AANA Study Reveals that Removing Practice Barriers Increases Patient Care Access

Newswise — PARK RIDGE, Ill. (AANA)—The American Association of Nurse Anesthetists (AANA) released a new study that proves removing scope of practice barriers for nurse anesthetists results in increased access to patient care and eliminated unnecessary layers of supervision. 

When the World Health Organization declared the COVID-19 outbreak a pandemic one year ago, Certified Registered Nurse Anesthetists (CRNAs) were deployed across the country to care for patients infected with the virus. CRNAs stepped into leadership roles, providing expertise in triage, airway and ventilation management, emergency care, ground and air patient evacuation, physical and psychosocial support and recovery, and disaster management—making CRNAs a highly sought-after healthcare provider. 

In the study, “From the OR to the Front lines: Shared Experiences of CRNAs during the COVID-19 Pandemic,” CRNAs described their shared experiences.  Details of the survey are available in the April edition of the AANA Journal, the association's official scholarly journal.  

“The study revealed that CRNAs can assume expanded roles and apply their knowledge and skills to provide expert clinical care in a multitude of settings both in and out of the operating room,” according to Lorraine M. Jordan, PhD, CRNA, CAE, FAAN. Jordan is the chief executive officer of the AANA Foundation, which funded the study, and the AANA chief advocacy officer.  “While it was not uncommon for the CRNAs interviewed to experience fear and anxiety while caring for unprecedented numbers of patients infected with COVID-19, they simultaneously and unselfishly provided highly skilled care during a pivotal moment in our nation’s history,” said Jordan. 

Acknowledging the role of CRNAs during the pandemic, the Centers for Medicare & Medicaid Services (CMS) temporarily suspended the physician supervision requirement for CRNAs to increase the capacity of the healthcare delivery services. Governors also removed many barriers to CRNA practice, granting state healthcare systems better flexibility during this crisis. According to a January 2021 CMS report, CRNAs were among the top 20 specialties that served the most beneficiaries in non-telehealth care between March 2020 and June 2020—the height of the COVID-19 public health emergency.   

Utilizing a mixed-method study to reveal the impact of the pandemic on CRNA practice, six themes were identified in the qualitative component of the AANA study: CRNAs as part of the solution, “doing whatever it takes,” the removal of barriers to promote positive change, “trying times,” and expertise revealed. 

Another “key finding of the study was the remarkable innovation, leadership, and courage exhibited by CRNAs during the pandemic,” said Jordan. 

According to study researchers, the majority of CRNAs found themselves front and center of the crisis educating, developing protocols, acting as consultants and intensivists, manning incident command centers, and innovatively solving problems. They adapted to every situation they were confronted with, which one CRNA identified as fulfilling “right size roles.” Findings of the study confirmed that CRNAs are adept at meeting challenges and leading during a crisis. 

While the pandemic has resulted in a massive loss of life, it prompted people to work in ways and adopt solutions that were thought impossible, said Jordan, adding that physicians, healthcare administrators and others were “able to witness the high level of education and expertise that CRNAs possess as well as their ability to apply this knowledge to a multitude of challenges during the crisis.” 

Authors of the study are Marjorie Everson, PhD, CRNA, FNAP; Bryan A. Wilbanks, PhD, DNP, CRNA; Anne Marie Hranchook, DNP, CRNA; Maria Hirsch, DNAP, CRNA; Beth Ann Clayton, DNP, CRNA, FAAN; Lorraine Jordan, PhD, CRNA, CAE, FAAN; Vicki Callan, PhD, CRNA, CHSE.