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1 1 (May 27, 2020)

handle is hein.crs/govdawx0001 and id is 1 raw text is: Researh Sevice Full Practice Authority for VA Registered Nurse Anesthetists (CRNAs) During the COVID-19 Pandemic May 27, 2020 On April 21, 2020, the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) issued guidance to VA medical facilities to allow Certified Registered Nurse Anesthetists (CRNAs) to have full practice authority (maximum breadth of practice allowable for a provider) within the scope of their license to provide anesthetic care. Specifically, it allows CRNAs to practice without physician supervision when licensed in a state that allows such practice. CRNAs are advanced practice registered nurses (APRNs) who have completed postgraduate education and training and have been certified in the provision and managing of anesthesia. This temporary change in policy has once again brought into focus the debate, mainly between the American Society of Anesthesiologists (ASA) and the American Association of Nurse Anesthetists (AANA), about the scope of practice of CRNAs in the provision of anesthesia services at VA medical facilities. Scope of practice refers to requirements for practicing a skill or profession including types of patients or case load and practice guidelines that determine the boundaries within which a physician or other health care professional practices. This Insight briefly reviews the new directive during the COVID- 19 pandemic and, to provide some context, briefly discusses the previous policy debate surrounding CRNAs delivering anesthesia services to veterans. New CRNA Full Practice Authority The April 21 guidance allows VA medical facilities to amend bylaws and rules to permit CRNAs to practice independently if their state license permits independent practice. This full practice authority would be applicable at VA medical facilities located in 18 states that have permanently granted full practice authority, and at least 9 states (as of April 21) that have granted temporary full practice authority during the COVID-19 pandemic and were listed in the VA guidance. These states are listed in Table 1. There are two states (Connecticut and Pennsylvania) that granted this practice authority but were not included in the list of states in the VA guidance. Congressional Research Service https://crsreports.congress.gov IN11408 CRS NStGHT Prepaimed for Mernbeis and Committees o.i C- --q .. . . . . . . . ...----------------------------------------------------------------------------------------------------------------------------------------------------------------------

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