Certified Registered Nurse Anesthetist Perceptions of Factors Impacting Patient Safety

Abstract

Certified registered nurse anesthetists (CRNAs) provide more than 40 million anesthetics each year in the United States. This article describes a study that investigates relationships among CRNA organizational structures (CRNA practice models, work setting, workload, level of education, work experience), CRNA ratings of patient safety culture, and CRNA adverse anesthesia-related event (ARE) reporting. This is a cross-sectional survey study of 336 CRNAs randomly selected from American Association of Nurse Anesthetists database. Workload was measured using NASA Task-Load Index and the Revised Individual Workload Perception Scale. Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Overall Perceptions of Safety Scale and Hospital Survey on Patient Safety Patient Safety Grade Scale were utilized to measure safety culture. Dependent variables (ARE) included difficult intubation/extubation, inadequate ventilation/oxygenation, and pulmonary aspiration. The Revised Individual Workload Perception Scale workload was significantly associated with ARE. Years' experience and Patient Safety Grade Scale were inversely associated with ARE. Overall Perceptions of Safety Scale was significantly and inversely associated with ARE. Practice model, education, and work setting were not associated with ARE. Based on findings, CRNA workload, years' experience, and patient safety culture may be important markers for ARE. Administrative interventions designed to upgrade patient safety culture and ensure manageable CRNA workload may foster quality patient care.

Psychometric Properties of a Safety Culture Index among Mental Health Workers in Ghana

“…Based on Table 1, we excluded items 8 and 25 because they showed low discrimination (i.e., a < 0.65) [31]. In addition, using Figure 1 (which represents the item information trace's line plots), we retained eleven items (1,2,3,6,9,11,14,15,20,21,22) because of their contribution to the instrument based on information and coverage of θ. For instance, items 5, 7, 8, 12, 19, 23, and 25 are clear examples of items with low information (the blue line is almost flat on the vertical axis).…”

“…According to Roscoe's rule-of-thumb, sample sizes between 30 and 500 are acceptable for behavioural science studies [18]. Similar sample sizes have been used across safety culture studies [19,20].…”

"The Development of an Instrument to Measure Perceived Workload for Certified Registered Nurse Anesthetists (CRNAs)"

“…In order to further evaluate how CRNA workload affects patient safety culture and, ultimately, patient safety, it is important to determine exactly what factors comprise CRNA perceived workload because it is unclear whether existing workload tools capture the domains of CRNA workload [15]. Additionally, the workload of a CRNA is vastly different from that of a staff nurse.…”

The levels and related factors of mental workload among nurses: A systematic review and meta‐analysis

“…Thus, we focused on the evidence base for subjective measurement of mental workload using the NASA-TLX. Some studies have reviewed the types of physiological measures of mental workload (Charles & Nixon, 2019;Marchand et al, 2021;Tao et al, 2019); several reviews have summarized the definition and measuring tools used for mental workload (Alghamdi, 2016;Kremer et al, 2019;Young et al, 2015). However, no systematic review and meta-analyses have been conducted to estimate nurses' overall mental workload based on subjective ratings using the NASA-TLX tool.…”