section epub:type=”chapter” id=”c0010″ role=”doc-chapter”> Sarah Marie Independence Cartwright; Susan M. Andrews Perianesthesia nursing as a specialty introduces the dynamics of perianesthesia nursing, including practice areas, scope, functions, and an introduction to relevant standards. The role of perianesthesia nurses through the entire perianesthesia continuum is discussed including information about nontraditional settings for care and the opportunity for certification in the specialty. certification; practice areas; scope of practice; specialty; role Perianesthesia nursing is a diverse field that encompasses patient care in a variety of settings. Recognition of perianesthesia nursing as a critical care specialty is well established.1 The main goal of the perianesthesia nurse is to provide competent, efficient care to patients and their families who are experiencing an anesthetic event. This care can be given in a traditional care setting, such as a hospital setting, or in a nontraditional care environment, such as a physician’s office. When there is an opportunity for a patient to experience anesthesia—from moderate sedation to general anesthesia—there is an opportunity for a perianesthesia nurse to provide care. The evolution of modern health care practice continues to encourage interprofessional care models and shared clinical focus which includes factors relevant to the practice of perianesthesia nursing. Among these factors are the emphasis on cost containment in health care, declining reimbursement for medical services, the aging and increased acuity level of the population, advances in technology and pharmaceutical therapy, and fast-tracking of patients through the postanesthesia process. The American Society of PeriAnesthesia Nurses (ASPAN) is the professional organization representing the interests of perianesthesia nurses and sets the clinical standards of care in this specialty in the United States and its territories. To define the role of the perianesthesia nurse, ASPAN has published a formal Scope of Perianesthesia Nurse Practice document (Box 2.1) that addresses the core, dimensions, boundaries, and intersections of the perianesthesia nursing practice.2 The members and governing bodies partner to establish practice standards, guidelines, and evidence-based practices to promote safe patient care. These standards encourage competent practice through their use as vetted through peer review processes and member representation. The guidelines define practice issues such as evaluation of patient condition, practice statements for staffing patterns, use of unlicensed care personnel, and overflow of intensive care patients. ASPAN also partners with other nursing professional organizations to establish professional nursing standards advocating for safe conditions for both the patient and the caregiver.2 Scope of Perianesthesia Nursing Practice Scope of Perianesthesia Nursing Practice The American Nurses Association (ANA) Nursing Scope of Practice requires specialty nursing organizations to define their individual scope of practice and to identify the characteristics within their unique specialty.1 The American Society of PeriAnesthesia Nurses (ASPAN), the professional organization for the specialty of perianesthesia[a] nursing, is responsible for defining and establishing the scope of perianesthesia nursing. Evolving professional and societal demands have necessitated a statement clarifying the scope of perianesthesia nursing practice. Given rapid changes in health care delivery, trends, and technologies, the task of defining this scope is complex. This document allows for flexibility in response to emerging issues and technologies in health care delivery and the practice of perianesthesia nursing. The scope of perianesthesia nursing practice involves the cultural, social complexities, developmental and age-specific assessment, diagnosis, intervention, and evaluation, of individuals across the perianesthesia continuum and phases[b] of care. Individuals across the age continuum will have or have had sedation/analgesia and/or anesthesia for surgical, diagnostic, or therapeutic procedures. Perianesthesia practice is systematic, integrative and holistic, and involves clinical judgment and clinical inquiry.[c] ASPAN promotes an environment in which the perianesthesia registered nurse works with an interprofessional health care team to deliver quality care to a diverse population. This scope of practice includes, but is not limited to: The delivery of care includes, but is not limited to, the following environments: The specialty of perianesthesia nursing encompasses the care of the patient and family[e] along the perianesthesia/periprocedural continuum of care—Preanesthesia, Postanesthesia Phase I, Phase II, and Extended Care. Characteristics unique to perianesthesia practice are: Perianesthesia nursing roles include patient care, clinical inquiry, leadership, education, consultation, and advocacy. The specialty practice of perianesthesia nursing is defined through the implementation of specific role functions that are delineated in documents including ASPAN’s PeriAnesthesia Nursing Core Curriculum: Preprocedure, Phase I and Phase II PACU Nursing5 and the 2019-2020 Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements.6 The scope of perianesthesia nursing practice is also regulated by policies and procedures dictated by the individual hospital/facility, state and federal regulatory agencies, and national accreditation organizations. Professional behaviors inherent in perianesthesia practice are the acquisition and application of a specialized body of knowledge and skills, accountability and responsibility, communication, autonomy, and collaborative relationships with others. Resources to support this defined body of knowledge and nursing practice include: ASPAN interacts with other professional groups to advance the delivery of quality care. These can include, but may not be limited to: This scope of perianesthesia nursing practice document defines the specialty practice of perianesthesia nursing. The intent of this document is to conceptualize practice and provide education to practitioners, educators, researchers, and administrators, and to inform other health professions, legislators, and the public about perianesthesia nursing’s unique participation in and contribution to health care. This Scope of Perianesthesia Nursing Practice was reviewed and updated at the October 2019 meeting of the Standards and Guidelines Strategic Work Team in Dallas, Texas.
2: Perianesthesia Nursing as a Specialty
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Perianesthesia Nursing as a Specialty
