transitioning into a doctoral program in nurse anesthesia presented by: daniel stairs, crna, msn,...
TRANSCRIPT
Transitioning Into a Doctoral Program in
Nurse Anesthesia
Presented by:Daniel Stairs, CRNA, MSN, MBA
Assistant DirectorExcela 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
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 StatementWhere 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 NA2. University of Minnesota NA Program -Doctor of Nursing Practice
Where are we TODAY? Several schools offer doctoral completion
programs for masters prepared CRNA:1. Virginia Commonwealth University -Doctor of Nurse Anesthesia Practice (DNAP)2. Texas Wesleyan University -Doctor of Nurse Anesthesia Practice (DNAP)3. Robert Morris University (for all APNs) -Doctor of Nursing Practice (DNP)4. University of Pittsburgh -Doctor of Nursing Practice (DNP)
What’s the Difference in the Initials?
PhD is a research oriented degree; requires a dissertation
DNP and DNAP are clinical (practice-oriented) doctorates:
1. Prepares graduates to function at the highest clinical level
2. 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
For doctoral curriculum development Are 8 competencies:1. Ethics2. Health Systems Management3. Public and Social Policy4. Technology and Informatics5. Practice Inquiry6. Healthcare Improvement7. Professional Role8. 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