News – PARK RIDGE, Ill. (AANA)—Leaders of the American Association of Nurse Anesthesiology (AANA) congratulated Shereef Elnahal, MD, on his confirmation as the U.S. Department of Veterans Affairs (VA) Undersecretary of Health and pledged the continued support of the ‘AANA at the VA to ensure that the nation’s veterans receive prompt, expert, and quality care.
In an Aug. 1 letter to the Undersecretary, AANA CEO Bill Bruce, MBA, CAE, emphasized the critical role that Certified Registered Nurse Anesthetists (CRNAs) play in the VA healthcare system. Bruce requested a meeting with the new Undersecretary to continue AANA’s discussions with the agency on the need to permanently expand the full practice authority under the CRNA license to provide medical services. anesthesia to veterans in every state.
Standardizing the most effective anesthesia care delivery models across the country will help ensure veterans receive safe, high-quality care at all VHA facilities, Bruce said. “VHA’s failure to utilize the safest and most effective models of care is causing our veterans to wait too long for the critical care they have earned and deserve.”
“Nurse anesthesiologists are experienced and highly trained anesthesiologists who provide high quality patient care, demonstrated by evidence from decades of scientific research,” Bruce wrote. “More than 1,000 CRNAs are available in the VHA to provide all types of anesthesia care as well as chronic pain management services to veterans.”
“We appreciate the work the agency has already done to protect our country’s veterans, especially during the [COVID-19] public health emergency,” Bruce wrote. The public health emergency “showed the urgent need for healthcare professionals to care for patients and also underscores the important role that CRNAs play in our healthcare system, especially when barriers to workforce practice work are eliminated at the state and federal levels,” he said. .
In April 2020, the VA issued Directive 1899, which allowed medical professionals, including CRNAs, to practice and operate at the peak of their training and state scope of practice. The following fall, the VA issued an interim final rule confirming that VA medical professionals, including CRNAs, may practice within the scope and requirements of their VA employment, notwithstanding any state licensing, registration, certification or other requirements that unduly interfere. with their practice. The regulations also confirm the authority of the VA to establish national standards of practice for healthcare professionals, which will standardize the practice of a healthcare professional at all VA medical facilities.
CRNAs are the primary providers of anesthesia for US military personnel. The ability of CRNAs to provide high quality care, even under the most difficult of circumstances, has been recognized by all branches of the U.S. military. CRNAs have full practice authority in the Army, Navy, and Air Force and are the primary provider of anesthesia in forward surgical teams and in combat support hospitals, where 90% of surgical teams advances are made up of CRNAs.
“We appreciate the recognition by the VA and VHA of the skills and value of CRNAs to healthcare, including the work on Directive 1899 which emphasized the importance of allowing CRNAs to practice to the fullest extent of their training,” Bruce said.
“We strongly applaud the VHA’s decision to remove barriers to care for our country’s veterans, including encouraging facilities to implement full practice authority for CRNAs, to enable them to practice at the top of their scope and training. This decision has allowed the VHA greater flexibility to care for our veterans, in a more efficient and cost-effective way that increases access to care,” he wrote. “Our country’s veterans deserve access to timely, cost-effective, high-quality care within the VA health care system. Removing unnecessary oversight and permanently implementing FPA for CRNAs will improve excellence in healthcare and practice by increasing veterans’ access to safe, high-quality healthcare personnel in the GO.