Prof Aspects - Defining Practice

Approximately how many CRNAs/SRNAs does AANA represent?

57,000.

What percentage of all CRNAs are represented by AANA?

Nearly 90%.

When did AANA rebrand to the American Association of Nurse Anesthesiology?

2020.

Approximately how many anesthetics do CRNAs provide annually in the U.S.?

~45 million.

CRNAs are licensed as what type of practitioner?

Independent APRNs.

In nearly what percentage of rural hospitals is the CRNA the sole anesthesia provider?

Nearly 100%.

What landmark legislation allowed CRNAs to bill Medicare directly?

Omnibus Budget Reconciliation Act of 1986.

What was the significance of the 1986 Medicare legislation?

CRNAs became the first nursing specialty able to bill Medicare directly.

In what year was the federal supervision/opt-out rule established?

2001.

Which state was the first Medicare supervision opt-out state?

Iowa.

How many states have opted out of federal physician supervision requirements?

25 states.

Has any published evidence shown worse anesthesia safety in opt-out states?

No.

What are the 4 NBCRNA practice roles?

Clinical, administration, education, research.

What practice models are recognized as equally safe?

CRNA-only, consultative, and medical-direction models.

Which anesthesia practice models are most cost-effective?

CRNA-only and consultative models.

What AANA document defines CRNA scope of practice?

Scope of Nurse Anesthesia Practice.

When was the current Scope of Nurse Anesthesia Practice updated?

2019/2026.

What are the 5 major scope-of-practice categories?

Preoperative, intraoperative, postoperative, pain management, other services.

Can CRNAs obtain informed consent for anesthesia?

Yes.

Can CRNAs prescribe controlled substances?

Yes.

Can CRNAs order and administer blood products?

Yes.

What advanced monitors are specifically listed within CRNA scope?

CVP, arterial lines, cerebral oximetry, BIS, TEE.

Can CRNAs discharge patients from PACU?

Yes.

Can CRNAs provide advanced pain management?

Yes, including acute, chronic, and interventional pain.

Can CRNAs perform regional anesthesia for obstetric pain?

Yes.

What educational background is required before CRNA school?

RN with critical care experience.

What organization accredits nurse anesthesia programs?

COA (Council on Accreditation).

When was the COA established?

1975.

Which agency is the only nurse anesthesia accreditor recognized by the U.S. Department of Education and CHEA?

COA.

When did master's degrees become required for nurse anesthesia education?

1998.

When were doctoral standards approved by the COA?

2015.

When did all new CRNA students have to enter doctoral programs?

January 1, 2022.

Minimum RN critical care experience required for admission?

≥1 year full-time.

Average admitted ICU experience reported in the lecture?

2.9 years.

What are the 3 COA-mandated advanced science courses?

Advanced physiology/pathophysiology, pharmacology, health assessment.

Doctoral curricula add what major professional subjects?

Ethics, policy, finance, informatics, leadership, management.

Minimum anesthesia cases required after Jan 1, 2022?

650 cases.

Minimum clinical hours required after Jan 1, 2022?

2,000 clinical hours.

Average anesthesia cases reported in CY2019 graduates?

851 cases.

Average anesthesia hours reported in CY2019 graduates?

1,675 hours.

Average total clinical hours reported in CY2019 graduates?

2,573 hours.

What level of competence is expected at graduation?

Proficient, not expert.

What are the 4 requirements to become a CRNA?

RN license, COA-accredited program, pass NCE, obtain CRNA licensure if applicable.

How recently must a COA-accredited program be completed before certification eligibility?

Within previous 2 calendar years.

What exam grants initial CRNA certification?

National Certification Examination (NCE).

Which organization administers the NCE?

NBCRNA.

What does the CRNA credential signify?

Meets criteria and qualified to practice within CRNA scope.

What program maintains CRNA certification?

Continued Professional Certification (CPC).

When did CPC replace the legacy recertification program?

August 2016.

How often must CRNAs renew under CPC?

Every 4 years.

How long is the full CPC cycle?

8 years.

How is the CPC cycle structured?

Two 4-year cycles.

How many Class A credits are required every 4 years?

60.

How many Class B credits are required every 4 years?

40.

How many core modules are required every 4 years?

4.

How often is the CPC Assessment taken?

Once every 8 years.

How many questions are on the CPC Assessment (CPCA)?

150 questions.

Is the CPC Assessment pass/fail?

No.

What are the 4 CPCA content domains?

Airway, pharmacology, physiology/pathophysiology, equipment/technology/safety.

What percentage of the CPCA covers airway management?

34%.

What percentage covers applied pharmacology?

24%.

What percentage covers physiology/pathophysiology?

24%.

What percentage covers equipment/technology/safety?

18%.

What annual documentation is required to maintain certification?

Practice documentation, active license, attestation of fitness for practice.

What are the 3 foundational AANA professional documents?

Scope, Standards, Code of Ethics.

Which AANA document is currently under 2026 revision?

Code of Ethics.

What are the 6 major Code of Ethics domains?

Patient, professional, research, business, endorsements, society.

What do the Standards for Nurse Anesthesia Practice represent?

Minimum rules and responsibilities for CRNAs.

Do the Standards apply to all anesthetizing locations?

Yes.

What organization is the membership association?

AANA.

What organization handles certification and recertification?

NBCRNA.

What organization accredits educational programs?

COA.

What are the "Three Pillars" of nurse anesthesia?

AANA, NBCRNA, COA.

When was NBCRNA formed?

2007.

What two organizations merged to create NBCRNA?

CCNA and COR.

When did the COA separately incorporate?

2009.

Who elects the AANA Board of Directors?

Voting-eligible AANA members.

What positions comprise AANA leadership?

President, president-elect, vice president, treasurer, 7 regional directors.

What is AANA's mission statement?

Advance patient safety, practice excellence, and its members' profession.

When did COA adopt fellowship accreditation standards?

2014.

How many COA-accredited fellowships were noted in the lecture?

Five.

What two fellowship specialties were identified?

Advanced pain management and pediatric anesthesia.

What national framework governs APRN licensure, accreditation, certification, and education?

APRN Consensus Model (2008).

What specialty credential did NBCRNA establish in 2015?

NSPM-C (Nonsurgical Pain Management Certification).

What ultimately defines CRNA practice?

COA education, NBCRNA certification, AANA scope/standards/ethics, CPC maintenance, professional engagement.