Salt Lake City (UANA)—Utah has consistently been recognized as one of the best U.S. states for healthcare, but a bill circulating in the state’s legislature is threatening to compromise patients’ access to affordable, quality care.
Senate Bill 121 will limit the availability of proven, cost-efficient anesthesia delivery in the state, according to Dan Bunker, CRNA, president of the Utah Association of Nurse Anesthetists (UANA).
“Passage of this bill will create an anesthesia model that will be costly to our healthcare system,” said Bunker. “The legislation would require two healthcare providers to do the work of one Certified Registered Nurse Anesthetist (CRNA). This model raises costs to both patient and healthcare facilities, limiting the accessibility of care and with no scientific evidence of increased patient safety.”
More than 250 CRNAs practice across Utah, providing expert anesthesia care as well as caring for critically ill patients in emergency rooms and assisting ICU teams with intubations and sedation procedures for COVID-19 patients.
“Managed care plans recognize CRNAs for providing high-quality anesthesia care with reduced expense to patients and insurance companies,” Bunker said. “As advanced practice registered nurses, CRNAs practice with a high degree of autonomy with a sterling patient safety record. CRNAs were also the first nursing specialty to be accorded direct reimbursement rights under the Medicare program.”
CRNAs are trained and educated to deliver anesthesia care regardless of whether a physician anesthesiologist is involved. Unlike anesthesiologist assistants (AA), a CRNA’s education includes nursing school, critical care experience, and completion of a nurse anesthesiology educational program. The AA program curriculum is characterized by training that only allows them to “assist” anesthesiologists in technical functions. AAs are not required to have any healthcare education, training, experience, or license before entering an AA program.
In addition to being the predominant anesthesia providers in rural settings, studies have shown CRNAs acting as the sole anesthesia provider is the most cost-effective model for anesthesia delivery. There is no measurable difference in the quality of care between CRNAs and other anesthesia providers.
“CRNAs are qualified to make independent judgments regarding all aspects of anesthesia care,” said American Association of Nurse Anesthesiology (AANA) President Dina F. Velocci, DNP, CRNA, APRN.
“In contrast, AAs administer anesthesia solely under the direct supervision and medical direction of physician anesthesiologists. If an AA’s supervising anesthesiologist is not available, on vacation, or simply home for the day, the AA may not provide anesthesia care, and surgery or other important procedure cannot take place. At best, this inconveniences a patient who may already be anxious about his or her health. At worst, this could compromise the quality of a health outcome.”
Krystal Tipping, UANA president-elect cited risks with a physician anesthesiologist assisting multiple AAs at a time. “What happens if that physician anesthesiologist is at the bedside with one AA, when a patient in another room has a life-threatening emergency? The AA can only do the best they can given their limited training. That puts patients at risk and should raise alarm for every patient in Utah on who is delivering their anesthesia.”
CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and other medical professionals; Public Health Service; and Veterans Administration healthcare facilities. CRNAs are the primary anesthesia providers in the U.S. military.
“Not only are CRNAs the nation’s most highly sought-after anesthesia expert, we are also advanced practice registered nurses,” said Velocci, adding that as such, CRNAs are members of one of “the most trusted professions for more than 20 consecutive years, according to Gallup. Patients can trust that a CRNA will stay with them throughout their procedure, advocate on their behalf, and provide high-quality, patient-centered care.”