An Overview of the Anesthesiologist Assistant: What the CRNA Should KnowHeather Baglio, RN, BSN, SRNAJessica Hammond, RN, BSN, SRNA

Objectives• Explain the historical development of the Anesthesiologist

Assistant (AA) profession• Define the scope and standards of practice for AAs• Discuss specific legalities of the AAs practice • Discuss the AAs educational background, curricula, program

accreditation, certification and continuing education• Differentiate the role of the CRNA and AA in the healthcare

setting.

HistoryJoachim S. Gravenstein John E.

Steinhaus

Perry P. Volpitto

Facts and Figures

WHO ARE THEY?? HOW MANY ARE THERE??

By the Numbers…

In the Workforce

Anesthesiologist and ResidentsCRNAAA

ACT Model

Anesthesiologist

Resident Physician CRNA AA

Educational Background

Admission Requirements

• Bachelor’s degree• Science and math pre-requisites

•MCAT/GRE

• Clinical shadowing experience (8 hrs)

• Personal Interview

Program of Study

•Master’s Degree Programs• 24-28 months • 56-132 didactic hours • Clinical hour requirements 2000-2500

hours•Minimum of 600 cases (avg ~ 800) • All sub- specialties of anesthesia

CRNA vs. AAEducation

Accreditation and Certification

Governing Entities/Professional Organizations

Scope

Legalities Supervision Prescriptive Authority

Anesthesiologist to AA Ratio

Location of Practice

Supervision and Practice Jurisdiction

CRNA AA

Patient Safety: What the Literature Says…

Evidence Supporting AAs

• University Hospital Quality Assurance

• Kentucky Legislative Research Commission

Evidence Supporting CRNAs

• Dulisse & Cromwell (2010)

• Needleman & Minnick (2009)

• Pine, Holt & Lou (2003)

• Simonson, Ahern & Hendryx (2007)

“Opinions have caused more ills than the plague or earthquakes on

this little globe of ours.”-Voltaire

The Future

References• The American Academy of Anesthesiologist Assistants. (2012). Retrieved from http://www.anesthetist.org• American Academy of Anesthesiologist Assistants. (2006, March 31). Statement on the anesthesia care team model.

Retrieved from http://www.anesthetist.org/practicestatements/ACT_Position_Statement.pdf• American Academy of Anesthesiologist Assistants. (n.d.) AAAA statement on clinical doctorate degrees. Retrieved from

http://www.anesthetist.org/practicestatements/Statement_on_Clinical_Doctorate_Degrees.pdf• American Academy of Anesthesiologist Assistants. (2011, February). Comparison of AAs and CRNAs education and practice.

Retrieved from http://www.anesthetist.org/lobby/Comparison_of_AAs_and_CRNAs_Education.pdf• American Association of Nurse Anesthetists (2012). Anesthesia assistant tool kit. Retrieved from http://www.aana.com• Berry, A.J., Odom, S.H. (2003). Assuring competency of anesthesiologist assistants: Education program accreditation and

graduate certification. ASA Newsletter, 67(3), 9-10. Retrieved from http://www.asahq.org/For-Members/Publications-and-Research/Periodicals/ASA-Newsletter.aspx?year=2012&ypp=5

• Case Western Reserve University. (2010). Anesthesia program: Program overview. Retrieved from http://casemed.case.edu/anesthesiaprogram/program/

• Commission on Accreditation of Allied Health Education Programs. (n.d.) Anesthesiologist assistant. Retrieved from http://www.caahep.org/Content.aspx?ID=2

• Commission on Accreditation of Allied Health Education Programs. (2004). Standards and guidelines for the accreditation of educational programs in anesthesiologist assistant. Retrieved from http://www.anesthesiaprogram.com/pdfs/AA_Standards.pdf

• Daugherty, L., Fonseca R., Kumar, K.B., Michaud, P. (2010). An analysis of the labor markets for anesthesiology. Santa Monica, CA: RAND Corporation. Retrieved from http://www.rand.org

• Dulisse, B., & Cromwell, J. (2010). No harm found when nurse anesthetists work without supervision by physicians. Health Affairs, 29(8), 1469-1475.

• doi: 10.1377/hlthaff.2008.0966• Emory University. (2013). Master of science program in anesthesiology. Retrieved from http://med.emory.edu/aa_program/• Georgia Association of Nurse Anesthetists. (2012). Fact sheet about AAs. Retrieved from http://www.gana.org• Gravenstein, J.S., Steinhaus, J.E., & Volpitto, P.P. (1970). Analysis of manpower in anesthesiology. Anesthesiology, 33(3), 350-

357.• Gunn, I.P. (2000). Rural health care and the nurse anesthetist. CRNA, 11(2), 77-86. doi:10.1053/CRNA.2000.8004 • Institute of Medicine. (2011, June). Relieving pain in America: A blueprint for transforming prevention, care, education, and

research (Report Brief). Retrieved from http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research/Report-Brief.aspx

References• Legislative Research Commission. (2007, February). A study of anesthesiologist assistants (Research Report No. 337). Retrieved from

https://www.asahq.org/For-Members/Advocacy/State-Legislative-and-Regulatory-Issues/~/media/For%20Members/Advocacy/State%20Issues/AA%20Study%20Report%20337.ashx

• Mackey, D.C. (2003). Anesthesiologist assistants: A new direction for the anesthesia care team begins to accelerate (finally!). ASA Newsletter, 67(3), 4. Retrieved from http://www.asahq.org/For-Members/Publications-and-Research/Periodicals/ASA-Newsletter.aspx?year=2012&ypp=5

• Nagelhout, J. J. & Zaglaniczny, K. L. (Eds.). (2009). Nurse Anesthesia (4th Ed.). Philadelphia: Saunders.• National Commission for Certification of Anesthesiologist Assistant. (n.d.). National Commission for Certification of Anesthesiologist

Assistant. Retrieved from http://www.aa-nccaa.org• Needleman, J., Minnick, A.F. (2009). Anesthesia provider model, hospital resources, and maternal outcomes. Health Services Research,

44(2), 464-482. doi:10.1111/j.1475-6773.2008.00919.x• Nova Southeastern University. (n.d.) Anesthesiologist assistant: Program overview. Retrieved from

http://www.nova.edu/chcs/healthsciences/anesthesia/fort_lauderdale/index.html• Pine, M., Holt, K.D., Lou, Y.B. (2003). Surgical mortality and type of anesthesia provider. AANA Journal, 71(2), 109-116. Retrieved from

http://ezproxy.ycp.edu:8000/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2003084684&site=ehost-live&scope=site

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• Simonson, D.C., Ahern, M.M., Hendryx, M.S. (2007). Anesthesia staffing and anesthetic complications during cesarean delivery. Nursing Research, 56(1), 9-17. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.ycp.edu:8000/sp-3.7.1b/ovidweb.cgi?&S=LNINFPGLJEDDLFKANCPKIDFBNPMKAA00&Link+Set=S.sh.18.19.23.27%7c1%7csl_10

• South University. (2013). Anesthesiologist assistant program. Retrieved from http://www.southuniversity.edu/nursing-and-health-professions-programs/anesthesiologist-assistant-programs/history.aspx

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