Using Evidence-Based Best Practices of Simulation, Checklists, Deliberate Practice, and Debriefing to Develop and...

The 2011 Institute of Medicine report on the future of nursing recommended that nurses practice to the full extent of their education and training. Nurse anesthetists in certain regions of the country have been unable to maintain regional anesthesia skills because of anesthesia practice models. Factors including increased patient loads, economic motivators, and desire to maintain skill sets are driving evolution of the anesthesia practice model. In many practices, Certified Registered Nurse Anesthetists (CRNAs) now have the opportunity to expand their practice scope to include regional anesthesia. This has created the need for a pathway to rapidly develop or augment skills for CRNAs who have not been performing regional anesthesia. Well-designed and facilitated simulation methods can be effective for teaching and evaluating clinical skills with incorporation of rigorous assessment instruments to ensure consistency in training outcomes. The purpose of this quality improvement project was to determine the effectiveness of a blended-learning regional anesthesia training curriculum on improving CRNA knowledge, skill, and attitude in regional anesthesia administration as part of a clinical credentialing pathway. Forty-nine CRNAs completed all course components, including meeting all skill training thresholds through deliberate practice and use of validated checklists. Knowledge and confidence levels demonstrated significant gains.