AANA journal最新文献_第8页

Simulation in Nurse Anesthesia Educational Programs: A Report by the AANA Simulation Subcommittee. 麻醉护士教育课程中的模拟：AANA 模拟小组委员会的报告。

AANA journal Pub Date : 2023-10-01

Michelle L R Gonzalez, L Alan Todd, Greta Mitzova-Vladinov, Brett Kendon, Cynthia Betron, Chad Moore, Bernadette Henrichs, John M O'Donnell, Gina Pantone

{"title":"Simulation in Nurse Anesthesia Educational Programs: A Report by the AANA Simulation Subcommittee.","authors":"Michelle L R Gonzalez, L Alan Todd, Greta Mitzova-Vladinov, Brett Kendon, Cynthia Betron, Chad Moore, Bernadette Henrichs, John M O'Donnell, Gina Pantone","doi":"","DOIUrl":"","url":null,"abstract":"Simulation is an integral part of the healthcare educational landscape and a key element in the future of graduate professional education. For the past three decades, simulation-based educational methodology has been gaining popularity in nurse anesthesia educational programs (NAEP). There is currently limited objective evidence documenting modalities used or educational outcomes addressed through simulation in NAEPs. In 2018, the American Association of Nurse Anesthesiology (AANA) established a Simulation Subcommittee of the AANA Education Committee and tasked the group with two primary goals: 1) to gain a better understanding of the current state of simulation education and 2) to review responses with regard to how NAEPs could best incorporate simulation elements within their curriculum to meet requirements while adhering to the guidelines of the Council on Accreditation of Nurse Anesthesia Educational Programs. A survey tool was developed and distributed to all programs to assess the utilization of simulation, available simulation resources, ongoing faculty development efforts, and barriers to use of this educational approach. Survey results indicated that simulation is valued as an effective method within NAEPs for a variety of teaching and learning activities and is utilized to support achievement of both technical and nontechnical learning outcomes for student registered nurse anesthetists.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 5","pages":"36-45"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160435","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

Practice Model Trends in Medicare Payments Across States and Regions. 各州和地区医疗保险支付的实践模式趋势。

AANA journal Pub Date : 2023-10-01

Ruby L Hoyem, Lorraine Jordan, Valentina V Lukyanova, Trinidad Legaspi

{"title":"Practice Model Trends in Medicare Payments Across States and Regions.","authors":"Ruby L Hoyem, Lorraine Jordan, Valentina V Lukyanova, Trinidad Legaspi","doi":"","DOIUrl":"","url":null,"abstract":"Anesthesia delivery models have long been shaped by workforce trends, state and federal regulations, economic incentives driven by reimbursement, and the normative preferences of provider and facility organizations. In recent years, there has been a significant shift toward greater use of more efficient certified registered nurse anesthetist (CRNA)-oriented delivery models observed at the national level Medicare data. However, given the wide range of these factors across states and regions, this shift has likely occurred at an uneven pace. This study analyzes the influence of provider workforce composition and CRNA scope of practice (SOP) regulations on usage of competing types of anesthesia delivery models, including anesthesiologist alone, care team, and undirected CRNA models. Results show that over the period from 2010-2019, anesthesia delivery models utilized under Medicare Part B have become increasingly oriented around the use of CRNAs. However, increases in the care team vs undirected CRNA model are highly uneven and inconsistent across states, even after adjusting for workforce and SOP. Speculation on additional normative or organization-driven reasons for persistent use of inefficient delivery models in some places is offered.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 5","pages":"327-340"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41098261","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

Hemostatic Spray TC-325 (Hemospray®) and Unexpected Esophageal Entrapment of Gastroscope With Airway Management Considerations: A Case Report. 止血喷雾TC-325（Hemospray®）与胃镜意外食管夹闭及气道管理注意事项：一例报告。

AANA journal Pub Date : 2023-10-01

Judith M Crowley

{"title":"Hemostatic Spray TC-325 (Hemospray®) and Unexpected Esophageal Entrapment of Gastroscope With Airway Management Considerations: A Case Report.","authors":"Judith M Crowley","doi":"","DOIUrl":"","url":null,"abstract":"Bleeding from the upper gastrointestinal tract is responsible for approximately 2% of all hospital admissions annually, with an up to 17% mortality rate. Therapeutic endoscopic interventions are often indicated for establishing hemostasis. These interventions include but are not limited to thermal coagulation with cautery, mechanical methods using band ligation or hemostatic clips, and hemostatic spray. Anesthesia providers are frequently involved in providing sedation for those endoscopic procedures. In 2018, the United States Food and Drug Administration approved a hemostatic spray, Hemospray® TC-325 (Cook Medical, Winston- Salem, NC, USA) for controlling nonvariceal upper gastrointestinal bleeding. The inorganic, mineral-based powder forms a mechanical tamponade by absorbing water and attracting clotting factors to the bleeding site. Adverse events associated with using the product are reported as rare but have included perforation and difficulty in removing the gastroscope. This case presents unexpected entrapment of the gastroscope in a patient's esophagus after the bleeding site was treated with Hemospray. Potential difficulties with airway management strategies are discussed.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 5","pages":"349-352"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41098998","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

Accidental Intraarterial Placement of a Venous Cannula: When In Doubt Take It Out!-A Case Report. 意外动脉内放置静脉插管:当有疑问时请取出!-病例报告。