CRNAs take on surgical cases without supervision — 3 study findings

Although Veterans Health Administration facilities primarily use anesthesia care teams, certified registered nurse anesthetists often practice without supervision, according to a study published in the Federal Practitioner.

The Veterans Health Administration comprises 110 inpatient medical centers and 27 ASCs, with anesthesia care models varying widely among facilities. Researchers studied 484,082 surgical cases from 109 inpatient facilities and 16 ASCs.

Three takeaways:

1. In 56.8 percent of surgical cases, a physician anesthesiologist supervised a CRNA. In 31.6 percent of all cases, the facility primarily used a physician-driven model.

2. However, it's not uncommon for CRNAs to provide anesthesia services for surgical cases at VHA facilities without supervision, researchers found. Nearly 12 percent of cases involved unsupervised CRNAs.

3. Twenty-eight facilities predominantly relied on CRNAs without supervision, rather than physician-driven models.

Researchers said, "As the practice of anesthesiology continues to evolve, it is imperative that research efforts further investigate ways anesthesia care models may optimize care delivery, benefit anesthesia providers and improve health outcomes for patients."

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