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Nurse Anesthetists Give Safe Care Without Supervision

Study finds no increased risk of death or complications when nurse anesthetists work alone

TUESDAY, Aug. 3 (HealthDay News) -- Certified registered nurse anesthetists providing anesthesia services without supervision by a physician do not put patients at increased risk of death or complications, according to research published in the August issue of Health Affairs.

Brian Dulisse, Ph.D., and Jerry Cromwell, Ph.D., of the Research Triangle Institute in Waltham, Mass., analyzed Medicare data from 1999 to 2005 for 481,440 hospitalizations in states that have opted out or not opted out of the Centers for Medicare and Medicaid Services (CMS) requirement that nurse anesthetists be supervised by a surgeon or anesthesiologist during the provision of anesthesia.

The researchers found that, by 2005, 21 percent of surgeries in opt-out states and 10 percent in non-opt-out states used nurse anesthetists without anesthesiologist supervision, compared to 17.6 and 7.0 percent, respectively, in 1999. The researchers found no significant increase in the odds of patient death or complications in the states that had opted out of the CMS supervision requirement, nor were there significant differences in patient outcomes for either the certified registered nurse anesthetists working without anesthesiologist supervision, anesthesiologists working alone, or the two providers working together.

"Based on our findings, we recommend that CMS allow certified registered nurse anesthetists in every state to work without the supervision of a surgeon or anesthesiologist," the authors write.

The American Association of Nurse Anesthetists funded the research.

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