Scholarly Work for Practice Doctorate Nurse Anesthesia Programs: Current State and Guidance.

The Standards for Accreditation of Nurse Anesthesia Programs: Practice Doctorate was adopted by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) in January 2015. Balancing academic and clinical preparation for doctoral students, preparation for the National Certification Examination, and requirements for scholarly work represents a major challenge for students, faculty, and programs. With most nurse anesthesia programs having transitioned to the practice doctorate, the COA was in a pivotal position to examine the current state of scholarly work and to produce a white paper to guide programs' development of criteria for scholarly work.

Development of a Common Clinical Assessment Tool for Evaluation in Nurse Anesthesia Education.

There is a lack of standardization among evaluations completed by clinical educators of student registered nurse anesthetists (SRNAs) during their clinical education as reported by nurse anesthesia program administrators and students. To address this issue, the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) Board created the Common Clinical Assessment Tool (CCAT) Special Interest Group to develop a standardized clinical evaluation instrument. The goal was to improve the consistency of clinical evaluation across nurse anesthesia programs while assisting program administrators to make programmatic changes to ensure compliance with COA standards.

Council on Accreditation of Nurse Anesthesia Educational Programs adopts standards for the Practice Doctorate and Post-graduate CRNA Fellowships.

The Council on Accreditation of Nurse Anesthesia Educational Programs appointed a Standards Revision Task Force to develop new accreditation standards. After 3 years of research and development (2011-2013) by the task force, the Council approved the first entry-level Practice Doctorate Standards and the first voluntary Post-graduate CRNA Fellowship Standards in January 2014. This defining moment in accreditation history marks a transition in the educational preparation of entry-level nurse anesthetists and provides opportunities for learning in a variety of post-graduate fellowships for Certified Registered Nurse Anesthetists.

Assessment of recent graduates preparedness for entry into practice.

To date no studies have been conducted to assess the preparedness of CRNA graduates for entry into practice by asking graduates and their respective employers to assess specific competencies. The purpose of this study was to assess recent graduates' preparation and performance. It was hypothesized recent graduates are prepared for entry into nurse anesthesia practice.

What keeps some program directors in their, positions so long? An examination of job longevity among anesthesia program directors.

The turnover rate of nurse anesthesia faculty has been monitored by the Council on Accreditation of Nurse Anesthesia Educational Programs for a number of years. In 2005, the turnover rate remained high, at 22%, indicating a problem with faculty retention. This article reports the results of a study in which 25 long-time nurse anesthesia program directors were interviewed to gain insights into faculty retention.

Hemodynamic and hormonal changes during pneumoperitoneum and trendelenburg positioning for operative gynecologic laparoscopy surgery.

Objective: The number and types of surgical procedures being preformed using laparoscopic technique is increasing due to technological advances. Recent studies suggest the carbon dioxide pneumoperitoneum and patient positioning causes hemodynamic alterations, respiratory acidosis, and a release of stress hormones. However, to date, no studies have investigated the physiological effect of laparoscopic procedures lasting more than 60 minutes on the stress response and the effect of Trendelenburg positioning.

The effect of flumazenil on patient recovery and discharge following ambulatory surgery.

Midazolam is a short-acting agent used for preoperative and conscious sedation. Despite a relatively short half-life, midazolam sedation contributes to postoperative sedation, delays in discharge, and increased costs. Administration of flumazenil, a benzodiazepine antagonist, can reverse the centrally mediated effects of midazolam and facilitate patient recovery and discharge, thereby reducing costs.

On-line interactive evaluation in course and clinical instruction.

Student evaluations incorporated into feedback for instruction modification are an important aspect of any educational program. It is particularly important for healthcare programs in which teaching processes are continually dynamic. An interactive evaluation was designed and implemented on-line for students.

Postoperative nausea and vomiting: a comparison of propofol infusion versus isoflurane inhalational technique for laparoscopic patients.

Gynecologic laparoscopic procedures frequently precipitate postoperative nausea and/or vomiting. The use of specific anesthetic agents and premedicants may decrease the incidence. This study determined the occurrence of postoperative nausea/retching/vomiting (N/R/V) when propofol was used for anesthesia maintenance compared with isoflurane when both groups of patients received metoclopramide and ranitidine preoperatively and were induced with propofol.

Hemostasis and diagnosis of preeclampsia.

The diagnosis of preeclampsia, with all of its consequences, is at times difficult to establish, especially when the patient has underlying chronic hypertension and is not known from prior prenatal care visits. Many screening tests have been proposed. These should be sensitive, relatively specific, easy to perform, of low cost, and have a reasonable interval from prediction to disease onset.

Certification: past, present and future implications. Report of the National Commission on Nurse Anesthesia Education.

In 1942, the National Association of Nurse Anesthetists established a voluntary certification program to safeguard the interests of surgeons, hospitals and the public. Prerequisites for certification included minimum training standards, a valid nursing license and successful completion of a national certification examination. In 1975, the Council on Certification of Nurse Anesthetists was established as an autonomous decision-making body.

Changes in hemostasis activity during delivery and the immediate postpartum period.

Postpartum deep vein thrombosis is believed to be related to increased activation of the hemostasis system at the time of delivery. To date, studies designed to test this hypothesis have had relatively small sample sizes or used the measurement of specific coagulation factors and functional tests reflecting hemostasis activity in vitro. With the use of recent technologic advances we determined the effect of delivery on hemostasis in vivo by measuring 11 hemostatic indices simultaneously in 70 healthy pregnant women.

Increased intravascular coagulation associated with pregnancy.

Based on an increased turnover of the hemostatic system, it is believed that pregnancy is associated with "hypercoagulability." However, this hypothesis is based primarily on the measurement of specific coagulation factors or functional tests reflecting hemostatic activity in vitro. Using recent technological advances, we determined the effect of pregnancy on hemostasis in vivo by measuring 11 specific hemostatic indices simultaneously in 28 healthy pregnant women and in 24 nonpregnant female controls.