Pa. Should Utilize Nurse Anesthetists in COVID-19 Response

Pennsylvania Association of Nurse Anesthetists

FOR IMMEDIATE RELEASE

CONTACT: Kurt Knaus, P: 717-724-2866

E: kurt@ceislermedia.com

Pa. Should Utilize Nurse Anesthetists in COVID-19 Response

Public affairs TV program to spotlight role of nurse anesthetists in pandemic

HARRISBURG (April 17, 2020) --- As the COVID-19 pandemic continues its spread in Pennsylvania, certified registered nurse anesthetists are uniquely qualified to provide care for critically ill patients, according to the Pennsylvania Association of Nurse Anesthetists. Yet, these frontline health-care workers remain an untapped resource for fulfilling critical roles outside the operating room during this crisis.

PANA President Angelarosa DiDonato and PANA Federal Political Director Laura Wiggins outlined the work of CRNAs and the challenges they face during a taping of the statewide public affairs TV program, “Pennsylvania Newsmakers,” which is set to begin airing this weekend.

PHYSICIAN SUPERVISION: Pennsylvania still requires physician supervision of a CRNA. However, under the directive of President Donald Trump, the Centers for Medicare and Medicaid Services removed the national physician supervision requirement and encouraged states to allow CRNAs to practice to the fullest extent of their education and training to best care for patients during this crisis.

States like New York, West Virginia, Maine, Michigan, New Jersey, Arizona and others already have acted to remove barriers, allowing them to better utilize all available health-care providers without risking patient safety. PANA has been urging Gov. Tom Wolf and his administration to lift the requirement in the commonwealth.

“This is a respiratory pandemic,” DiDonato said. “CRNAs often work with patients’ airways and perform intubations and other procedures. Our education and clinical experience make us central to any response. We want to do all we can to help.”

Removing the supervision requirement of CRNAs in Pennsylvania will avail more physicians to provide hands-on care, expand the capacity of both CRNA and physician providers, and augment the state’s health-care system to meet the growing demands of this pandemic.

PERSONAL PROTECTIVE EQUIPMENT: Like other frontline health-care workers, personal protective equipment (PPE) is crucial for CRNAs, and the shortage of some material has been alarming --- especially after guidance came from the federal government that during shortages, any facial covering, even a bandanna, would be better than nothing.

To help protect its members, PANA, which represents more than 3,700 CRNAs and students in Pennsylvania, invested $40,000 to purchase 1,000 masks for CRNAs who need them, or for those who may have been working in facilities where PPE was limited or quantities were diminishing, especially in high-need areas.

The masks, which are being sourced and manufactured in part through Ifft Enterprises in Evans City in western Pennsylvania, have been innovatively designed after extensive review of a variety of mask prototypes used by health- care professionals. The masks are reusable and feature a filter, with three replacements.

Each CRNA must request the mask individually. The manufacturer then ships the masks directly to the CRNA. But PANA is underwriting the full cost --- both manufacturing and shipping.

“We are proud of the work CRNAs are doing to respond to this crisis and remain committed to doing all we can as an association to keep CRNAs healthy and safe so they in turn can keep patients healthy and safe,” Wiggins said.

PROFESSIONAL DESIGNATION: Pennsylvania is one of just two states that fails to formally recognize CRNAs in some form. Because there is no definition for “certified registered nurse anesthetist” under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses, not as CRNAs. That brings logistical and financial burdens, and it continues to inhibit our full response to this health-care pandemic.

In response to COVID-19, many CRNAs want to contribute more in the facilities where they work but can’t. Likewise, hospitals and other health-care institutions want to use CRNAs to their fullest capacity but can’t. Many of these facilities feel restricted by the way the state licenses CRNAs and will not allow nurse anesthetists to provide advanced, critical care services, even though it is within their education, training, clinical experience and scope of practice --- meaning this valuable health-care resource remains untapped during a time of crisis.

There are other challenges as well. Pennsylvania nurse anesthetists who serve in the military must secure designation in another state to provide anesthesia in the armed services. They cannot assist on rapid response teams in states affected by natural disasters because they lack formal credentials. And, after receiving training in Pennsylvania, many nurse anesthetists relocate to states with full credentialing, contributing to the state’s “brain drain.”

Bipartisan measures have been introduced in both chambers to recognize nurse anesthetists as “CRNAs” under Pennsylvania statute, with one bill (S.B. 325), sponsored by Sen. John R. Gordner (R-Columbia), receiving Senate approval last year. The legislation remains under consideration in the House Professional Licensure Committee.

Results of a recent statewide public opinion poll shows that two-thirds (67%) of Pennsylvania voters support professional designation for certified registered nurse anesthetists, including those who identify as Republican (59%), Democrat (75%) and Independent (62%).

“Broad support like this should give lawmakers the confidence they need to advance this measure and finally provide CRNAs with professional designation,” DiDonato said.

“Pennsylvania Newsmakers” is one of the state’s premier politics and public policy television talk shows. The program runs statewide. For more information or to view the program, visit: www.newsmakerstv.com.

For more information about CRNAs in Pennsylvania, visit www.PANAforQualityCare.com or follow along on social media via Twitter at @PANACRNA or on Facebook at www.facebook.com/PANACRNA.

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PANA Letter to Gov. Wolf RE: Authorizing Professional Designation to Facilitate Crisis Response

Pennsylvania Association of Nurse Anesthetists

March 25, 2020

Re: Certified Registered Nurse Anesthetists in Pennsylvania

Hon. Tom Wolf, Governor

Commonwealth of Pennsylvania

Office of the Governor

508 Main Capitol Building

Harrisburg, PA 17120

Dear Gov. Wolf:

On behalf of the Pennsylvania Association of Nurse Anesthetists (PANA), which represents more than 3,700 certified registered nurse anesthetists (CRNAs) and students in Pennsylvania, we want to commend you and your administration for the aggressive actions to slow the spread of the coronavirus (COVID-19) and respond to this pandemic. We fully recognize that this unfolding situation has everyone anxious, and we appreciate your leadership on this issue.

As you know, certified registered nurse anesthetists are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; pain management centers and more. As frontline health-care professionals, we play a crucial role in the state’s response to this pandemic. Unfortunately, the full contribution of CRNAs is being limited.

Putting the Full Extent of CRNA Education and Training to Work

As our health-care system strains to address the demands created by the current crisis, one way to increase the number of health-care providers that can address patient needs is to grant advanced practice nurses, including CRNAs, the ability to practice to the full extent of their education and training. Many of the limits on CRNA practice are not based on any data or research, and CRNAs can safely practice beyond these limits (and often do safely practice in other states). States like New York, West Virginia, Maine and Arizona already have acted to remove barriers, allowing them to better utilize all available health-care providers without risking patient safety.

In Pennsylvania, education and clinical training for certified registered nurse anesthetists is extensive, requiring national board certification. In total, CRNAs ultimately complete approximately 9,000 clinical hours including their intensive care unit clinical experience, anesthesia clinical training and undergraduate nursing clinical experience before board certification as a CRNA. Patient safety data from these states do not differ compared to national statistics. In fact, numerous medical studies show there is no statistical difference in patient outcomes when a nurse anesthetist provides treatment, compared to an anesthesiologist, even for rare and difficult procedures.

We don’t know what demands will be placed on our health-care system in the near future, but freeing providers from unnecessary statutory and regulatory burdens will allow CRNAs to contribute more efficiently to the response.

Authorizing Professional Designation to Facilitate Crisis Response

Pennsylvania remains one of only two states that fails to recognize CRNA professional designation in some form. Because there is no formal definition for “certified registered nurse anesthetist” under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses (RNs). This creates fiscal and logistical challenges that are magnified at times like this.

Pennsylvania ranks among the top draws nationally for CRNAs and students, with 13 highly rated nurse anesthetist programs serving every corner of the commonwealth and helping to sustain one of the largest contingencies of professionals in the country. In times of need, our professionals are in demand to help with crisis response. However, Pennsylvania-based CRNAs cannot be part of response teams in other states that are asking for help simply because our CRNAs lack formal credentials that nearly every other state already recognizes.

Neighboring states like Maryland, Ohio and Virginia, as well as Washington, D.C., all have declared states of emergencies. Because states of emergencies have been declared, Pennsylvania-based CRNAs and other medical licensees are able to work in these states, even if not licensed there. But, we have to practice according to Pennsylvania’s State Board of Nursing requirements, which again only define CRNAs as RNs, limiting our capacity to provide anesthesia as we are trained to do.

Professional designation legislation (S.B. 325) passed the Senate last year but has not yet been taken up by the House. The bill currently sits in the House Professional Licensure Committee. Additionally, a companion bill (H.B. 1064) by Rep. Tarah Toohil (R-Luzerne) has been introduced in the House and remains in committee. These simple professional designation measures would address the current issues that prevents CRNAs from acting in their fullest capacity to help out state and nation at this time of crises.

Other states already are allowing health-care providers to work across state lines. For example, New York Gov. Andrew Cuomo temporarily suspended state licensing laws “to the extent necessary to allow registered nurses, licensed practical nurses, and nurse practitioners licensed and in current good standing in any state in the United States to practice in New York State without civil or criminal penalty related to lack of licensure.” Not only does this allow health-care workers to move to areas that are hardest hit in order to provide care for the patients who need it most, it also greatly expands the possibility of using telehealth, as a nurse in one state would be able to address patient needs in any state. This helps to extend providers’ reach and efficiency, and alleviate demand on local practitioners.

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Our team continues to monitor the situation, relying on state and federal updates, while employing the most effective measures to keep our patients, providers and peers safe and well informed. Like the rest of the country, we are watching with deep concern as the COVID-19 pandemic continues to affect a world already brought to a standstill. Projections show the impact getting worse before things get better. We stand ready to do all we can in partnership with your administration to respond effectively to this crisis. We urge your support for these measures. Thank you.

SINCERELY,

Angelarosa DiDonato, DNP, CRNA

President

Pennsylvania Association of Nurse Anesthetists

Jessica Poole, DNAP, MHS, CRNA

Director, State Government Affairs

Pennsylvania Association of Nurse Anesthetists

cc: Pennsylvania Health Secretary Dr. Rachel Levine

Nurse Anesthetists in Pa. Ensure Patient Safety, Help to Control Rising Health-care Costs

Pennsylvania Association of Nurse Anesthetists

CONTACT: Kurt Knaus; P: 717-724-2866; E: kurt@ceislermedia.com

Nurse Anesthetists in Pa. Ensure Patient Safety,

Help to Control Rising Health-care Costs

HARRISBURG (Jan. 20, 2020) --- Pennsylvania ranks among the top draws nationally for certified registered nurse anesthetists (CRNAs) and students, with 13 highly rated nurse anesthetist programs serving every corner of the commonwealth and helping to sustain one of the largest contingencies of professionals in the country.

This week marks CRNA Week in Pennsylvania, when patients, hospital administrators, health-care professionals, policy-makers, and others learn more about CRNAs and the work they do to keep patients safe and help reduce the cost of health care. The week-long celebration runs in conjunction with the 21st annual National CRNA Week from Jan. 19 to Jan. 25.

“Surgery and anesthesia can be intimidating,” said Angelarosa G. DiDonato, DNP, CRNA, president of the Pennsylvania Association of Nurse Anesthetists (PANA). “That’s why it’s so important for people to understand the vital role CRNAs play as a patient advocate. We stay with our patients for every heartbeat and every breath, administering their anesthetics and watching over their vital signs. We never leave their side.”

Pennsylvania is recognized as a leader in anesthesia education and training, with 13 programs spread throughout Allegheny, Columbia, Erie, Lackawanna, Lehigh, Montgomery, Philadelphia, Westmoreland and York counties. (For a full list of programs, visit www.PANAforQualityCare.com and click “Resources.”)

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons; pain management centers and more.

The nation’s 54,000 CRNAs and student registered nurse anesthetists safely and cost-effectively provide more than 49 million anesthetics each year. PANA itself represents more than 3,700 CRNAs and students across the state --- one of the largest contingencies in the country.

The role CRNAs play in Pennsylvania’s and the nation’s health-care system is expansive.

CRNAs are the main providers of anesthesia care in rural communities and medically underserved areas, delivering essential health care and preventing gaps in services. CRNAs also are battle-tested, serving on the front lines since World War I as the main providers of anesthesia care to U.S. military personnel in austere combat theaters.

With advanced degrees and a high level of education and clinical experience, CRNAs are able to deliver the same safe, high-quality anesthesia care as other anesthesia professionals but at a lower cost, helping to control the nation’s rising health-care costs.

Because of their training and experience, numerous medical studies show there is no statistical difference in patient outcomes when a nurse anesthetist provides treatment. In fact, these studies by nationally recognized health-care policy and research organizations prove that CRNAs provide high-quality care, even for rare and difficult procedures.

That’s because CRNAs are with the patient throughout the entire procedure. Anesthesiologists, on the other hand, may have several cases to attend to simultaneously, or they may be somewhere else handling another response.

CRNAs provide routine anesthesia care but also quickly respond to patient changes and emergencies during surgical and medical procedures, ensuring patient health and safety.

For more information about certified registered nurse anesthetists in Pennsylvania, visit www.PANAforQualityCare.com or follow along on social media via Twitter at @PANACRNA or on Facebook at www.facebook.com/PANACRNA.

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