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Proving Competence: Evidence of Excellence in Nurse Anesthesia Practice

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Primary Author:</td>
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Carol A. Rizer CRNA, RN</td>
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Co-Principal Investigators/Collaborators:</td>
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N/A</td>
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Organization:</td>
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The University of Texas at Tyler</td>
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Abstract</h2>
<h3>
Purpose</h3>
<p>The purpose of this project was to develop a practice portfolio for each Certified Registered Nurse Anesthetists (CRNA) that would provide evidence of competent performance in a rural acute care setting.&nbsp;</p>
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Background</h3>
<p>Sweeping changes in the healthcare environment exposes a greater need for the placement of qualified and cost-effective providers in all areas. Certified Registered Nurse Anesthetists have a proven track record of safety as a provider group. A gap exists in identifying, quantifying, and linking existing practice evidence to the performance of individual CRNAs.&nbsp;</p>
<h3>
Materials &amp; Methods</h3>
<p>The portfolio sections included 1) Performance Improvement data; 2) quarterly performance evaluations; 3) credentials, certifications, and continuing education transcripts; 4) evidence of accurate patient care documentation and billing records; and 5) scholarly work. Implementation of the project was completed over three weeks, including teaching and explanation of project phases, portfolio development and organization, and final evaluation. Feedback evaluation questionnaires were completed by the CRNAs, the Medical Director, the Office Manager, and the Administrative Assistant.&nbsp;</p>
<h3>
Results</h3>
<p>The majority of respondents agreed that the portfolio was an easier way to organize and access the data and that the components included provided adequate, reasonable, and truthful evidence of CRNA professional competence. The CRNAs felt that having the performance improvement data in their own portfolio would allow them to be informed of the criteria the hospital is keeping and be aware of quarterly reporting results on a regular basis. Also, that peer review and the feedback on documentation/billing packet completeness and legibility would inspire practice change. The majority of respondents stated the data collected from this project could improve the way CRNAs complete documentation, making billing processes more efficient.&nbsp;</p>
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Conclusion</h3>
<p>This project demonstrated that CRNA practice portfolios can be utilized to demonstrate competent practice through the compilation of objective, as well as quantifiable evidence. CRNAs in all practice settings might use a similar method to demonstrate practice competence to a variety of stakeholders.</p>
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Bibliography</h3>
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American Association of Nurse Anesthetists (2013a). Scope of Nurse Anesthesia Practice. Retrieved from http://www.aana.com/resources2/professionalpractice/Documents/PPM%20Scop...
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Buppert, C. (2012). Nurse Practitioner&rsquo;s business practice and legal guide (4th Ed.). Sudbury, MA: Jones &amp; Bartlett Learning.</li>
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Dulisse, B., &amp; Cromwell, J. (2010). No harm found when nurse anesthetists work without supervision by physicians. Health Affairs, 29(8), 1469-1475.</li>
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Dunn, L. (2009). Assessing alignment, action and accountability within your hospital with Quint Studer of the Studer Group. Becker&rsquo;s Hospital Review: Business and Legal Issues for Health System Leadership. Retrieved from http://www.beckershospitalreview.com/news-analysis/assessing-alignment-a...
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Hawks, S. J. (2012). The use of electronic portfolios in nurse anesthesia education and practice. AANA Journal, 80(2), 89-93.</li>
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Maurer, T. J., &amp; Pierce, H. R. (1998). A comparison of Likert scale and traditional measures of self-efficacy. Journal of Applied Psychology, 83(2), 324-329.</li>
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Melnyk, B. M., &amp; Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice (2nd Ed.). Philadelphia: Wolters Kluwer/Lippincott Williams &amp; Wilkins.</li>
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National Board of Certification and Recertification of Nurse Anesthetists, NBCRNA (2013a). Changing needs: Limitations of the current system. Retrieved from http://www.nbcrna.com/cpc/Pages/Changing-Needs.aspx</li>
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National Board of Certification and Recertification of Nurse Anesthetists, NBCRNA (2013b). Time frame. Retrieved from http://www.nbcrna.com/cpc/Pages/Timeframe.aspx</li>
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Pine, M., Holt, K. D., &amp; Lou, Y. (2003). Surgical mortality and type of anesthesia provider. AANA Journal, 71(2), 109-116.</li>
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Plaus, K., Muckle, T. J., &amp; Henderson, J. A. (2011). Advancing recertification for nurse anesthetists in an environment of increased accountability. AANA Journal, 79, 413-418.</li>
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<p>&copy; Improvement Science Research Network, 2012</p>
<p>The ISRN&nbsp;published this as received and with permission from the author(s).</p>

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