Impact of Legislation on Scope of Practice Among CRNAs
Impact of Legislation on Scope of Practice Among CRNAs
As a preliminary study on SOP of nurse anesthetists, this research was exploratory in nature. Nurse anesthesia practice has historically been studied in terms of quality of care attributed to various anesthesia delivery models but not from an individual SOP perspective. By quantifying SOP, we are able to see the degree to which the location of practice and health care policies such as the "opt out" influence actual practice. This research shows that CRNAs who practice in rural areas exhibit broader SOP to meet the needs in their communities. Limitations to practice to the fullest extent of one's capabilities are evident when 40.6% of respondents said that the hospital or surgery center imposes even greater restrictions on their practice than the state mandates. Working in a location that imposes such restrictions appears to impact the overall SOP of this group because they report a 30% lower average SOP score than those who do not feel they have such restrictions.
We have seen that CRNAs practicing in opt-out states exhibit a higher average SOP than those who do not. The influence of practicing in an opt-out state was further probed in the series of questions presented in Table 2. The responses revealed that 18.7% of the 333 respondents who live in an opt-out state report experiencing a personal impact on their SOP. This change appears to have had a positive impact on their collective SOP, with this group exhibiting the highest mean SOP at 90.05. Removal of the supervision barrier for CRNA practice appears to have resulted in a broader SOP for this group of CRNAs.
The final survey item listed in Table 2 asked subjects if they believed that their practice adequately reflected their education, experience, and training. A disappointing 35% of respondents did not feel that they were being used to the fullest extent of their capabilities. This finding correlated with the resulting SOP scores, in that CRNAs who perceived themselves to be underutilized reported a mean SOP of 54.56 and appropriately utilized CRNAs reported a mean SOP of 82.83.
Discussion
As a preliminary study on SOP of nurse anesthetists, this research was exploratory in nature. Nurse anesthesia practice has historically been studied in terms of quality of care attributed to various anesthesia delivery models but not from an individual SOP perspective. By quantifying SOP, we are able to see the degree to which the location of practice and health care policies such as the "opt out" influence actual practice. This research shows that CRNAs who practice in rural areas exhibit broader SOP to meet the needs in their communities. Limitations to practice to the fullest extent of one's capabilities are evident when 40.6% of respondents said that the hospital or surgery center imposes even greater restrictions on their practice than the state mandates. Working in a location that imposes such restrictions appears to impact the overall SOP of this group because they report a 30% lower average SOP score than those who do not feel they have such restrictions.
We have seen that CRNAs practicing in opt-out states exhibit a higher average SOP than those who do not. The influence of practicing in an opt-out state was further probed in the series of questions presented in Table 2. The responses revealed that 18.7% of the 333 respondents who live in an opt-out state report experiencing a personal impact on their SOP. This change appears to have had a positive impact on their collective SOP, with this group exhibiting the highest mean SOP at 90.05. Removal of the supervision barrier for CRNA practice appears to have resulted in a broader SOP for this group of CRNAs.
The final survey item listed in Table 2 asked subjects if they believed that their practice adequately reflected their education, experience, and training. A disappointing 35% of respondents did not feel that they were being used to the fullest extent of their capabilities. This finding correlated with the resulting SOP scores, in that CRNAs who perceived themselves to be underutilized reported a mean SOP of 54.56 and appropriately utilized CRNAs reported a mean SOP of 82.83.