Student Registered Nurse Anesthetists: The Impact of Structured High Fidelity Simulation on Anesthesia Ready Time

Abstract

Introduction: Student registered nurse anesthetists (SRNAs) at a large academic medical center are limited in clinical training experiences owing to the subjective perception by local anesthesia department administrators of decreased oper-ating room efficiency with SRNA involvement. The purpose of this project was to utilize structured high-fidelity simula-tion (HFS) to increase basic skill proficiency in SRNAs and evaluate the impact of the simulation within the first month of clinical training.Methods: Utilizing the Iowa Model of Evidence-Based Practice to Promote Quality Care, a 5-week structured HFS program was inserted into the nurse anesthesia curriculum before the SRNAs’ first clinical rotation. The program pro-moted basic anesthesia skill proficiency through the assimilation of previously taught and tested technical skills. In-room times and anesthesia ready times of all SRNA cases involving general anesthesia with the placement of an endotrache-al tube during September 2012 and 2013 were compiled by use of retrospective chart review. Using the calculation of elapsed time between in-room time and anesthesia ready time (IRTART), the clinical performance of 2 consecutive classes of SRNAs was compared, one with structured HFS training and one without.Results: The mean IRTART for both groups was similar at 20 minutes with a standard deviation of 10 minutes. The IRTARTs from both groups were within the institution’s operative norm.Conclusion: Structured HFS did not impact the anesthesia ready time of new-to-practice SRNAs. However, the in-formation collected during implementation of HFS and data analysis can be used to develop future avenues to improve current processes for structured HFS and clinical training opportunities.