A Narrative, Qualitative Research Study of CRNA Perspectives of Practice Within the Anesthesia Care Team Model.

Abstract

This research focused on the perspectives of certified registered nurse anesthetists on practice within the anesthesia care team (ACT) model. This narrative, qualitative study examined participants' perspectives on the strengths, challenges, conflict resolutions, and any other information they provided about working in the ACT model. The participants drew sharp distinctions between the supervision requirement of the ACT and that of collaboration with a team approach. The participants reported that they enjoyed and supported collaboration and found that the team approach led to efficient patient care while having extra hands to help and minds to problem-solve complicated patient scenarios. They did not believe physician supervision over their practice was necessary and proved burdensome. They further reported that they often relied on collaboration, accommodation, or compromise to resolve decision-making conflicts when they practiced within the ACT. However, several reported avoiding or leaving the ACT care model for independent practice. Participants who left ACTs reported that they were much happier with their profession and would never return to the ACT model. The recommendations from this study include discontinuing supervision of their practice while strengthening collaboration, a change in payment structure for anesthesia services, and reformed hospital credentialing. They believe that these recommendations would facilitate the full scope of practice and work independently to deliver the high-quality anesthesia care they trained for.