Anesthetists
Intraop handover of anesthesia care linked to adverse outcomes
Editor's Note Complete handover of intraoperative anesthesia care was significantly linked to adverse postoperative outcomes in this Canadian study. In this analysis of 313,066 adult patients having major surgery, complete intraoperative handover of anesthesia care, compared with no handover, was significantly associated with a higher risk of a composite of…
PACU patient flow improves with CRNA assistance
Throughput inefficiencies are a growing problem in surgical services departments. Patients are held in the OR because there is no room in the postanesthesia care unit (PACU), and patients are held in the PACU because there are no beds available in the patient care unit or because outpatients having major…
CRNAs encourage patients to learn about pain management options
Editor's Note For the National Patient Safety Foundation’s Patient Safety Awareness Week, March 12 to 18, certified registered nurse anesthetists (CRNAs) are urging surgical, obstetric, and chronic pain patients to learn about the risks and benefits of pain relief options available to them, including opioid and non-opioid treatments. Partnering with…
CRNAs not included in new VA nurse practice rule
Editor's Note The Department of Veterans Affairs (VA) on December 13 issued a final rule allowing full practice authority for certain advanced practice registered nurses working in VA facilities, including certified nurse practitioners, clinical nurse specialists, and certified nurse midwives. The rule excludes certified registered nurse anesthetists (CRNAs), following lobbying…
Defining the anesthesia provider’s role in pathogen dispersion
Editor's Note Double gloving by anesthesia providers was associated with less spread of oral inoculum to the workstation but was not uniformly protective in this simulation study. Between-case cleaning was found to be ineffective in removing contaminants, indicating that biologic material from one patient may still be present for subsequent…
Effect of practice restriction, physician supervision on anesthesia patient safety
Editor's Note Scope of practice restrictions and physician supervision requirements for nurse anesthetists have no impact on anesthesia patient safety, this study finds. Examining 5.7 million anesthesia cases, researchers found that anesthesia complications differed significantly with: patient characteristics patient comorbidities the procedures being administered. Complication odds did not differ by…
Study: Use of self-filled vs prefilled syringes during anesthesia
Editor's Note In this work system analysis, the inclusion of prefilled syringes into medication delivery by anesthesia providers simplified work processes and reduced the number and associated risks of system vulnerabilities. Eight system vulnerabilities were found in the prefilled syringe system versus 21 in the self-filled syringe system. An example…
PSH initiative demonstrates measurable impact on quality, costs
Editor's Note The American Society of Anesthesiologists and Premiere on February 9 announced results from the first phase of the Perioperative Surgical Home (PSH) learning collaborative. The collaborative included 44 healthcare organizations that piloted and evaluated the PSH model from July 2014 through November 2015. Many members of the collaborative…
New clinical practice guideline on postop pain management
Editor's Note The American Pain Society, American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists have issued a new guideline on the “Management of Postoperative Pain.” The guideline provides recommendations that address aspects of postoperative pain management, including: preoperative education perioperative pain management planning use…
Effect of anesthesia care transitions on postop complications
Editor's Note The number of additional attending anesthesiologists and in-room providers (ie, anesthesia residents, nurse anesthetists) involved in a surgical procedure was independently associated with an increased odds of postoperative complications in this study. Though a surgical patient may receive anesthesia care from several anesthesia providers, the safety of anesthesia…
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