Examining Certified Registered Nurse Anesthetists’ Perspective on the Utilization of Regional Anesthesia in Outpatient Orthopedic Surgery

PURPOSE: The purpose of this study was to qualitatively examine the experiences and perspectives of CRNAs surrounding the utilization of regional anesthesia in outpatient orthopedic surgery. DESIGN: A descriptive qualitative design was utilized. METHODS: Study participants described their current practices and experiences with regional anesthesia utilization in the outpatient orthopedic surgery setting in individual interviews using a semi-structured interview guide. RESULTS: Among the study participants (N=14), four key themes describing factors that promote CRNAs' utilization of regional anesthesia for outpatient orthopedic surgery emerged: (1) employment selection, (2) institutional factors, (3) practice variation, and (4) policy change. CONCLUSIONS: Overall, CRNAs felt strongly about implementing regional anesthesia techniques in this patient population due to consistent experiences with its positive impact on patient outcomes. CRNAs expressed the desire to perform regional anesthesia, allowing them to practice to the full scope of their education and training, which ultimately impacted their choice of employment. However, there are several barriers on an institutional, organizational, and systemic level that prevent the universal administration of regional anesthesia by CRNAs, leading to practice variations that inhibit equitable, efficient care delivery. CLINICAL IMPLICATIONS: This study highlights the importance of the universal utilization of regional anesthesia by CRNAs and the necessity for advocacy efforts to alter unnecessary restrictive policies and barriers, ultimately improving equity in healthcare.