Certified Nurse Anesthetist (CRNA)

West River Health Services • hettinger, nd, us • 4m ago

Assesses and monitors the client pre-operatively, intra- operatively and post- operatively
A pre-anesthetic check list shall be performed before the first case and before each additional case of the day
Always evaluates the client's current mental and physical status
Always identifies any historical adverse re-action(s) to anesthesia
Always reviews anesthetic history to include family's anesthetic history and potential problems
Proactively advocates for customers who should not be anesthetized
Conducts history and physical assessment as per professional standards
Always reviews current diagnosis of the client and proposed surgical procedure
Identifies and documents the client's current medications
Always reviews all pertinent laboratory data and takes appropriate action
Assures informed consent has been obtained from client during interview
Always evaluates the client for major system abnormalities
Always verify allergies, Anesthetic problems, NPO status and other pertinent information
Discusses the proposed anesthetic technique and alternative anesthetic techniques in a calming, patient focused and professional manner
Appropriately discusses the risks and complications associated with Anesthesia, including but not limited to reactions, intubation, oral and dental damage and possible death
Assembles drugs including emergency and routine anesthetic drugs, labeled and dated. Drugs and dosages are weight and age appropriate
Prepares equipment, selecting type of equipment and quantity as per type of procedure, as appropriate for the age and size of the patient, i.e. neonates, pediatrics, adolescents, adults and geriatrics
Prepares an appropriate anesthesia plan of care, as observed by Supervisor/random chart audit
Continues patient oversight through anesthesia discharge
Prepares for and provides anesthesia procedures in remote locations as per established protocols
Utilizes disconnect alarm as per established procedures
Utilizes carefully considered judgment in deciding which monitoring techniques are to be used on each client, based on physical diagnosis, to verify adequate ventilation and circulation. Utilizes ASA standards for basic intra- operative monitoring
Plan of care includes post anesthesia care and completes follow up post op visit and care as needed
Provides individualized pre-medication, meeting each client's unique requirement and the provider’s preference
Client's vital signs and condition upon arrival to the recovery unit using the Par's scoring system
Adheres to appropriate safety precautions during all procedures to minimize the risk of fire, explosion, electrical shock and equipment failure
Documents presence of a nurse anesthetist during the course of the anesthetic
Documents Blood pressure and EKG monitoring on all surgical clients (general, regional and local anesthetics)
Documents the client’s response (acceptance or refusal) to the explanation of the proposed anesthetic
Records Anesthesia plans; utilizes ASA classification, documents appropriate plan and interventions via information system
Completes and accurately documents pertinent information on client's record per WRHS policy/procedures
For the Induction phase always documents: Drugs, dosages and times of administration; technical difficulties during the induction period; and verification of airway control as well as frequency of ventilation in adverse airway situations and Anesthetic technique used
For the Intra-operative phase always documents: client's physiological responses to Anesthesia; monitoring modalities; all intra-operative events/problems; Communications regarding client's concerns to other health care providers; Position changes and pulse verification. Anesthetic techniques and methods of drug administration; total amount of all drugs, fluid/blood loss and replacements
For the Emergence phase always documents: reversal of Anesthetic Agents as needed; Airway management during emergence; Condition of client prior to being transported to the post-Anesthesia care units
PACU Note - Documents either on the anesthetic record or the PACU record depending on the disposition of the patient
Entries are legible
Documents patient events/occurrence reports accurately and completely
Does not use unapproved abbreviations
Documents all charges in an appropriate and timely manner
Reports patient/visitor/employee incidents according to WRHS policy
Immediately responds to code and takes appropriate equipment
Always remains calm in a crisis
Able to diffuse high stress situations
Able to evaluate situations in seconds and respond appropriately. Must be able to effectively interact with others
Demonstrates competence in allaying patient fears
Thoroughly performs machine checks in compliance with FDA recommendations
Adheres to appropriate safety precautions during all procedures to minimize the risk of fire, explosion, electrical shock and equipment failure
The anesthetic machine is always inspected by CRNA according to established guidelines before use. The CRNA assure readiness, availability, cleanliness and working condition of all equipment to be utilized in the administration of the anesthesia care
Documentation on client record always includes verification of that the anesthetic machine and equipment were checked and documents what adjunct equipment is being used for each patient
Orders and tracks all supplies. Evaluates new equipment and supplies and makes recommendations
Promptly reports malfunctioning equipment, or equipment needing repair, to appropriate personnel
Ensures that preventative maintenance is performed according to regulatory requirements. Notifies supervisor immediately if there are lapses
Stocks Rooms - Replaces outdated drugs and supplies in the work area
Attends facility and other departmental meetings, as required. Reads minutes and demonstrates knowledge of content
Delegate’s tasks appropriate to patient condition and team member skills and are flexible to meet unit needs. Anticipates issues and consistently takes appropriate action
Demonstrates problem solving skills with employees, other departments, visitors and others as indicated
Consistently demonstrates leadership and organizational skills that provide for a safe environment for the patient
Consistently promotes teamwork
Provides support and direction to staff to facilitate quality patient care
Consistently demonstrates empathy in interactions with patient/families
Appropriately communicates unit needs regarding equipment/supplies. Reports equipment in disrepair/needing replacement immediately
Manages practice according to AANA standards and recommended practices

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