AANA journal最新文献_第9页

The Application of Radiofrequency Ablation in Acute and Chronic Pain Management. 射频消融在急性和慢性疼痛治疗中的应用。

AANA journal Pub Date : 2024-06-01

Emily Biel, Anne Pivarunas, Taylor Prentice, Nina Rowe, Sarah Jingying Zhang

引用次数: 0

Improving CRNAs' Confidence and Perceived Knowledge of Endosurgical Patients Who Use Marijuana: A Quality Improvement Project. 提高 CRNA 对使用大麻的内外科患者的信心和认知：质量改进项目。

AANA journal Pub Date : 2024-04-01

Janice Cain, Teri Lindgren, Alexandra Duke

{"title":"Improving CRNAs' Confidence and Perceived Knowledge of Endosurgical Patients Who Use Marijuana: A Quality Improvement Project.","authors":"Janice Cain, Teri Lindgren, Alexandra Duke","doi":"","DOIUrl":"","url":null,"abstract":"Although some researchers have reported health-related benefits of marijuana, others have reported adverse side effects in nearly every organ system. Patterns of marijuana use are evolving, as is researchers' understanding of marijuana use for healthcare. Despite these findings and developments, nurse anesthetists are inadequately educated about marijuana's perioperative effects on endosurgical patients. As a result, many nurse anesthetists lack confidence in and knowledge of the perioperative care of endosurgical patients under the influence of marijuana. This lack of confidence and knowledge limits the ability of nurse anesthetists to provide optimal care, threatens patient safety, and potentially impairs surgical outcomes. To improve the confidence and perceived knowledge of certified registered nurse anesthetists (CRNAs) regarding perioperative care of endosurgical patients who use marijuana, a quality improvement project was conducted in a metropolitan endosurgical center in California. After the project, participating CRNAs (N = 15) reported increased confidence (z = -0.982; P = .325, > .05) and significantly improved perceived knowledge (z = -3.04; P = .002, < .05) regarding care of patients who use marijuana. For endosurgical patients who used marijuana prior to their procedure, knowledgeable and confident anesthesia care for the side effects of marijuana substantially improved the quality of care, communication, and reduced cancellations.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 2","pages":"121-130"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334267","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

Quantitative Neuromuscular Monitoring Permits Early Diagnosis of Abnormal Butyrylcholinestrase: Two Case Studies Demonstrating Prevention of Awareness from Premature Awakening. 定量神经肌肉监测可及早诊断丁酰胆硷酯酶异常：两例研究证明可预防过早觉醒。

AANA journal Pub Date : 2024-04-01

Erica M Harris, Emily M Funk, Daniel Plezia, Judson Elliott, Ryland Elliott, Jessica Szydlowski Pitman, Stuart A Grant

引用次数: 0

A New Distal Pharyngeal Airway Device Associated with a Reduced Need for Chin-Lift and Jaw-Thrust Maneuvers in Sedated Patients. 新型远端咽部气道装置可减少镇静患者的抬下巴和推颌动作。

AANA journal Pub Date : 2024-04-01

Carol Daniel, Monika Feeney, Leah Gordon

{"title":"A New Distal Pharyngeal Airway Device Associated with a Reduced Need for Chin-Lift and Jaw-Thrust Maneuvers in Sedated Patients.","authors":"Carol Daniel, Monika Feeney, Leah Gordon","doi":"","DOIUrl":"","url":null,"abstract":"Oropharyngeal airways (OPA) or nasopharyngeal airways (NPA) sometimes require chin-lift or jaw-thrust (CLJT) maneuvers to relieve airway obstruction which creates the burden of continuous hands-on care by the anesthesia provider. A new distal pharyngeal airway device (DPA) was used on 63 successive ambulatory surgery patients to assess the frequency of patients requiring manual CLJT maneuvers to prevent airway obstruction. Results were then compared with a contemporaneous group of patients who had used OPA or NPA devices for similar procedures. Patients using the DPA had a 38.5% lower rate of CLJT maneuvers compared with the combined OPA/NPA groups (22.2% of 63 vs. 60.7% of 163, P ≤ .001). Moreover, the results for the DPA group were close to those of the natural airway group (22.2% of 62 vs. 24.8% of 233, P = .66) Results were similar for a sub-set of the above groups who required deep sedation or deep extubation. CLJT maneuvers were common in this ambulatory surgery setting. The new DPA device was associated with a reduced need for such manual maneuvers when compared with similar patients who received OPA or NPA devices and is comparable with the rate for natural airways.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 2","pages":"115-120"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334300","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

Challenges for Nurse Anesthetists Reentering Practice Following Substance Use Disorder Treatment. 麻醉师在药物使用障碍治疗后重新执业面临的挑战。

AANA journal Pub Date : 2024-04-01

T'Anya Carter, Nancy Wingo, Susan McMullan, Gwen Childs, Bernadette Roche, Lisa J Merlo, Karen Heaton

{"title":"Challenges for Nurse Anesthetists Reentering Practice Following Substance Use Disorder Treatment.","authors":"T'Anya Carter, Nancy Wingo, Susan McMullan, Gwen Childs, Bernadette Roche, Lisa J Merlo, Karen Heaton","doi":"","DOIUrl":"","url":null,"abstract":"Substance use disorder (SUD) is a persistent, relapsing condition that is present in approximately 10% of anesthesia providers, who, compared with other healthcare providers, face a greater risk of developing an SUD by virtue of constant access to medications. The ability of certified registered nurse anesthesiologists (CRNAs) to obtain or maintain employment after treatment for SUD treatment is not well documented. The purpose of this qualitative study was to explore challenges encountered by CRNAs in recovery as they attempt to reenter practice following SUD treatment. The phenomenon was explored through multiple-case study, using qualitative semistructured interviews with participants in four cases: CRNAs in recovery, CRNA colleagues, CRNA employers, and professional health program employees. Thirty-six participants conveyed their perspectives about challenges that CRNAs in recovery face upon reentry into practice following SUD treatment. The Worker Well-Being conceptual model was used to guide this study. The study revealed that more SUD education is a key facilitator for reentry, risk of relapse was a major concern, and stigma was the most significant barrier for CRNAs in recovery. Stigma persists as a considerable barrier in many facets of SUD, contributing to an increase in shame associated with having the disease.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 2","pages":"131-138"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334265","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 Mechanistic Model for Future Research in the Elements of the ERAS Program in Patients With Sickle Cell Disease. 镰状细胞病患者 ERAS 计划要素未来研究的新机制模型。

AANA journal Pub Date : 2024-04-01

Marcy Purnell, Michong Rayborn

{"title":"A Novel Mechanistic Model for Future Research in the Elements of the ERAS Program in Patients With Sickle Cell Disease.","authors":"Marcy Purnell, Michong Rayborn","doi":"","DOIUrl":"","url":null,"abstract":"Enhanced recovery after surgery (ERAS) is a patient-centered, evidence-based, multidisciplinary team-developed approach to a surgical stress response that is implemented to optimize physiological function and facilitate recovery for the best possible outcomes from surgery. Although there are currently well-known published guidelines for the perioperative management of patients with sickle cell disease, there are currently no specific and evidencebased ERAS protocols that address the needs of these patients. A novel mechanistic model has recently been found that could change ERAS protocols for patients with sickle cell disease with regard to a current preoperative carbohydrate loading drink recommendation, nutrition and intravenous fluid management. ERAS has great benefits for most patient populations, but emerging research suggests that patients with sickle cell disease may process and respond differently to varying concentrations of serum glucose and serum cations (hyperglycemia and hypertonic states). This adverse response involves actin, a cytoskeletal protein, in the red blood cell and how increased hemoglobin glycosylation may lead to a malfunction in this protein and a transition to vaso-occlusive crises in patients with sickle cell disease. Further research is warranted with this new mechanistic model to develop more meticulous and customized perioperative management plans to address risk mitigation in patients with sickle cell disease.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 2","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334263","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 Medication Safety in Relation to Pharmacopeia Medication Use Best Practice Initiatives. 麻醉用药安全与药典用药最佳实践倡议的关系。

AANA journal Pub Date : 2024-04-01

David B Koontz

{"title":"Anesthesia Medication Safety in Relation to Pharmacopeia Medication Use Best Practice Initiatives.","authors":"David B Koontz","doi":"","DOIUrl":"","url":null,"abstract":"Improvement to anesthesia medication safety is a useful and worthwhile area of research. Anesthesia is one of the few healthcare professions to have immediate access to compounding and label high-hazard medications at the bedside. There is a need to assess the perceptions of anesthesia medication safety and this relationship with pharmacopeia's updated recommendations for anesthesia to improve medication safety and prevent adverse drug events. Certified registered nurse anesthetist (CRNA) perceptions of medication safety climate in Florida were measured utilizing a validated Likert-scale that merged the Attitudes Questionnaire themes of teamwork, climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture themes utilized were organizational learning, error communication, and support for patient safety. The overall email invitations delivered 5,890, 524 participants voluntarily started, and 401 completed the questionnaire resulting in a 77% completion rate. The overall response rate was 8.896% and 6.8% overall completion rate. The findings demonstrate a correlation between themes related to supportive organizational learning, stress reduction, positive changes, and creating anesthesia medication quality improvements. CRNAs' openness in adopting new pharmacopeia best practice recommendations can improve anesthesia medication safety delivery. The survey indicated clinical noteworthiness that supports the importance of additional examination of frontline providers' perceptions regarding anesthesia medication safety, buy-in, and adoption of updated pharmacopeia recommendations.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 2","pages":"93-103"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334264","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

Implementation of a Spaced Learning Program for Educating CRNAs on a Scalpel-Bougie Cricothyrotomy Procedure for Emergency Front of Neck Access. 实施间隔学习计划，对急诊前颈入路手术中的手术刀-鼻饲环甲膜切开术的急诊麻醉师进行教育。

AANA journal Pub Date : 2024-04-01

Antoinette T Padula, Joy Elwell, Maria Madonick, Michael Wilhelm, Don Boyd

{"title":"Implementation of a Spaced Learning Program for Educating CRNAs on a Scalpel-Bougie Cricothyrotomy Procedure for Emergency Front of Neck Access.","authors":"Antoinette T Padula, Joy Elwell, Maria Madonick, Michael Wilhelm, Don Boyd","doi":"","DOIUrl":"","url":null,"abstract":"Certified registered nurse anesthetists (CRNAs) who are responsible for airway management, may lack adequate continuing education for emergency front of neck access (EFONA), an advanced skill necessary in situations when a patient cannot be intubated and cannot be oxygenated (CICO). The purpose of this study was to improve CRNA knowledge and confidence when performing a scalpel-bougie cricothyrotomy for EFONA in a CICO event through the implementation of a spaced learning intervention. Thirteen CRNAs at a 160-bed community hospital participated in a 3-week educational intervention. Week 1: online preintervention survey followed by an educational video. Week 2: video review and skills component practiced on a cricothyrotomy trainer. Week 3: skills component practiced on a cricothyrotomy trainer followed by postintervention survey. This was a single-arm study and Wilcoxon sign ranked tests and a paired t-test were utilized to monitor for change in CRNA knowledge, confidence, and skill in performing EFONA. Implementation of a 3-week spaced learning program for educating CRNAs to perform a scalpel-bougie cricothyrotomy significantly increased CRNA knowledge, confidence, and skill when performing EFONA. Utilizing a spaced learning program may therefore improve provider skills, resulting in optimized patient care during a CICO event, leading to improved patient safety and outcomes.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 2","pages":"145-152"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334266","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 Mixed-Methods Exploration of Competencies and Professional Development Needs Among Chief Certified Registered Nurse Anesthetists. 对首席注册麻醉师能力和职业发展需求的混合方法探索。

AANA journal Pub Date : 2024-04-01

Austin L Cole, Virginia C Simmons, Barbara S Turner, Robert Whitehurst, Denise H Tola

{"title":"A Mixed-Methods Exploration of Competencies and Professional Development Needs Among Chief Certified Registered Nurse Anesthetists.","authors":"Austin L Cole, Virginia C Simmons, Barbara S Turner, Robert Whitehurst, Denise H Tola","doi":"","DOIUrl":"","url":null,"abstract":"This project sought to explore the experiences, self-perceived preparation, professional development needs, and preferred learning methods of certified registered nurse anesthetists (CRNAs) in a management role. A sample of 10 current chief CRNAs responded to a demographics survey and participated in one-on-one interviews using a 14-question, semi-structured interview framework modified from a previous study. Interview responses were deidentified and qualitatively analyzed for common themes by two content experts and one qualitative analysis expert. Results suggest that CRNAs entering the management field feel somewhat unprepared to perform the administrative tasks associated with their role. Qualitative analysis of interview responses elicited multiple key themes including interpersonal communication and handling crucial conversations, time and organizational management skills, team building and motivation, and financial management skills. Themes related to preferred learning methods of chief CRNAs included mentorship, peer networking, and experiential learning to obtain the required knowledge and skills for the role. The authors recommend incorporating each of the identified themes to guide development of CRNA management-specific educational programs. Establishing such a program will serve to better prepare aspiring CRNA managers and further develop the knowledge and skillset of current chief CRNAs.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 2","pages":"105-113"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140338539","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

Imagining in Time: The Legacy of Olive Berger (1898-1981). 时间中的想象：奥利弗-伯杰（1898-1981 年）的遗产。

AANA journal Pub Date : 2024-04-01

Andrew R Benson, Catherine Horvath, Marjorie Everson, Bruce Schoneboom

引用次数: 0