Advancing the science of anesthesia through education and research Advocate Workshop November 2012...

Advancing the science of anesthesia through education and research

Advocate Workshop

November 2012

Working for the Future –

Programs and Awards

Lorraine M. Jordan, CRNA, PhD, FAANAANA Foundation Executive Director

and

AANA Senior Director of Research

Mission is to advance the science of anesthesia through education and research.

Goal is to support new and seasoned investigators in nurse anesthesia through grants, fellowships and post doctoral fellowships. Programs are designed to develop researchers in nurse anesthesia.

AANA Foundation Research


Q. Does the AANA and the Foundation work together at

awarding money from the AANA Foundation?

A. AANA makes all of the decisions

B. Foundation makes all the decisions

C. Both groups have a vote on disbursement of money from the Foundation


AANA2013 Research Agenda

Research Priorities for 2013

One of the top priorities for fiscal year 2013 is healthcare policy research. Additional targeted areas for funding include education, practice and clinical.


Research Priorities for 2013-Health Services Research 1. Determine the impact of nurse anesthesia care regarding (i.e.,

cost effectiveness, quality): hospital readmissions, per-patient Medicare costs, quality outcome, geographical variation and identify how payment claims for CRNA services vary among state Medicare and Medicaid service areas in pain management

2. Examine the variability of the CRNA’s scope of practice in each state

3. Examine the impact that limiting CRNA scope of practice would have on cost and access

4. Assess CRNA practice patterns (specialty anesthesia services) identified by locale

5. Explore how the implementation of health reform (i.e. ACSs/other share savings plans/payment innovations) may affect CRNA practice and reimbursement

• Advancing the science of anesthesia through education and research

Research Priorities for 2013Practice and Clinical 1. Examine the comparative effectiveness of research on

competency of healthcare providers performing specific procedures including central line insertions, ultrasound and arterial-line placements.

2. Evaluate the impact of teamwork and hand offs related to patient safety

3. Assess the role of the CRNA regarding surgical site infections

4. Determine the top 10 activities anesthesia providers can do to reduce administrative costs while upholding optimal patient safety

5. Analyze the current literature detailing the competency and technical skills of CRNAs


Research Priorities for 2013Practice and Clinical (cont)6. Assess the impact that clinical relationships have between

healthcare providers on improving patient care (Supervision – medical direction of CRNAs for cases involving intubation, etc.)

7. Identify which situations or scenarios enable CRNAs to be or become the best patient advocate: mass casualty, incident preparedness and the role of CRNAs.

8. Describe role that RNs play in continuous epidural infusion

9. Determine if changes in surgical scheduling impact non-routine events (error prevention)

10. Analyze the comparative effectiveness of different types of innovative educational models for the preparation of nurse anesthetists on student satisfaction and performance and ultimately on performance measures reflecting safety, quality of care and health outcomes for patients served.


Research Priorities for 2013Practice and Clinical (cont)11. Determine the comparative effectiveness of different types of

organizational arrangements of practice (solo, group, faculty practice arrangements, salaried etc.) that influence compensation, retention in practice, age at retirement and professional satisfaction

12. Analyze the potential impact of changes in the organization and reimbursement of the nurse anesthesia care given different health reform options

13. Assess the impact of the differences in patient characteristics, practice settings, practice arrangements, case complexity and types of procedures on safety and quality

14. Create demonstration projects to evaluate innovative practice models that may improve care and the practice of nurse anesthesia in the future

15. Explore various models of practice arrangements and environments that may led to an ideal practice environment

• Advancing the science of anesthesia through education and research

Research Priorities for 2013Education1. Determine the value of the DNP (assess the measurable

difference)

2. Examine the current design of the DNP curriculum for “best practices” in DNP education

3. Determine if critical thinking skills can be taught, measured and/or predicted.

4. Assess the effectiveness of simulation on student education as well as on continuing education, maintenance and competency for CRNAs

5. Examine the effectiveness of current criteria for admission into a nurse anesthesia program, i.e. applicant’s behavior, attitude, etc. that could be used as a way to assist educators.– Measure of maturity– Promising individuals for leadership positions


Can the Foundationfund research on

pediatric development andstill meets its’ mission?

a. Yes

B. No

C. Depends


AANA Foundation’s and the AANA’sPartnership in Research for Nurse

Anesthetists

How will this help YOU?


“Foundation develops the evidence, AANA protects the practice.”

AANA

Foundation

PAC

The AANA Foundation sets a broad research agenda that includes the following areas:– Science of anesthesia – Education – Practice/Clinical – Leadership – Healthcare policy

AANA FoundationResearch Agenda


Partnership ActivitiesHealth Services Research

Unsupervised CRNAs

are

Unsafe CRNAsDEBU

NKED

Supports funding of individuals

Health Services Research

Foundation

Individual

CRNAs&

Students

AANA and Foundation’s partnership

Programmatic Funding Distribution

Foundation ProgramsResearch Grant (On-Line)

General GrantsWellness GrantsOffice Based AnesthesiaVeterans Research Grant

“State of the Science”Oral Poster Presentation - “State of Science” General Poster Presentation

WorkshopsWorkforce Study WorkshopGrant Writing WorkshopMentorship Program**


Foundation Programs (cont)Awards

Advocate of the Year Award . John F. Garde Researcher of the Year Award Rita L. LeBlanc Philanthropist of the Year Award Janice Drake CRNA Humanitarian Award Jack Neary Pain Management Award

CRNA Funding for Research and Education Doctoral Fellowship Post Doctoral Research Awards Palmer Carrier, CRNA Scholarship Lorraine D. Dankowski Doctoral Fellowship Florida Association of Nurse Anesthetists Practice and Research

Doctoral Fellowship Kay Wagner Pennsylvania Association of Nurse Anesthetists

Practice and Research Doctoral Fellowship


AANA FoundationApplication Deadline Dates for 2013

November 1st Research Grants (General)

January 1st Advocate of the YearJohn F. Garde Researcher of the YearRita L. LeBlanc Philanthropist of the YearJanice Drake CRNA Humanitarian AwardJack Neary Pain Management AwardStudent Scholarship Donors

March 1st Dean Hayden Student Research Scholarship“State of the Science” – Oral Poster PresentationStudent Scholarship Applicants

April 1st Doctoral FellowshipPalmer Carrier, CRNA ScholarshipPost Doctoral Fellowship“State of the Science” – General Poster Presentation

May 1st

Research Grants

June 15th

Friends for Life

Open SubmissionProgram Director’s Outstanding Student Researcher AwardOffice Based Research GrantVeterans Research GrantWellness Grant


Process for Review for Funding

Board Committee’s Recommendation

Foundation Board for Approval

External Committee Evaluation is Reviewed, Evaluated & Scored

Chair and Board Committee

Application is submitted

Completed Application Any Fees are Accepted


Student Scholarships

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

$0

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000


Research Grants

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000


Examples of Grants• Effects of Acupuncture on the Hypothalamus

Pituitary Adrenal Axis in Allaying Stress, an Animal Model

• Anti-inflammatory Antinociceptive Effects of Ellagic Acid and Epigallocatechin Gallate

• Revision and Psychometric Evaluation of the Peroperative Catastrophe Survey

• Motivating a Change towards Evidenced Based Practice: Best Practice for Central Line Insertion for the Novice Anesthesia Provider


• Motivating a Change towards Evidenced Based Practice: Best Practice for Central Line Insertion for the Novice Anesthesia Provider

• A Preventive Intervention for Rising Intraocular Pressure: Development of an Observation Scale

• Impact of Isoflurane and Sevoflurane on Cortical Activity: In Vivo Multi-channel Electrophysiology Studies and Implications in Monitoring Consciousness


• Patient Safety Assessment and Economic Outcomes after Implementation of a Surgical Safety Checklist in a National Cancer Institute”

• The Effect of Non-Technical Skills Instruction on First-Year Nurse Anesthesia Students’ Skills during Crisis Simulation

• Impact of Geography, Training, and Experience on Scope of Practice among CRNAs

• Evaluation of Crisis Resource Management Skills in a Simulation Environment


Doctoral and Post Doctoral Fellowships

1989

1991

1993

1995

1997

2000

2003

2006

2008

2010

2012

$0

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

$160,000


Examples of Doctoral Projects• Psychoneuroimmune Responses and Chronic

Pain• Impact of isoflurane and sevoflurane on

cortical activity: in vivo multi-channel electrophysiology studies and implications in monitoring consciousness

• Stakeholder Perceptions of APRN Consensus Model Implementation


• “Incidence of Venous Air Embolism in Awake Craniotomy for Deep Brain Stimulator Implantation”

• “Utilization of Computer-Based Anesthesiology Paging System for Intraoperative Emergencies in Adult Surgical Patients”

• “Assessment of Recent Graduates Preparedness for Entry into Practice”

• “Stop Bang Tool Usage to Detect Obstructive Sleep Apnea for the “Ionizing Radiation Exposure with Interventional Pain Management Procedures”


State of the SciencePoster Session Participants

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

2011

0

20

40

60

80

100

120

140


Examples of State of the Science

• “Continuing Clopidogrel During Elective Total Hip and Knee Arthroplasty: Assessment of Bleeding Risk and Adverse Outcomes”

• “The Incidence of Postoperative Acute Kidney Injury following Bariatric Surgery”

• “Platelets Potentiate Cancer Metastasis- A Review”

• “Anesthetic Care of Patients with Fontan Circulation Undergoing Scoliosis Surgery”


AANA Foundation Doctoral Fellowship

• Name: Julia Lassegard, CRNA, MS• School: University of California, Los Angeles• Research Title: Extracranial

Dissection Involving the Trigeminal Nerve Results in Acute Cephalalgia

• Degree Sought: PhD• Funding: $10,000



• Name: Jason Lowe, CRNA, MS• School: Virginia Commonwealth University • Research Title: Patient Handoffs

in Anesthesia: Improving Patient Safety Using a Handoff Checklist

• Degree Sought: PhD• Funding: $4,000



• Name: John Gasko, CRNA, MSN• School: Northeastern University • Research Title: Review and

Development of Current Ultrasound Guided Regional Anesthesia Curriculum for Student Registered Nurse Anesthetists

• Degree Sought: DNP• Funding: $5,000


Nursing FoundationsSurvey Benchmarks

• 15 Nursing Foundations participated in a survey January of 2012

• All of the nursing organizations funded programs

• 30% played a role in the development and administrative follow up


Programs and events;Conference Scholarships;Certification

Certification; None

Presented January 13, 2011 at Nursing Foundation Alliance Meeting by L. Jordan, AANA Foundation

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Advancing the science of anesthesia through education and research Advocate Workshop November 2012...

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