultrasound-guided procedures. This quasiexperimental study utilized two computed tomography 3D printed models. Thirty-two students performed each procedure twice, once without and once with needle guidance. Measures focused on accuracy and procedural performance to determine the impact that guidance versus no guidance had on attempts. Students evaluated their experiences, self-confidence, feasibility, and usability using needle guidance technology. Needle guidance improved the distance to target, total procedure time, phantom penetration time, number of attempts, completion rate, and effectiveness in both procedures. Overall, a decrease in distance to target in millimeters was uncovered when needle guidance was utilized (Z = -5.723, P < .001). Needle guidance showed a decrease of 3.96 attempts when guidance was utilized for the infraclavicular (F[1, 22] = 51.79, P < .001) and 0.96 attempts during the thoracic paravertebral procedure (F[1, 22] = 6.02, P = .023). Students found that needle guidance enhanced ease, speed, and overall performance, while feeling significantly more confident performing the infraclavicular (P < .001) and thoracic paravertebral (P < .001) procedures. The use of needle guidance technology showed improvement in accuracy comparable with results obtained using external tracking technology.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"30-38"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405130","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: Journal Updates. 编辑台：期刊更新。

AANA journal Pub Date : 2025-02-01

Ladan Eshkevari

引用次数: 0

Critical Events in Patients With Alternating Hemiplegia of Childhood: A Cohort Study Subgroup Analysis. 儿童交替性偏瘫患者的关键事件：队列研究亚组分析。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001028

Emily M Funk, Guy de L Dear, Mary E Moya-Mendez, Andrew P Landstrom, Andrew Breglio, Lauren E Parker, April Boggs, Lyndsey Prange, Loraine Barstow, Mohamad A Mikati

{"title":"Critical Events in Patients With Alternating Hemiplegia of Childhood: A Cohort Study Subgroup Analysis.","authors":"Emily M Funk, Guy de L Dear, Mary E Moya-Mendez, Andrew P Landstrom, Andrew Breglio, Lauren E Parker, April Boggs, Lyndsey Prange, Loraine Barstow, Mohamad A Mikati","doi":"10.70278/AANAJ/.0000001028","DOIUrl":"10.70278/AANAJ/.0000001028","url":null,"abstract":"People with alternating hemiplegia of childhood undergoing general anesthesia are at risk for severe complications including critical bradycardia and hemiplegic incidents. We performed a 10-year historical cohort study and completed a subgroup analysis of patients who specifically underwent general anesthesia. Patients with ATP1A3 positive variants were compared with those without such variants. The 14 patients reviewed underwent general anesthesia a combined total of 39 times. Two patients had a short QTc documented prior to anesthesia and presented with bradycardia in the recovery room. Two other patients experienced a suspected seizure and hemiplegic incident; one of those patients received no facility-administered medications prior to experiencing a hemiplegic incident, and the other experienced a hemiplegic incident on emergence from anesthesia with subsequent cardiac arrest and successful resuscitation. No apparent association was identified between type of anesthesia and the development of bradycardia or hemiplegic incidences. Of the four patients experiencing critical events, three had the ATP1A3-D801N variant. Although additional research is necessary to confirm such associations, patients with alternating hemiplegia of childhood, specifically the ATP1A3-D801N variant, appear to be at elevated risk for complications associated with general anesthesia, suggesting the need for an increased anticipation of complications for this population.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"19-29"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405001","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