www.anes.upmc.edu/anesnews
The
Year in Review
Key Events in the University of Pittsburgh Nurse Anesthesia Program 2001-2002
Human Simulation Center Construction and Grand Opening
The University of Pittsburgh Nurse Anesthesia
Program Human Simulation Program improved dramatically over the past year
with the construction of the Human Simulation Lab in the School of Nursing.
Located on the second floor adjacent to the School of Nursing Skills Lab,
the Simulation Lab is a state-of-the-art facility designed to facilitate
'full context' simulation programs. The educational approach is to have
learning occur in an environment that is as close as possible to reality
in order to promote learning.
The lab contains the MPL/Laerdal SimMan Human Simulator, an Ohmeda Anesthesia
Gas Machine, anesthesia cart, emergency cart, malignant hyperthermia (MH)
cart, OR supplies, critical care supplies, gas supply, vacuum, OR lights,
intercom, and alarm systems. The lab has full audiovisual capability with
two active cameras, audio and video mixers, monitor, and videocassette
recorder.
Over the past seven years, the Nurse
Anesthesia Program faculty has worked closely with Dr. John Schaefer,
director of the University of Pittsburgh Human Simulation Center and the
Winter Institute for Simulation and Education and Research (WISER). The
goal has been to offer nurse anesthesia students a multi-tiered program
in human simulation. Educational programs currently offered include Preparation
for Clinical Practice (first-year anesthesia students), Crisis Management
Team Training (second-year anesthesia students and residents), Trauma
Call (second-year anesthesia students), Anesthesia Crisis Resource Management
(second-year anesthesia students), undergraduate nursing Critical Care
Course, undergraduate nursing Transition to Clinical Practice, and the
Nurse Anesthesia Program Summer Anesthesia Seminar.
Working within the Sim Lab and with a human simulator means that trainees
must suspend their disbelief long enough to forget that the environment
and patient are not real. It isn't difficult when the "patient"
speaks (from an embedded microphone), exhales carbon dioxide, produces
heart tones and pulses, and generates EKG output, bowel sounds, and breath
sounds (both normal and abnormal). Computerized controls and software
allow simulation of tongue edema, laryngospasm, airway obstruction, and
various cardiac arrhythmias. Students are videotaped as they perform in
a given scenario. They then undergo debriefing and often receive a short
lecture on the key points behind the event. Students not actually simulating
may view the events from one of several multimedia classrooms.
| Human Simulation Anesthesia providers involved in daily clinical care must rapidly assess and interview patients in a system that places increasing emphasis on speed, productivity, and efficiency. Anesthesia Crisis Resource Management (ACRM), developed by Dr. David Gaba in the early 1990s, is now an accepted component of many nurse anesthesia and anesthesiology program curricula. The theory is based on simulation work developed in the military and industry, and parallels Crew Resource Management that has been widely adopted in the aviation industry. Cutting-edge nurse anesthesia educational efforts now offer a variety of courses to assist students in the development of critical-event management skills for high-intensity, low-frequency anesthetic situations. Key to the implementation of ACRM courses is the use of high-fidelity human-simulation devices. Along with a simulated anesthetic environment, these realistic mannequins allow trainees to develop ACRM skills in a low-risk setting. |
Community Outreach
Efforts: East Hills and Milliones Schools ‘Go’ to the OR
The purpose of these projects was to introduce elementary and middle school
students, grades K-8, to the operating room environment, with particular
emphasis on the role of the nurse anesthetist. The project was initiated
by Ms. Sandy Sell CRNA, MSN in 2001 and was first presented at East Hills
Elementary. Second-year nurse anesthesia students developed and implemented
a daylong program that included demonstration of an actual OR event to
every class. Ms. Loren Pulliam CRNA, MSN, and Ms. Ella Thomas CRNA, MS
also assisted with the endeavor. The School of Nursing SimMan Human Simulator,
an anesthesia gas machine, OR table, surgical equipment, and a variety
of other educational aids were transported to the school for this two-day
event. A videotape was then completed and submitted to the AANA for the
2001 Public Relations contest.
Because of the success of this program, it was continued for a second
year at Milliones Middle School in the Hill District. Because UPMC is
closely partnered with Milliones, a collaborative agreement was reached
with Dr. Duncan and Ms. Ruthie King to assist with the event. Ms. Sell
again organized the two-day event, with the help of senior students who
assembled the many educational modules. The ‘OR’ was arranged,
and the middle school children learned about the process of anesthesia
and the roles of various member of the surgical team, again emphasizing
the role of the nurse anesthetist. Channel 11 News covered the event and
aired a segment on the evening news. The Pittsburgh Post Gazette
is planning a feature article to highlight this outstanding effort.
Certification Examination Performance Remains Outstanding
We are very pleased to report on the University
of Pittsburgh Nurse Anesthesia Program Class of 2001 National Certification
Examination results. A total of 26 students graduated from the Nurse Anesthesia
Program on December 15, 2001. Certification of Graduation forms were faxed
to the Council on Certification of Nurse Anesthetists on December 17,
and all students sat for the national certification examination between
1/8/02 and 2/19/02. The exam is computer-adapted and is based on a scaled
score, with a top score of 600 and a minimum pass level set at 450. The
test is a maximum of 3 hours in length, and candidates answer between
90 and 160 items, depending on performance. One hundred percent of our
graduates (26/26) passed the examination on the first attempt, and all
26 answered the minimum 90 items. We will not have the official report
of this exam period until August. However, I was able to obtain an interim
report showing our graduates’ scores, and I can relate our Programs’
scores to national averages for the previous two six-month periods. The
class scores on the examination were as follows:
University of Pittsburgh Nurse
Anesthesia Program
Class of 2001 National Certification Examination Results
| Mean score | 569.31 |
| Median Score | 579.00 |
| Range | 505.00-600.00 |
| SD | 33.46 |
Nationally the mean scores for first-time test-takers in the previous two six-month periods were 536 and 517, respectively. Pass rates, nationally, for first-time test-takers in the same two periods were 91% and 87%. Not only did our graduates surpass the national average, but eight of our students (31%) achieved a score of 600! This appears to be the best performance on the National Certification Examination in the history of our program. Congratulations to all of our newly certified CRNAs!
Nurse Anesthesia Program
Receives Federal Appropriation Grant for NAREEP Proposal
The Nurse Anesthesia Program received a 100,000 award through the U.S.
Health and Human Services Office for the Advancement of Telehealth for
a project entitled ‘Nurse Anesthesia Rural and Elderly Expansion
Project’ (NAREEP). This project will allow transmission of educational
offerings to students at distant clinical sites. NAREEP is a consortium
in partnership with St. Francis Hospital School of Anesthesia for Nurses/LaRoche
College. The primary aims of the project are:
- To address the national shortage of CRNAs
- To expose students to rural clinical practice
- To expose students to settings with a large elderly population.
Funding is anticipated for Summer 2002 and implementation is scheduled for September 2002.
Nurse Anesthetist Traineeship
Grant Funding at Highest Level in Program History
This year the Nurse Anesthesia Program received $87,700 in funding for
the Nurse Anesthesia Traineeship. The Program has received this critical
funding support for over 15 years and this year’s award is the largest
in the Program’s history. Funds will be used to support students
who have completed a minimum of 12 months of full-time work in the Program.
The grant is administered by the U.S. Department of Health and Human Services
under Title VIII.
Innovations in Education
Grant to Support Simulation Training for Undergraduate Students and RNs
Learning Conscious Sedation
The University of Pittsburgh has awarded an ‘Innovations in Education’
Grant of $17,337 to Ms. Rose Hoffman, RN, MSN, Dr. Leslie Hoffman, RN,
PhD, and Mr. John O’Donnell, CRNA, MSN for their program titled
‘Enhancing Professional Competence through Human Simulation Training.’
Senior undergraduate students will see human-simulation training incorporated
into their Transition to Clinical Practice course. Training will focus
on practice with arrest events commonly encountered by the RN. In addition,
a continuing education program will target improving safety in the area
of conscious sedation provided by RNs.
Nurse Anesthesia Program
Adds Clinical Sites in Baltimore, East Lansing, and Saginaw
In order to meet case requirements in the area of regional anesthesia,
and to provide enrichment experiences, the Nurse Anesthesia Program continues
to expand clinical site opportunities. Additional clinical sites added
this year included R. Adams Cowley Shock Trauma Center in Baltimore, MD;
Sparrow Health System in East Lansing, MI; and Covenant Medical Center
in Saginaw, MI. The Shock Trauma and Sparrow Sites were enrichment rotations
with one student rotating to each. The Covenant Medical Center site is
an ongoing rotation with two students per month rotating to the site.
Covenant has agreed to work with the Nurse Anesthesia Program as part
of the NAREEP proposal; distance education offerings will be transmitted
to the site beginning this autumn.
Student Honors, Awards,
and Offices
Sigma Theta Tau, Ruth Perkins Kuehn Award
Michelle Pfenninger
Given to 2002 Outstanding Masters Student
Graduate Student Nursing Organization Officers: 2002-2003
President: Matthew Nypaver, Class of 2003
Vice President: Michael Hackett, Class of 2003
Secretary: Carol Strickler, Class of 2003
Treasurer: Allison Kaestner, Class of 2003
School of Nursing Graduate Professional Student Association Representative
(University)
Beth Holmes, Class of 2003
University of Pittsburgh Nurse Anesthesia Program
Agatha Hodgins Award
William Lees, Class of 2001
Tim Lyons, Class of 2001
Aaron Ostrowski, Class of 2001
University of Pittsburgh Nurse Anesthesia Program
“Above and Beyond” Service Award
Rachel Gray, Class of 2001
Drew Hicks, Class of 2001
Fran Higgins, Class of 2001
American Association of Nurse Anesthetists (AANA)
Student Researcher Award
Shelly Hood, Class of 2001
Jeanne Gordon, Class of 2001
University of Pittsburgh Nurse Anesthesia Program
Susan Nath Bywaters Endowment Award
Christopher Youst, Class of 2001
Pennsylvania Association of Nurse Anesthetists (PANA)
Outstanding Anesthesia Student of the Year
Tim Lyons, Class of 2001
University of Pittsburgh School of Nursing
Patricia P. Lynch Scholarship
Tim Lyons, Class of 2001
University of Pittsburgh School of Nursing
Dorothy Drake Brooks Endowment
Stephen Vetovich, Class of 2003
Presented at Convocation, September 10, 2001
American Association of Nurse Anesthetists (AANA)
Joyce E. Kelly Scholarship
Tim Lyons, Class of 2001
Presented at the AANA Annual Meeting in San Francisco, August 2001
American Association of Critical Care Nurses Scholarships:
Ngocha Dang, Class of 2002
Kelley Mowry, Class of 2003
Bonita Keaveny, Class of 2003
Nursing Foundation of Pennsylvania
Pauline S. Thompson Clinical Research Grant
Allyn Miller, Class of 2002
Representative to PANA Board of Trustees (2001-2002)
Dennis Phillips, Class of 2002
Graduate and Professional Student Association (GPSA) Representative (University)
- 2001
Allyn Miller, Class of 2002
Graduate Student Nursing Organization Officers: 2001-2002
President: Jerry Ciancione, Class of 2002
Vice President: Amy Garrett, Class of 2002
Secretary: Joel Tompkins, Class of 2002
Treasurer: Michelle Pfenninger, Class of 2002
Faculty Honors and Awards
Lucy Kelly Faculty Leadership Award 2002-2005
Presented at 2002 Alumni Day
John M. O’Donnell, CRNA, MSN
Director, Nurse Anesthesia Program
American Association of Nurse Anesthetists (AANA)
Outstanding Clinical Instructor of the Year
Elaine Kasha, CRNA, BSEd
CRNA Senior Clinician and Student Specialty Coordinator, UPMC Presbyterian
Pennsylvania Association of Nurse Anesthetists
(PANA) Awards
PANA Outstanding Didactic Instructor of the Year
John O’Donnell, CRNA, MSN
Director, Nurse Anesthesia Program
PANA Outstanding Clinical Instructor of the Year
Helen DeFranco, CRNA, BSN
CRNA Assistant Coordinator, UPMC Presbyterian
PANA Outstanding Clinician of the Year
Sandra Sell, CRNA, MSN
Instructor, Nurse Anesthesia Program
PANA Hilda Solomon Memorial Award
John O’Donnell, CRNA, MSN
Director, Nurse Anesthesia Program
Publications by faculty, students, alumni,
2001-2002
Bernardo LM, Gardner MJ, Seibel K. Playground injuries
in children: A review and Pennsylvania trauma center experience. Journal
of the Society of Pediatric Nurses. 2001; 6(1):11-20.
Lyons T. Herbal medications and possible anesthetic interactions.
Journal of American Association of Nurse Anesthetists. 2002;
70(1):47-52
O’Donnell JM, Sell S, Goode J, Rauso L. Case study:
anesthesia for port wine stain: Anesthetic considerations and psychosocial
implications. Journal of American Association of Nurse Anesthetists.
2001; 69(3):206-211.
O’Donnell JM. Issues in anesthesia patient safety:
What they don’t tell you can hurt. American Association of Nurse
Anesthetists 68th Annual Meeting. Summaries of Professional Sessions (abstract).
San Francisco, CA 2001:25.
Weir JW, Ciancione J, O’Donnell JM. Living related
kidney transplant in a 15-year-old patient with type I hyperoxaluria.
Journal of American Association of Nurse Anesthetists. 2002;
70(3):107-110.