A second California hospital is in the spotlight for issues related to certified registered nurse anesthetists care provision, The Modesto Bee reported June 24.
Modesto, Calif.-based Stanislaus Surgical Hospital was found to be out of compliance with certain Medicare conditions of participation following a survey from the California Public Health Department after reports of patient harm. The hospital was cited for issues including handling patient emergencies following surgeries, infection prevention, sterilization processes, governance and use of CRNAs in place of anesthesiologists.
Dozens of CRNAs have been laid off at the hospital and hundreds of surgeries have been canceled or rescheduled, according to the Bee.
Earlier this month, Modesto-based Doctors Medical Center was cited for immediate jeopardy by CMS for using CRNAs to sedate and monitor surgical patients. The hospital has been canceling and rescheduling dozens of procedures as the California Department of Public Health investigates complaints. The CRNAs were sent home and cannot return to work until the hospital submits its corrective plan.
The American Association of Nurse Anesthesiology opposes the citations related to CRNAs.
"For the past 15 years, CRNAs have been recognized as autonomous providers of anesthesia services and do not require physician supervision as a condition of Medicare participation," a spokesperson for the American Association of Nurse Anesthesiology said in a statement shared with Becker's. "The safety of CRNA practice has long been established and documented by evidence-based, peer-reviewed studies. Any attempt to discredit the safety of CRNA care is politically motivated fear mongering.
The spokesperson added that CRNAs provide anesthesia services in rural America and work with vulnerable populations.
"Healthcare facility bylaws should recognize CRNAs as autonomous providers for the delivery of anesthesia care and medications," the spokesperson added. "Eliminating unnecessary duplication of services or administrative signoffs reduces delays in delivering care and has been proven to improve anesthesia service availability across the facility without increasing costs."
According to the Modesto Bee, the California Society of Anesthesiologists published an alert June 11 over concerns for patient safety at both hospitals.The society said that the Stanislaus survey found CRNAs were making questionable decisions in prescribing drugs, sloppy paperwork and improper communication about what drugs were given to patients. It also found that CRNAs were given full prescriptive and diagnostic authority at the hospital.
According to the Bee, the California Association of Nurse Anesthesiology has criticized the survey, saying that there's been a larger movement of physician groups to "discredit CRNAs and take a larger portion of business back from them," the report said.