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CRNA prescribing practices: the Washington State experience
Louise Kaplan1, Marie-Annette Brown, Dan Simonson
1Department of Nursing Practice and Policy, American Nurses Association, Silver Spring, Maryland, USA. louise.kaplan@ana.org
AANA Journal
|April 9, 2011
Summary
One year after a law change, only 30% of Certified Registered Nurse Anesthetists (CRNAs) in Washington had prescribing authority. Many CRNAs practiced without it, highlighting challenges in adopting new scopes of practice.
Area of Science:
- Nursing Practice
- Pharmacology
- Healthcare Policy
Background:
- Washington State enacted a law in 2005 granting Certified Registered Nurse Anesthetists (CRNAs) authority to prescribe controlled substances.
- One year post-implementation, a significant gap existed between the law's intent and CRNA adoption of prescriptive authority.
Purpose of the Study:
- To describe the prescribing practices of Washington State CRNAs.
- To characterize the workforce and practice attributes of CRNAs in Washington State.
Main Methods:
- A questionnaire survey was distributed in 2006 to CRNAs licensed in Washington.
- The survey targeted CRNAs residing in Washington, Oregon, and Idaho.
Main Results:
- Only 41% of surveyed CRNAs possessed prescriptive authority, with 11% lacking necessary Drug Enforcement Administration (DEA) registration.
- CRNAs without prescriptive authority relied on the Nurse Practice Act's "select, order and administer" provision.
- Among those with prescribing authority, anesthetics were most commonly prescribed (94.7%), followed by NSAIDs (60%) and narcotic analgesics (53.3%).
Conclusions:
- The study identified a low rate of CRNA prescriptive authority adoption and practice one year after legislative changes.
- Barriers to CRNA prescribing and the transition to expanded scopes of practice require further investigation.
- Professional and policy debates surrounding autonomous CRNA prescribing persist.
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