The Psychometric Analysis of the Certified Registered Nurse Anesthetist Workload Perception Scale (CWPS): Final Phase

Background and PurposeIn two previous studies, the Certified Registered Nurse Anesthetist (CRNA) Workload Perception Scale (CWPS) was developed. The purpose of this paper is to report the final psychometric validation of the CWPS.MethodsAn 11-item CWPS was tested in a population of CRNAs. Classical psychometrics were performed on the 11-item instrument piloted in a sample of 393 CRNAs.ResultsParametric and nonparametric analysis indicated 7 of 11 items were a good fit to measure perception of workload. Conclusions: A revised 7-item final CWPS was developed.

Prática Clínica Do Enfermeiro Anestesista Nos Estados Unidos Da América

O objetivo deste trabalho foi descrever o perfil profissional do enfermeiro anestesista nos EUA (Estados Unidos da América) e descrever as atribuições do enfermeiro anestesiologista. A pesquisa é uma revisão bibliográfica de abordagem descritiva e qualitativa. Foi realizada nos bancos de dados da SciELO (Scientific Electronic Library Online), Google Acadêmico e BVS (biblioteca virtual em saúde) e com a seguinte pergunta de pesquisa: como é a prática clínica do enfermeiro anestesista nos Estados Unidos? Foram inclusos os artigos acadêmicos publicados entre 2011 à 2021, disponíveis de forma gratuita, em língua inglesa ou portuguesa. Foram excluídos os artigos inferiores a 2011, em outros idiomas, resumos, periódicos que não contemplavam nenhum dos objetivos, que não respondessem à pergunta de pesquisa e artigos repetidos encontrados nas bases de dados citadas acima, no qual resultou em uma amostra final de 18 artigos. Os Certified Registered Nurse Anesthetists (CRNAs) são profissionais aptos a desenvolverem práticas avançadas de enfermagem e em muitos estados norte-americanos praticam sem supervisão médica. São responsáveis por fornecer anestesia segura com alta qualidade e com melhor custo-benefício para o paciente, além de ter um perfil profissional que assume grande responsabilidade. A prática de enfermagem em anestesiologia não existe no Brasil, pois é uma área da medicina privativa ao profissional médico. A enfermagem nos EUA é bem avançada, não só para o enfermeiro anestesista, que possui autonomia para realizar a anestesia de um paciente, mas para as demais especializações da área. Os profissionais de práticas avançadas devem se especializar e estudar muito para desenvolver estas atividades, assim como se manterem atualizados.

The French Pre-Deployment Advanced Course in Anesthesia and Resuscitation: Development and Future Prospects

ABSTRACT Introduction Military anesthesiologists from the French Military Medical Service (FMMS) are part of the Forward Surgical Teams deployed in overseas military operations. The practice of anesthesia in combat zones requires specific skills that are not taught during the initial curriculum for French civilian anesthesiologist. The Pre-Deployment Advanced Course in Anesthesia and Resuscitation (DACAR) program was developed to prepare military anesthesiologist from the FMMS before their deployment in overseas military operations. Methods Created in 2013 by the French Military Medical Academy, the DACAR program is divided into two modules and carried out once a year. The DACAR program trains all military anesthesiologist residents at the end of their curricula. Since 2019, a number of Certified Registered Nurse Anesthetists have completed the DACAR program. The DACAR program is organized around the main axes of experience feedback from previous deployments in combat zones as well as didactic learning and practical training using high-fidelity simulation. Results Since 2013, a total of 99 trainees completed the DACAR program during six complete cycles of two modules. The DACAR program has gradually been enriched from 14 courses in 2013 to 28 in 2019. Participants’ reported satisfaction rates have increased steadily since 2016, when 88% of courses were rated as “interesting” or “very interesting,” and only 4% as “not very interesting.” By 2019, those figures had improved to 96% and 2%, respectively. Conclusion The DACAR program is a structured and adapted military medical course aimed at completing the curriculum of military anesthesiologists from the FMMS before deployment in overseas military operations. Regular audits and updates ensure that the DACAR training program maintains the highest standards of quality and rigor.

The Psychometric Analysis of an Instrument to Measure the Perceived Workload for Certified Registered Nurse Anesthetists

Background and PurposeIn a previous study, the CRNA Workload Perception Scale (CWPS) was developed. The purpose of this article was to investigate the psychometrics of the CWPS.MethodsThe CWPS was tested in a population of CRNAs. This study was conducted in two phases. Phase I consisted of classical psychometrics; the 12-item instrument was piloted in a sample of 265 CRNAs. Phase II consisted of qualitative analysis to provide feedback on items that did not perform well.ResultsPhase I: Instrument demonstrated good reliability (r = .77). Parametric and nonparametric analysis indicated 6 of 12 items were good fit to measure perception of workload. Phase II: Qualitative analysis resulted in refinement of four items, addition of one item, and elimination of two items.ConclusionsA revised 11-item CWPS was developed.