Nurse Anesthetists

护士麻醉师
  • DOI:
    文章类型: Journal Article
    简介 :推理错误是临床实践中决策不良的主要原因。为了补救这一点,许多研究强调了在医疗实习期间监督临床推理的重要性。尽管在围手术期的所有关键时刻,决策都是一个持续的过程,没有关于在学生护士麻醉师实习期间监督临床推理的研究。这项研究的目的是确定麻醉专业人员与学生护士麻醉师一起监督临床推理的特征。方法 :使用观察和对五名护士麻醉师和五名学生的个人访谈进行了多中心定性研究。结果 :确定了三个主题 :学习者&#8217的特征;和主管’的姿势 使用的教学方法 和临床推理的特殊性。分析 :护士麻醉师只有在发现学生的困难时才会质疑临床推理。然而,没有可追溯性。当意外事件发生时,学生自发地说出他们的临床推理。讨论 :结果将用作在实习期间追踪学习的新工具的基础。
    Errors in reasoning are the main causes of poor decision-making in clinical practice. To remedy this, many studies highlight the importance of supervising clinical reasoning during medical internships. Although decision-making is an ongoing process at all key moments of the perioperative period, there are no studies on the supervision of clinical reasoning during student nurse anesthetist internships. The objective of this study was to identify the characteristics of the supervision of clinical reasoning by anesthesia professionals with student nurse anesthetists.
    A multicenter qualitative study was carried out using observations and individual interviews with five nurse anesthetists and five students.
    Three themes are identified : the characteristics of the learner’s and supervisor’s posture ; the teaching methods used ; and the specificities of clinical reasoning.
    The nurse anesthetists question clinical reasoning only when they detect difficulties in the student. However, no traceability is carried out. Students spontaneously verbalize their clinical reasoning when unexpected events occur.
    The results will be used as a basis for a new tool for tracing learning during internships.
    Les erreurs de raisonnement sont les principales causes de mauvaise prise de décision en clinique. Pour y remédier, de nombreuses études montrent l’importance de la supervision du raisonnement clinique pendant les stages en médecine. Bien que la prise de décision soit permanente lors de tous les moments clés de la période péri-opératoire, il n’existe aucune étude sur la supervision du raisonnement clinique durant les stages des étudiants infirmiers anesthésistes. L’objectif de cette étude est d’identifier les caractéristiques de la supervision du raisonnement clinique par les professionnels d’anesthésie auprès des étudiants infirmiers anesthésistes.
    Une étude qualitative multicentrique a été réalisée à l’aide d’observations et d’entretiens individuels auprès de cinq infirmiers anesthésistes et cinq étudiants.
    Les trois thèmes identifiés sont les caractéristiques de la posture de l’apprenant et du superviseur, les méthodes pédagogiques utilisées et les spécificités du raisonnement clinique.
    Les infirmiers anesthésistes questionnent le raisonnement clinique uniquement quand ils détectent des difficultés chez l’étudiant ; cependant, aucune traçabilité n’est réalisée. Les étudiants verbalisent spontanément leur raisonnement clinique lors d’événements imprévus.
    Les résultats serviront de base à un nouvel outil de traçabilité des apprentissages en stage.
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  • DOI:
    文章类型: Journal Article
    模拟是医疗保健教育格局的组成部分,也是研究生专业教育未来的关键要素。在过去的三十年里,基于模拟的教育方法在护士麻醉教育计划(NAEP)中越来越受欢迎。目前,通过NAEP中的模拟记录所使用的方式或教育成果的客观证据有限。2018年,美国护士麻醉学协会(AANA)成立了AANA教育委员会模拟小组委员会,并责成该小组有两个主要目标:1)更好地了解模拟教育的现状;2)审查有关NAEP如何在其课程中最好地纳入模拟元素以满足要求,同时遵守护士麻醉教育计划认证委员会的准则。开发了一种调查工具,并分发给所有程序,以评估模拟的利用情况,可用的仿真资源,正在进行的教师发展努力,以及使用这种教育方法的障碍。调查结果表明,模拟是NAEP中用于各种教学活动的有效方法,可用于支持学生注册护士麻醉师的技术和非技术学习成果的实现。
    Simulation is an integral part of the healthcare educational landscape and a key element in the future of graduate professional education. For the past three decades, simulation-based educational methodology has been gaining popularity in nurse anesthesia educational programs (NAEP). There is currently limited objective evidence documenting modalities used or educational outcomes addressed through simulation in NAEPs. In 2018, the American Association of Nurse Anesthesiology (AANA) established a Simulation Subcommittee of the AANA Education Committee and tasked the group with two primary goals: 1) to gain a better understanding of the current state of simulation education and 2) to review responses with regard to how NAEPs could best incorporate simulation elements within their curriculum to meet requirements while adhering to the guidelines of the Council on Accreditation of Nurse Anesthesia Educational Programs. A survey tool was developed and distributed to all programs to assess the utilization of simulation, available simulation resources, ongoing faculty development efforts, and barriers to use of this educational approach. Survey results indicated that simulation is valued as an effective method within NAEPs for a variety of teaching and learning activities and is utilized to support achievement of both technical and nontechnical learning outcomes for student registered nurse anesthetists.
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  • DOI:
    文章类型: Journal Article
    冒名顶替现象(IP)正在演变,多维结构被定义为在高性能或竞争性环境中工作的个人经常经历的自我感知的智力虚伪和专业无能。知识产权后果包括心理困扰,角色优化不足,职业不满。作为一个职业中的高成就高级实践护士,经常被同龄人评价,注册护士麻醉师(CRNA)面临IP风险。在CRNA的职业生涯早期识别错误并采用健康的管理策略可以优化护士麻醉师的医疗保健角色,导致更充实的职业生涯,并支持个人健康。
    Imposter phenomenon (IP) is an evolving, multidimensional construct defined as self-perceived intellectual phoniness and professional ineptitude frequently experienced by individuals working in high-performance or competitive environments. IP consequences include psychological distress, role underoptimization, and career dissatisfaction. As high-achieving advanced practice nurses in a profession often evaluated by peers, certified registered nurse anesthetists (CRNAs) are at risk for IP. Identifying impostorism early in the CRNA\'s career and adopting healthy management strategies can optimize the nurse anesthesiologist\'s healthcare role, lead to a more fulfilling career, and support personal wellness.
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  • DOI:
    文章类型: Journal Article
    可委托专业活动(EPA)是可以委托给有能力完成该任务的学习者的任务或职责,以允许无监督的实践。EPA的概念在医学教育文献中有很好的记载,但只是最近在护理教育中。关于EPA框架在护士麻醉中的应用的文献很少。基于EPAs在基于能力的医学和护理教育中的成功应用,我们认为,该框架也可以用于过渡到基于能力的护士麻醉学习者的教育。许多经过认证的注册护士麻醉师临床专家缺乏基于能力的教育和教学培训。EPAs的概念可以帮助临床专家翻译能力和学习者的绩效评估。EPA是为护士麻醉临床教育环境定义的。特定于护士麻醉的EPA的示例包括麻醉机检查,插管,侵入性线路放置,区域麻醉阻滞,和术前评估。EPA的标准,使用障碍,并提供了具体的例子。临床受体故意使用EPA框架可能会导致对学习者的更有效评估,从而导致有目的地发展为能力。
    Entrustable professional activities (EPAs) are the tasks or responsibilities which can be entrusted to a learner competent in that task to allow for unsupervised practice. The concept of EPAs is well documented in medical education literature, but only recently in nursing education. A paucity of literature exists on the application of an EPA framework specifically in nurse anesthesia. Based on the successful application of EPAs in competency-based medical and nursing education, we are of the opinion that this framework may also be utilized in the transition to competency-based education for nurse anesthesia learners. Many certified registered nurse anesthetists clinical preceptors lack training in competency-based education and teaching. The concept of EPAs may assist clinical preceptors in the translation of competencies and performance evaluation of learners. EPAs are defined for the nurse anesthesia clinical education setting. Examples of EPAs specific to nurse anesthesia include anesthesia machine checks, intubation, invasive line placement, regional anesthesia blocks, and preoperative assessment. Criteria of EPAs, barriers to use, and concrete examples are provided. Deliberate use of the EPA framework by clinical preceptors may lead to a more effective evaluation of the learner, thus resulting in purposeful progression to competence.
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  • DOI:
    文章类型: Letter
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    文章类型: Journal Article
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  • DOI:
    文章类型: Editorial
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  • DOI:
    文章类型: Journal Article
    美国护士麻醉实践委员会协会和主题专家最近评估了新发布的大麻指南,标题为“关于大麻和大麻素的围手术期患者管理的ASRA疼痛医学共识指南”。“对循证指南的总结性审查提供了必要的建议,直接适用于注册护士麻醉师临床实践。
    The American Association of Nurse Anesthesiology Practice Committee and subject matter experts recently evaluated newly published cannabis guidelines titled \"ASRA Pain Medicine Consensus Guidelines on the Management of the Perioperative Patient on Cannabis and Cannabinoids.\" A summative review of the evidence-based guidelines provides essential recommendations, which are directly applicable to certified registered nurse anesthetist clinical practice.
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  • DOI:
    文章类型: Journal Article
    美国处于战争状态近二十年,支持战场上前所未有的生存。随着国家转向相对和平,至关重要的是,美国陆军认证的注册护士麻醉师(CRNA)领导者应减轻经验教训的损失,并为未来的陆军CRNA做好准备。本文介绍了美国陆军CRNA就绪模型,该模型结合了这些知识,技能,以及维持战备状态所需的能力。该模型将为美国陆军护理领导者提供框架,以实施和评估士兵在作战环境中提供麻醉的准备情况。
    The U.S. was at war for nearly two decades, supporting unprecedented survival on the battlefield. As the nation pivots to a relative peace, it is critical that U.S. Army certified registered nurse anesthetist (CRNA) leaders mitigate the loss of lessons learned and prepare future Army CRNAs for war. This article describes the U.S. Army CRNA Readiness Model that incorporates the knowledge, skills, and abilities required to sustain readiness. This model will provide U.S. Army nursing leaders with the framework to implement and evaluate solider readiness to provide anesthesia in operational environments.
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  • DOI:
    文章类型: Journal Article
    安静的辞职是一个术语,用来描述做你的工作所需的最低限度的想法,但不是彻底的辞职。随着COVID-19大流行的疲劳和不断升级的劳动力短缺,安静的戒烟可能是注册护士麻醉师的一种现象。讨论了缓解安静戒烟的健康策略。
    Quiet quitting is a term used to describe the idea of doing the minimum that is required to do your job but not outright quitting. With the extended fatigue from the COVID-19 pandemic and escalating workforce staffing shortages, quiet quitting could be a phenomenon occurring with certified registered nurse anesthetists. Wellness strategies to mitigate quiet quitting are discussed.
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