PURPOSE: This study was done to identify job tasks and task elements of Korean nurse anesthetists according to type of medical institution. METHODS: A job task scale which consisted of 9 job tasks and 40 task elements was developed. Data were collected from December, 2009 to February, 2010 from 182 nurse anesthetists who were working in medical institutions (response rate: 75.8%). RESULTS: Forty-eight percent of nurse anesthetists were independent from anesthesiologists in anesthetic practice. Preanesthetic nursing assessment was much more frequent in small hospitals than in general hospitals (p<.05), and anesthetic nursing intervention, administering the anesthetics, monitoring the patient's status during anesthesia, and provision of safety and compliance with anesthetic ethics were much more frequent in general hospitals than medical centers (p<.001). There were no differences among the medical institutions for job tasks in post-anesthetic nursing interventions (p=.229), administering anesthetics (p=.354) and monitoring patients' status during anesthesia (p=.099), providing safe anesthetic environment (p=.896), and management of ancillary personnel/equipment (p=.617). CONCLUSION: Results indicate that nurse anesthetists contribute significantly to anesthetic practice in small hospitals and general hospitals. Therefore, it recommended that nursing leaders make efforts to enact legal nurse anesthetist-related policies for safe and high quality anesthetic nursing care.
Anesthesia ; Anesthetics ; Compliance ; Hospitals, General ; Humans ; Job Description ; Nurse Anesthetists ; Nurse Practitioners ; Nursing Assessment ; Nursing Care

PURPOSE: This descriptive study was conducted to project the number of nurse anesthetists needed in hospital settings, up to the year 2015. METHOD: Necessary data and information were collected from various funded reports, professional literature, web sites and personal visits to national and private institutions. The number of nurse anesthetists needed was projected after considering the total number of cases requiring anesthesia including deliveries, workload ratio for caesarean section to total number of deliveries, and percent of deliveries requiring and anesthesia. RESULT: The projected number of nurse anesthetists needed for hospital settings are as follows: 1. The number of registered anesthesia personnel in Korea in 2002 was 2,481 anesthesiologists and 543 nurse anesthetists but only 60%of anesthesiologists and 30% of nurse anesthetists (147) were actually practicing in the field of surgery. 2. By the year 2015, the total number of projected nurse anesthetists needed in hospital settings will be between 214 and 265. CONCLUSION: In order to match the supply to the need, the professional organizations should direct efforts towards enacting legislation. Educational systems should identify strategies to initiating an adequate number of nurse anesthetist programs at the master's level as well as standardizing curriculums across programs.
Anesthesia ; Cesarean Section ; Curriculum ; Female ; Financial Management ; Humans ; Korea* ; Nurse Anesthetists* ; Pregnancy ; Societies

BACKGROUND/AIMS: The use of moderate to deep sedation for gastrointestinal endoscopic procedures has increased in Europe considerably. Because this level of sedation is a risky medical procedure, a number of international guidelines have been developed. This survey aims to review if, and if so which, quality aspects have been included in new sedation practices when compared to traditional uncontrolled sedation practices. METHODS: A questionnaire was sent to the National Associations of Nurse Anesthetists in Europe and the National Delegates of the European Section and Board of Anaesthesiology from January 2012 to August 2012. RESULTS: Huge variation in practices for moderate to deep sedation were identified between and within European countries in terms of safety, type of practitioners, responsibilities, monitoring, informed consent, patient satisfaction, complication registration, and training requirements. Seventy-five percent of respondents were not familiar with international sedation guidelines. Safe sedation practices (mainly propofol-based moderate to deep sedation) are rapidly gaining popularity. CONCLUSIONS: The risky medical procedure of moderate to deep sedation has become common practice for gastrointestinal endoscopy. Safe sedation practices requiring adequate selection of patients, adequate monitoring, training of sedation practitioners, and adequate after-care, are gaining attention in a field that is in transition from uncontrolled sedation care to controlled sedation care.
Analgesia* ; Deep Sedation ; Endoscopy, Gastrointestinal ; Europe* ; Humans ; Informed Consent ; Nurse Anesthetists ; Patient Safety ; Patient Satisfaction ; Surveys and Questionnaires

PURPOSE: This study attempted to test whether there are differences in the level and hemodynamic side effects (blood pressure, heart rate, O2 saturation), and nausea & vomiting of spinal anesthesia using hyperbaric bupivacaine according to position (supine, lateral, and prone positions) in orthopedic surgery patients who received podiatric surgery under spinal anesthesia. METHODS: This study was conducted with 53 patients who had received orthopedic surgery under spinal anesthesia at I General Hospital. Data were analyzed using SPSS 20.0 through repeated-measures ANOVA, post-hoc test, Chi-test, and Fisher's exact test. RESULTS: The change of position after spinal anesthesia with hyperbaric bupivacaine caused a change in the level of spinal anesthesia (F=12.768, p<.001). However, no difference of blood pressure, heart rate, O2 saturation and nausea and vomiting caused by the change in anesthesia level was observed, and in prone position, drug was administered for the correction of side effects. CONCLUSION: As expected, recognizing that there can be a change in the level of spinal anesthesia after the change of position in surgical patients, nurse anesthetists should monitor their conditions carefully and continuously.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine* ; Heart Rate ; Hemodynamics ; Hospitals, General ; Humans ; Nausea ; Nurse Anesthetists ; Orthopedics ; Prone Position* ; Vomiting

BACKGROUND/AIMS: The efficacy of bispectral index (BIS) monitoring during colonoscopic sedation is debated. We aimed to determine whether BIS monitoring was useful for propofol dose titration, and to evaluate differences in sedative administration between expert and inexperienced medical personnel during colonoscopy procedures that required moderate sedation. METHODS: Between February 2012 and August 2013, 280 consecutive patients scheduled to undergo a screening colonoscopy participated in this study and were randomly allocated to the expert or inexperienced endoscopist group. Each group was further divided into either a BIS or a modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) subgroup. Trained nurses administered combined propofol sedation and monitored sedation using either the BIS or MOAA/S scale. RESULTS: The mean BIS value throughout the procedure was 74.3 +/- 6.7 for all 141 patients in the BIS group. The mean total propofol dose administered in the BIS group was higher than that in the MOAA/S group, independently of the endoscopists' experience level (36.9 +/- 29.6 and 11.3 +/- 20.7, respectively; p < 0.001). The total dose of propofol administered was not significantly different between the inexperienced endoscopist group and the expert endoscopist group, both with and without the use of BIS (p = 0.430 and p = 0.640, respectively). CONCLUSIONS: Compared with monitoring using the MOAA/S score alone, BIS monitoring was not effective for titrating the dose of propofol during colonoscopy, irrespective of colonoscopist experience.
Adult ; Aged ; Anesthetics, Intravenous/*administration & dosage/adverse effects ; *Clinical Competence ; *Colonoscopy ; Conscious Sedation/adverse effects/*nursing ; Consciousness/*drug effects ; *Consciousness Monitors ; Electroencephalography/*instrumentation/*nursing ; Female ; Humans ; Male ; Middle Aged ; *Nurse Anesthetists ; Predictive Value of Tests ; Propofol/*administration & dosage/adverse effects ; Prospective Studies ; Republic of Korea

BACKGROUND: 42 anesthesia-related medico-legal cases, consulted to the Korean Society of Anesthesiologists (KSA) in a recent 2 year period (1994, 11~1996, 10) were analysed. METHOD: Results of the analysis were classified into 11 items. RESULTS: Cases sources were 26 cases from civil court, 2 cases from criminal court, 8 cases from police stations and 6 cases from health centers, and involved surgical departments were obstetric & gynecology (17 cases), general surgery (7), orthopedic surgery (6), and others (12). Operation classification were Cesarean section (14 cases), reduction and fixations (5), gastrectomy (4) and others (19), and anesthesia methods were general anesthesia (36 cases), regional anesthesia (3), and local anesthesia (3). Involved hospitals were university hospitals (15), general hospitals (16) and private clinics (11), and involved anesthesiologists (anesthetists) were certified anesthesiologists (34), nurse anesthetists (3), and others (5). Patient's ages were classified into 0~20 years old (4), 20~40 years old (23), 40~60 years old (13) and over 60 years old (2), and patient's sex ratio was 16 (male) to 26 (female). Outcome of victims were deaths (26 cases), severe brain damages (10) and nerve injuries (6), and autopsy findings were hypoxic brain edema (4 cases), coronary artery diseases (3), and other findings (4). Causes of medico-legal problems were hypoxemia by ventilatory failure (12), pre-existing diseases (4), embolisms followed by operation (2), malignant hyperthermia (1), and uncertain cases (21). CONCLUSION: The most common cause of medico-legal problems was hypoxemia by ventilatory failure.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Anesthesia, Local ; Anoxia ; Autopsy ; Brain ; Brain Edema ; Cesarean Section ; Classification ; Coronary Artery Disease ; Criminals ; Embolism ; Female ; Gastrectomy ; Gynecology ; Hospitals, General ; Hospitals, University ; Humans ; Malignant Hyperthermia ; Middle Aged ; Nurse Anesthetists ; Orthopedics ; Police ; Preexisting Condition Coverage ; Pregnancy ; Sex Ratio