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2: Perianesthesia Nursing as a Specialty
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