Transitioning Into a Doctoral Program in Nurse Anesthesia
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Transcript Transitioning Into a Doctoral Program in Nurse Anesthesia
Transitioning Into a Doctoral
Program in Nurse Anesthesia
Presented by:
Daniel Stairs, CRNA, MSN, MBA
Assistant Director
Excela Health School of Anesthesia
April 4, 2008
Nurse Anesthesia Education
“If you don’t know where you are going,
you will probably end up somewhere
else”
Dr. Lawrence Peter, 1919
Nurse Anesthesia Education
Where have we come from?
Where are we now?
Where do we want to be?
Where Have We Come From?
1877 – Sister Mary Bernard, Erie PA
1915 – Lakeside Hospital School of Anesthesia
1931 – National Association of Nurse
Anesthetists (NANA) founded by Agatha
Hodgins
1933 – First NANA Annual Meeting
1939 – NANA changes name to AANA
1945 – AANA administers first certification
examination
Memories From the First Certification
Examination in 1945 . . .
"I Remember..."
"We had been well prepared by our instructors
at Charity Hospital, so I did not find the
questions overly difficult. I did not take
anesthesia work lightly. I worked and studied
very hard…the examination was a definite step
forward.“
Jessie Hood
Charity Hospital
New Orleans
Memories from the First certification
Examination in 1945 . . .
"I thought the examination was a good
idea…Nurse anesthesia was a very hard job. I
started at $250 a month and was on call
every day and every other weekend….The
examination was hard, too, considering the 9
month course I had taken in anesthesia. It
took me all day to write it."
Elizabeth Coolidge
Grace Hospital
Detroit
Memories from the First Certification
Examination in 1945 . . .
"I did not prepare ahead of time. Each school
taught what it wanted, because there were
not any regulations at that time. I felt the
first examination was a feeler to learn how
the schools measured up."
Gail Getway
Grace Hospital
Detroit
Other Important Dates in History
1944 – AANA membership extended to
African-American nurse anesthetists
1947 – AANA membership extended to male
nurse anesthetists
1952 – AANA implements program for
accrediting schools of nurse anesthesia
1955 – U.S. Department of Health education
and Welfare recognize AANA as accrediting
agency for schools of nurse anesthesia
1956 – AANA members adopt the credential of
CRNA
Where Have We Come From?
1987 – Bachelor’s degree required
1989 – 1998, Programs start to transition
into Master’s Degree
June 2007 – AANA Board of Directors
develop and unanimously adopt a
consensus Position Statement on
doctoral preparation of nurse
anesthetists
Reasons for Move Towards Doctorate
Change in scope and complexity of practice
Increase in required number of college credits
Increase the credibility of the nurse
anesthesia practitioner
Completion of career ladder
Increase the number of doctorally-prepared
faculty
Movement of other healthcare professions to
doctorate
Doctorate may be required by some states for
licensure
AANA Position Statement
Where Are We Going?
“The American Association of
Nurse Anesthetists supports
doctoral education for entry
into nurse anesthesia practice
by 2025.”
AANA Position Statement Rationale
Advances in technology, pharmacology, and
clinical practice mandate for evidence-based
practice
Healthcare is changing at a dramatic rate
Informatics
Systems approach to quality improvement
Increase in credit hours already required
Increase reliance on APNs to provide
healthcare
Some programs already moving to doctorate
Where are we at TODAY?
108 NA programs in U.S. (as of 3-25-09)
Vast majority offer various master’s degrees
such as MS, MSN, MS in nurse anesthesia,
MHS, master’s in biology
2 doctoral entry level programs now in
place:
1. Charleston Area Medical Center School of
Nurse Anesthesia/Marshall University (WV);
-Doctor of Management Practice in NA
2. University of Minnesota NA Program
-Doctor of Nursing Practice
Where are we TODAY?
1.
2.
3.
4.
Several schools offer doctoral completion
programs for masters prepared CRNA:
Virginia Commonwealth University
-Doctor of Nurse Anesthesia Practice (DNAP)
Texas Wesleyan University
-Doctor of Nurse Anesthesia Practice (DNAP)
Robert Morris University (for all APNs)
-Doctor of Nursing Practice (DNP)
University of Pittsburgh
-Doctor of Nursing Practice (DNP)
What’s the Difference in the Initials?
1.
2.
PhD is a research oriented degree; requires
a dissertation
DNP and DNAP are clinical (practiceoriented) doctorates:
Prepares graduates to function at the highest
clinical level
Requires capstone project completion
DNP program housed within a graduate
school of nursing
DNAP program housed within graduate
school of health sciences (outside nursing)
Competencies for the CRNA
Practitioner at Clinical Doctorate Level
1.
2.
3.
4.
5.
6.
7.
8.
For doctoral curriculum development
Are 8 competencies:
Ethics
Health Systems Management
Public and Social Policy
Technology and Informatics
Practice Inquiry
Healthcare Improvement
Professional Role
Biological Systems,Homeostasis,
Pathogenesis
Ethics
Apply ethically sound decision making
Informs public of role and practice
Upholds “Code of Ethics for CRNAs”
Health Systems Management
Ability to analyze structure, function and
outcomes
Negotiates, implements, assesses
Develops and implements integrated risk
management plan
Public and Social Policy
Advocates for health policy changes
Influences regulatory aspects of health
policy
Evaluates impact of local and global
political change
Technology and Informatics
Uses information systems and technology to
support systems improvement
Uses systems/technology to evaluate
programs of care
Critically evaluates clinical and research
databases
Practice Inquiry
Able to assess and evaluate health
outcome in diverse populations, clinical
settings, and systems
Ability to disseminate research evidence
Healthcare Improvement
Uses EBP in clinical decision making
Evaluates healthcare financing
Strategic planning
Professional Role
Ability to undertake complex leadership roles
Demonstrates leadership to facilitate
collaboration
Critical and reflective thinking
Utilizes a variety of leadership principles in
management of situations
Biological Systems, Homeostasis, and
Pathogenesis
Develops best practice models for nurse
anesthesia patient care management
Uses systematic outcomes analysis approach
Our Plans for Excela Health
Fall 2011 – DNAP Completion
Need to increase CRNAs with doctorate for
capstone advisors
Fulfillment of AANA doctoral competencies
Time frame for completion
Eventual program transition from MS to
DNAP
The Future of Nurse Anesthesia
So
what do you think???
Are you ready for doctoral
level education???
Nurse Anesthesia Educators
needed as we prepare for the
future of nurse anesthesia