In the Standards for Accreditation of Nurse Anesthesia Programs – Practice Doctorate (trial guidelines- effective 1/2015) the requirements for clinical experience numbers for regional anesthesia techniques, overall case numbers, and total clinical hours are all increased over the current Standards for Accreditation of Nurse Anesthesia Programs clinical experience requirements. When creating the new Standards, the Standards Revision Task Force performed a comprehensive literature review to determine whether the literature supported increasing the number of regional anesthesia case requirements. Of the literature available and reviewed, the most relevant studies (see below), as well as the requirements specified for other anesthesia learners, were among the factors used to support the rationale for the decision. There are no conclusive studies to support how many experiences are required to reach competence with the techniques. The opportunity for nurse anesthesia students to perform regional anesthesia techniques varies greatly from one clinical site to another (as it does for the CRNAs at these sites). The minimal clinical experience requirements take this variation into consideration, while also ensuring that all students have a minimum number of case experiences in these techniques.
Pre- and post-anesthesia assessment and management of patients is a requirement of the AANA Standards for Nurse Anesthesia Practice (2/2013), and the AANA Scope of Nurse Anesthesia Practice (6/2013). Students are required to perform a comprehensive history and physical assessment (Standard C21, b10) and perform a pre-anesthetic assessment and formulate an anesthesia care plan (Standard C21, c3) according to the current Standards for Accreditation of Nurse Anesthesia Programs. These same requirements are included in the Standards for Accreditation of Nurse Anesthesia Programs – Practice Doctorate (Standards D.8 & D.15). Post-anesthesia assessment is a component of the perianesthetic process/continuum, which is addressed in Standards C17 and C21, b1 (Standards for Accreditation of Nurse Anesthesia Educational Programs). The Standards for Accreditation of Nurse Anesthesia Programs – Practice Doctorate addresses the perianesthesia continuum in Standard D.5.
De Oliveira Filho GR. The construction of learning curves for basic skills in anesthetic procedures: an application for the cumulative sum method. Anesthesia & Analgesia. 2002; 95(2): 411-416.
Konrad C, Schupfer G, Wietlisbach M, Gerber, H. Learning manual skills in anesthesiology: is there a recommended number of cases for anesthetic procedures? Anesthesia & Analgesia. 1998; 86(3): 635-639.
Kopacz D. The regional anesthesia “learning curve”: what is the minimum number of epidural and spinal blocks to reach consistency? Regional Anesthesia. 1996; 21(3): 182-190.
Smith MP, Sprung J, Zura A, Mascha E, Tatzlaff J. A survey of exposure to regional anesthesia techniques in American anesthesia residency training programs. Regional Anesthesia and Pain Medicine. 1999; 24(1): 11-16.