Evidence-Based Policy Toolkit Supporting Full Practice Authority for Veterans Affairs Nurse Anesthetists

Abstract

Problem: The Department of Veterans Affairs (VA) Office of Inspector General’s (VA/OIG) (2017) audit of the Veterans Health Administration (VHA) for the fiscal year 2015 determined approximately 80% of newly enrolled veterans seeking care waited more than 30 days, and 53% of newly enrolled veterans seeking care finished their first appointment greater than 30 days over the established eligibility date. To address veteran’s access to care issues, the VA finalized a rule, RIN 2900-AP44, granting full practice authority to three roles of the VA’s advanced practice registered nurses (APRN) but excluded certified registered nurse anesthetists (CRNAs) (VA/OPA, 2016). Purpose: The purpose of implementing this evidence-based health policy toolkit was to provide resources on how to amend the current rule, RIN 2900-AP44, to include CRNAs. Methods: The health policy toolkit along with the evaluation survey (Appendix F) was implemented via SurveyMonkey. Data was also collected via SurveyMonkey. Results: The survey revealed (Appendix G, Figure 4) most participants, 83.3%, strongly agree granting CRNAs full practice authority will decrease delays in patient access to anesthesia care in the VA vs. 16.7% who strongly disagree. The survey (Appendix G, Figure 10) also revealed 83.3% of participants strongly agree and 16.7% agree the health policy toolkit is needed and will likely be supported by a vast majority of VA CRNAs in Maryland. Conclusion: Data analysis demonstrates there is a need for the health policy toolkit, and granting CRNAs full practice authority would decrease delays in patient access to anesthesia care in the VA.