The Certified Registered Nurse Anesthetist (CRNA) is direct care provider who possess the skills required for the delivery of competent, and safe anesthesia services. Within this role, the CRNA will provide anesthesia for general, regional and sedation cases that begins with the evaluation of patients needs in the preoperative period, management of the patient in the intra-operative period, and extends to the transition of care to the post-operative healthcare provider.
Essential Functions & Responsibilities: I. Process of Care
The CRNA utilizes scientific principles, clinical expertise and national standards of practice as the framework for managing patient care. This process includes:
A. Assessment of health status
- The CRNA will assess health status by:
- Obtaining a relevant health and medical history through direct patient/family interviews and medical records.
- Conducting an appropriate physical screening assessment
- Synthesizing and analyzing the collected data.
- Identifying both potential and actual risks associated with patient’s medical status and/or surgical procedure.
B. Develop and implement an anesthetic plan.
The CRNA, in collaboration with the supervising MDA, the patient and family establishes an evidence-based, mutually acceptable plan of care that is individualized to meet the needs of the patient.
The formulation of this plan includes:
- Selecting, obtaining, and administering pre-anesthetic medications and fluids.
- Obtaining informed consent for anesthesia and insuring that informed consent has been obtained for the proposed surgical procedure.
- Identifying the need for consults and additional diagnostic studies/tests.
C. Implementation of the plan
Interventions are based upon established principles.
Actions include the ability to perform required anesthetic techniques to include general, regional, monitored anesthesia, sedation and local anesthesia cases, for pediatric, adult and geriatric patient populations.
- Obtaining and preparing all equipment, monitors, supplies, and medications required for the administration of anesthesia. Performing and ordering safety checks as per unit guidelines.
- Providing appropriate invasive and non-invasive monitoring modalities utilizing current standards and techniques.
- Insertion of appropriate invasive monitoring modalities.
- Performing all aspects of airway management using current practice modalities that are driven by the needs of the patient
- Performing and managing regional anesthesia techniques including, but not limited to subarachnoid and epidural blocks; plexus, major and peripheral nerve blocks, intravenous regional anesthesia; transtracheal, topical and local infiltration blocks.
- Selecting, obtaining or administering the anesthetics, adjuvant drugs, accessory drugs, fluids and blood products necessary to manage anesthesia.
- Performing a continuous assessment of the physiologic status of the patient, analyzing patient data and based upon these factors, implementing corrective actions when indicated.
- Facilitating the emergence and recovery from anesthesia by selecting, obtaining and administering medications, fluids, and ventilatory support.
- Providing a thorough transition of care to the post-surgical care provider.
- Implementing acute pain management modalities and providing for reassessment of pain needs.
- Documenting all anesthetic interventions, pre-operative evaluations, plan of care and patient responses per department guidelines.
- Responding to emergency situations and provide airway management, administration of emergency drugs and fluids, and the implementation of basic and/or advanced cardiac life support techniques
D. Post anesthesia Care
The CRNA will provide post anesthesia follow-up and evaluation of the patient’s response to anesthesia and surgical experience, taking appropriate corrective action and requesting consultation when indicated.
- Initiating and administering respiratory support to ensure adequate ventilation and oxygenation in the post anesthesia period.
- Initiating and administering pharmacological or fluid support of the cardiovascular system during the post anesthesia period.
- Managing emergency situations, including initiating or participating in cardiopulmonary resuscitation.
- Initiating pain management therapy.
- Accepting additional responsibilities, which are appropriate within the expertise of the individual CRNA and are appropriate to the practice setting.
II. Care Priorities
The CRNA’s practice model emphasizes:
- The delivery of quality anesthesia services that are founded in scientific research, reflective of current standards, and are cost-efficient.
- The delivery of anesthesia services that optimizes and/or maintains the health status of the patient and is driven by the needs and directives of the patient and family.
- The initiation of pain management therapy that is ongoing and reflective of the individual needs of the patient.
III. Adjunct Roles as a CRNA
The CRNA will partici