Rural nurse anesthesia practice: a pilot study

Certified Registered Nurse Anesthetists (CRNAs) have been identified as the predominant anesthesia providers in rural areas; however, little information is available about the types of services provided by rural CRNAs. The purposes of this study were to pilot test the Nurse Anesthesia Rural Practice Inventory (NARPI); determine whether CRNAs can provide the requested data; and provide data about characteristics of rural nurse anesthesia practice. The NARPI is a newly developed, self-administered questionnaire containing 39 items related to anesthesia practice. The survey was mailed to a stratified convenience sample of 146 actively practicing CRNAs living in rural areas. Of the 33 surveys returned (23%), 28 were usable for data analysis with descriptive statistics. The findings revealed that rural CRNAs provide a broad range of anesthesia and anesthesia-related services within and outside the operating room and support the American Association of Nurse Anesthetists' statement that CRNAs are the predominant anesthesia providers in rural areas. Significant differences were found in the employment settings of independent and medically directed CRNAs, the availability of certain anesthetic agents and monitoring devices, and the representation of surgical specialists based on community and hospital size. The NARPI has the potential to provide needed information about rural anesthesia practice in future studies.