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2nd Ohio Pharmacy Advocacy Forum

Ohio College of Clinical Pharmacy, Ohio Colleges of Pharmacy
and Council for Ohio Health Care Advocacy
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ZIKA VIRUS

ZIKA VIRUS
Zika virus disease (Zika) is a disease caused by Zika virus that is spread to people primarily through …
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Proposed Bill Would Require Payment …

Proposed Bill Would Require Payment Disclosures to Advanced Practice Nurses and Physician Assistants

A proposed bi…
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Interprofessional Legislative Update

HPU-LogoBy Lori Herf, MA

The Ohio General Assembly has dedicated much of the winter and spring months to budget (HB 59) deliberations. With the new state fiscal year beginning on July 1st, 2013, legislative leaders will focus most of their attention not only on the fiscal operations of the state of Ohio, but also on the many policy changes made as amendments to state budget provisions.

APRNs and Physician Assistants

Language was considered that would have allowed advanced practice nurses and physician assistants to admit patients to hospitals. That provision is now being considered independently of the budget as HB 139.

Pharmacists

A number of pharmacy provisions remain part of the budget as well. One of the provisions would require that Medicaid managed care organiza-tions provide 90 days notice to pharmacies being terminated as a network provider and extends the notice to all types of health care providers. In the case of pharmacies, similarly the budget would require that 90 days advance notice be given regarding the removal of a prescribed drug from the formulary or preferred drug list used by the organization or administrator or any change in the terms governing access to the drug. The amendment that we are opposing in the budget which is HB 59 dealt with remote dispensing.

The amendment would have allowed a pharmacy that is licensed as a terminal distributor of dangerous drugs to use a remote drug dispensing system at a nursing home or residential care facility. The pharmacist would not be required to be physically present where the system is used to dispense the drugs. COHCA has strong concerns regarding this provision and asked legislators to remove the language from the budget bill. The Ohio Senate did remove the language from the substitute version of the bill; however the bill will be amended next week and then be considered by a conference committee that could reinsert the language into the final version of the bill.

Other Bills:

House Bill 44

HEALTH EMERGENCIES (McClain)
To require the Director of Health to develop protocols regarding the authority to administer, deliver, distribute, or dispense drugs during certain public health emergencies. This is currently pending in

House Health and Aging Committee where it has received two hearings.

Requires the Director of Health to develop one or more protocols that authorize certain licensed health professionals to administer, deliver, or distribute drugs during a public health emergency; requires the Director to develop protocols as well that authorize pharmacists and pharmacy interns to dispense limited quantities of dangerous drugs without a prescription or record of a prescription during a public health emergency; and provides that an individual who administers, delivers, distributes or dispenses a drug or dangerous drug in accordance with one or more of those protocols is not liable for, nor subject to civil damages, criminal prosecution, or professional disciplinary action, unless the individual’s acts of omissions constitute willful, wanton misconduct.

House Bill 60

MATERNITY UNITS (Huffman)
To require that rules governing maternity units, newborn care nurseries, and maternity homes include certain provisions pertaining to the authority to make decisions regarding the transfer of patients to other facilities and to specify procedures for granting variances or waivers of any requirement in the rules governing operation of such facilities.

Currently pending in House Health and Aging where it has received two hearings.

The bill codifies an administrative rule that authorizes the Director of Health to grant a variance from or waiver of any of the requirements of rules regarding the operation of a maternity unit, newborn care nursery, or maternity home; requires the Director to adopt rules regarding application forms to be used and procedures to be followed in applying for a variance or waiver; requires the Director to review all applications for variances and waivers and, not later than 90 days after receipt of an application, to determine whether to grant the variance or waiver and notify the applicant of the decision.

House Bill 83

PSYCHOLOGY LAWS (Hackett)
To make 14 major changes to the law that gov-erns the practice of psychology. Heard in the House Health and Aging Committee; reported out of committee; passed the House 96-1; currently pending in the Senate Medicaid, Health and Hu-man Services Committee.

House Bill 94

HEALTH PLANS (Gonzales)
To require a health insuring corporation, public employee benefit plan, or sickness and accident insurer to reimburse a board of health for any services provided to an individual by the board that is covered by a plan issued to the individual by the health insuring corporation, public employee benefit plan, or sickness and accident insurer upon request submitted by the Board of Health.

Currently pending in House Insurance Committee; has received two hearings.

House Bill 123

TELEHEALTH SERVICES (Gonzales, Wachtmann)
Regarding Medicaid and health insurance coverage of telehealth services.

Currently pending in House Health and Aging Committee where it has received two hearings.

The bill authorizes health care insurers to provide coverage of telehealth services provided by health care professionals and facilities, requires the Office of Medical Assistance to adopt rules establishing standards for Medicaid reimbursement of telehealth services provided by health care professionals and facilities; specifies that coverage of a telehealth service applies only if the service involves an immediate and direct interaction with a patient, is medically appropriate and necessary, and is provided by a licensed health care provider or facility; and requires that a health care provider seeking reimbursement for telehealth service maintain documentation of providing the service as part of the patient records the provider maintains.

House Bill 131

TANNING REGULATIONS (Johnson, Stinziano)
To regulate chemical tanning and prohibit tanning facilities from allowing the use of sun lamps by certain individuals under 18 years of age.

Currently pending in House Health and Aging Committee where it has received three hearings.

Prohibits an operator or employee of a tanning facility from allowing an individual under age 18 to use the facility’s fluorescent sun lamp tanning services unless the individual presents a prescription issued by a physician; and requires the State Board of Cosmetology to regulate chemical tanning facilities.

House Bill 139

HOSPITAL ADMISSIONS (Gonzales)
To permit certain advanced practice registered nurses and physician assistants to admit patients to hospitals.

Currently pending in House Health and Aging Committee where it has received two hearings.

Current law allows only physicians, dentists and podiatrists who are members of the medical staff to admit patients to hospitals. The bill would add clinical nurse specialists, certified nurse midwives and certified nurse practitioners who have a standard care arrangement with a physician or podiatrist who is a member of the medical staff. The bill would also allow physician’s assistants, under the supervision, control or direction of a physician or podiatrist who is a member of the medical staff, to admit patients to hospitals. The bill also would require the APRN or PA to notify the collaborating or supervising physician or podiatrist not later than 12 hours after admitting a patient to a hospital.

House Bill 147

MASTECTOMY GUIDANCE (Patmon, Wachtmann)
To require a surgeon performing a mastectomy, lymph node dissection, or lumpectomy in a hospital to guide the patient and provide referrals in accordance with the standards of the National Accreditation Program for Breast Centers and to name this act the Lizzie B. Byrd Act.”

Currently pending in the House Health and Aging Committee where it has had two hearings.

The bill, in addition to the above would require the sur-geon performing a mastectomy or lumpectomy to refer a patient if breast reconstruction is appropriate, and requires the surgeon to offer the patient a preoperative referral to a reconstructive or plastic surgeon in accordance with NAPBC standards.

House Bill 159

DENTAL SERVICES (Hacket, Schuring)
To prohibit a health insurer from establishing a fee schedule for dental providers for services that are not covered by any contract or participating provider agreement between the health insurer and the dental provider.

Currently the bill is pending in the House Insurance Committee where it has had one hearing.

Prohibits a contracting entity from requiring a dental provider to provide services to plan enrollees at a fee set by or subject to approval by the contracting entity unless certain circumstances are met; makes setting or requiring the insurer’s approval of fees for dental services an unfair and deceptive act in the business of insurance unless certain circumstances are met; and makes the offering of a health benefit plan that sets fees for dental services an unfair and deceptive act in the business of insurance unless certain circumstances apply.

House Bill 165

HYPERBARIC TECHNOLOGISTS (Roegner)
Exempts certified hyperbaric technologists from the laws governing the practice of respiratory care.

Currently pending in the House Health and Aging Committee. Has not been heard.

House Bill 170

DRUG OVERDOSES (Johnson, Stinziano)
To provide that a licensed health professional authorized to prescribe naloxone, if acting with reasonable care, may prescribe, administer, dispense or furnish naloxone to a person who is, or a person who is in a position to assist a person who is, apparently experiencing or who is likely to experience an opioid-related overdose without being subject to administrative action or criminal prosecution, to provide that a person who is in a position to assist a person who is apparently experiencing or who is likely to experience an opiod-related overdose is not subject to actions of professional licensing boards, administrative action, or criminal prosecution for a drug offense or practicing medicine without a license if the person acting in good faith, obtains naloxone prescription from a licensed health professional and administers it to a person for an opioid-related overdose, and to provide that peace officers and licensed emergency responders who are acting in good faith are not subject to administrative action or criminal prosecution for a drug offense or practicing medicine without a license for administering naloxone to a person who is apparently experiencing an opioid-related overdose.

Currently pending in the House Health and Aging Committee. It has not yet been heard by the committee.

Senate Bill 4

NEWBORN SCREENINGS (Manning, Oelslager)
To require a pulse oximetry screening for each newborn born in a hospital or freestanding birthing center.

Received two hearings in Senate Medicaid, Health and Human Services Committee, reported out of Committee; passed the Senate 33-0; referred to House Health and Aging Committee where it has received 5 hearings.

Requires hospitals and freestanding birthing centers to conduct a pulse oximetry screening on each newborn (unless a parent objects on religious grounds) for purposes of detecting critical congenital health defects; requires the Director of Health to adopt rules establishing standards and procedures for the pulse oximetry screenings.

Senate Bill 43

CIVIL COMMITMENT (Burke)
Makes a number of changes to the laws governing the civil commitment of and treatment provided to mentally ill persons.

Currently pending in Senate Criminal Justice Committee. It has received one hearing.

Senate Bill 99

CANCER MEDICATIONS (Oelslager, Tavares)
Regarding insurance coverage for rarely administered cancer medications.

Pending in Senate Insurance and Financial Institutions Committee where it has not received a hearing.

Neurosurgery Physician Assistant at Akron Children’s

Combines the Best of Care and Cure

Holly Zeller, PA-C sits down with Julie Tsirambidis, CNP to go over privilege delineation forms at Akron Children’s Hospital.  This is one of their many overlapping moments where NP and PA practice comes together.  Becoming more frequent is this visibility- that NPs and PAs sit side by side with their physician counterparts to enhance patient care.  After years of working in silos, these disciplines agree the time to work together is long overdue.  Hence, the Center for Advanced Practice at Akron Children’s Hospital was formed in April 2011.  The goals are vast, but include the practice and regulatory oversight of APNs and PAs, on boarding programs, and integration with medical staff leadership to name but a few.

Zeller, who is a board certified physician assistant, works in partnership with Dr. Roger Hudgins, director of the Division of Neurosurgery at Children’s Hospital.  When she is not examining patients during office hours, Holly assists Hudgins in the operating room and shares on-call duties with him for after-hours emergencies.  Additionally, on a daily basis, Zeller rounds on all inpatients, formulates plans of care, interprets imaging, triages new patient referrals, and completes various types of different procedures in the NICU, PICU, patient floors and ER.  At the end of each day, all “Mommy Call” questions which have accumulated throughout the day are addressed by calling the parent of the patient back to address their questions. “Every day is a little bit different,” she says.  Zeller, 44, of Richfield,Ohio, is one of now 18 physician assistants (PAs) who work all across Akron Children’s Hospital.  There are over 150 advanced practice providers at Akron Children’s with a director leading the way.  The center actually oversees and brings together Advanced Practice Nurses (CRNA, CNP, and CNS) and Physician Assistants under one umbrella.  The director, Julie Tsirambidis, CNP, truly believes this is the way of the future.  “We have more in common that we have separate.  Coming together to promote our professional needs, despite our regulatory difference truly sets us apart, and brings improved understanding to our patients, families, and hospital staff.”  “Many years ago, MDs and DOs, would not even work together in the same hospital, and see how far they have come- this journey is a similar beginning, in my opinion.” Tsirambidis said.

As part of their master’s degree program, PAs can elect a surgical track that prepares them to work in the operating room.   After college, Zeller worked in the pharmaceutical field before taking a break to stay home with her children.  When she decided to return to work, she wanted a job in the medical field but didn’t want to travel anymore.  She embarked upon graduate school education and completed the PA program.  The PA education is very similar to that of the medical school model.

Zeller initially practiced with the congenital heart surgical team at Rainbow Babies and Children’s Hospital inClevelandbefore joining Akron.  When Dr. Hudgins joined Children’s two years ago, he requested a PA for his team.  He has especially relied on Zeller to share the patient load since the death this summer of the hospital’s only other neurosurgeon, Dr. Henry Bartkowski.  When Dr. Bartkowski became ill, Dr. Hudgins and Zeller formulated a plan to continue the quality care provided to the neurosurgery patients, by trying to split the evening and weekend call, thus allowing the other some “off time.” The two divide and conquer on office days, with each visiting patients and talking with families.  They frequently huddle to compare notes and examine patients’ images and other test results.  Zeller will assist in the OR on surgery days, and often performs the closing procedures.  This teamwork allows Hudgins to dictate this post-operative notes and get ready for the next patient while Zeller finishes the procedures.  “It really becomes a seamless way for getting a lot more work done than you could by yourself, plus the families love her,” Hudgins said

For information, or to join our neurosurgery team, check us out at

https://www.akronchildrens.org/cms/careers/index.html

COHCA On Facebook

Shout out to APRNS……..

Early statistics concerning the GCOAT opioid guidelines video that was sent to prescribers has 486 APRNs having completed watching the video, compared to 2,852 physicians. The dentists are at 629. You might ask prescriber members to look for the e-mail that sent the video to them directly and take the 10-15 minutes to watch it and complete a couple questions.

New Actions to Fight U.S. Opioid Epidemic Announced

The Department of Health and Human Services (HHS) recently announced new actions to combat the U.S. opioid epidemic. Among the actions is a buprenorphine final rule that allows practitioners, who have had a waiver to prescribe buprenorphine for up to 100 patients for a year or more, to obtain a waiver to treat up to 275 patients. Practitioners eligible to obtain the waiver include those who have additional credentialing in addiction medicine or addiction psychiatry from a specialty medical board or professional society, or practice in a qualified setting as identified in the rule.

Other actions include:
• A proposal to eliminate any potential financial incentive for doctors to prescribe opioids based on patient experience survey questions;
• A requirement for Indian Health Service prescribers and pharmacists to check state prescription drug monitoring program databases before prescribing or dispensing opioids for pain;
• The launch of more than a dozen new scientific studies on opioid misuse and pain treatment; and
• Solicitation of feedback to improve and expand prescriber education and training programs.
These new actions build on the HHS Opioid Initiative launched in March 2015. The initiative focuses on three key priorities:
• Improving opioid prescribing practices;
• Expanding access to medication-assisted treatment for opioid use disorder; and
• Increasing the use of naloxone to reverse opioid overdoses.

U.S. Surgeon General Supports Treating Opioid Abuse like a Chronic Disease
While recently visiting a substance abuse treatment center in New York, U.S. Surgeon General Vivek Murthy stated that policymakers, health care providers and the public should treat substance abuse like a chronic illness. Murthy stated that government action or medical intervention alone will not solve the problem, and that people need to understand that addiction is not a bad choice, it’s a chronic illness of the brain that requires the same compassion, skill and urgency that diabetes, heart disease or cancer require. According to Murthy, the stigma surrounding substance abuse and addiction is one of the biggest obstacles preventing deployment of a comprehensive approach.
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2 weeks ago  ·  

Nurses Speak Out in Favor of VA Proposal

—Advance practice nurses don’t need physicians to supervise them, advocates say

Joyce Frieden
News Editor, MedPage Today
WASHINGTON — Advance-practice nurses have the skills and abilities to take good care of patients, and they should be able to practice independently within the Department of Veterans Affairs (VA) medical system, several nursing and military organization spokespeople said at a press briefing here.

"Our veterans are waiting too long to get the healthcare they have earned and they deserve," Juan Quintana, CRNA, president of American Association of Nurse Anesthetists, in Park Ridge, Ill., said at the briefing on Tuesday. "We, as advance practice registered nurses (APRNs) all realize we’re ready and capable [of providing] the services that are necessary for our veterans today. We fully support the proposal by the VA to expand veterans’ access to care by recognizing APRNs to the full extent of their education and skills."

Despite all the VA’s efforts so far, veterans still need better access to care, Quintana said. "In anesthesia, for example, an independent VA assessment indicated that anesthesia services and access to those services was one of the limiting factors to veterans getting surgical care — sometimes [causing veterans to wait] months to get those services," including cardiac procedures and colonoscopies.

The proposed rule, published May 25 in the Federal Register, would allow advance practice nurses working within the VA system to practice at the top of their licenses independent of physician supervision, regardless of what their state’s laws are. The proposal includes nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists (CRNAs).

Quintana noted that CRNAs "have been administering anesthesia for 150 years. We provide services in underserved areas, [rural areas], and at some VAs without anesthesiologist involvement, and in forward surgical teams that provide services to our soldiers in harm’s way. In terms of safety … our studies show we are very safe at what we do."

"Our opposition brings little to no evidence; their arguments go nowhere," he continued. "We have nine different studies done since 2000 that prove that anesthesia done by CRNAs is equal to our anesthesiologist colleagues." In particular, he cited a study published in May in the journal Medical Care which found no evidence that odds of anesthesia complications varied by either scope of practice or delivery model.

After the proposal was published, the VA clarified its initial press release to explain that "At this time, VA is not seeking any change to [current] policy on the role of CRNAs, but would consider a policy change in the future to utilize full practice authority when and if such conditions require such a change."

VA officials contend that, since there are very few vacancies currently for anesthesiologists, indications are that the agency’s anesthesia needs are being met. But Quintana noted in an interview that "the reality is, we currently use quite a bit of consultation, contract folks to fill those gaps, but even with those, we’re not getting it all done" and some veterans still have to wait for procedures.

Cindy Cooke, DNP, FNP-C, president of the American Association of Nurse Practitioners, in Austin, Texas, applauded the VA’s proposal. "The proposed rule is zero risk, zero delay, and a zero-cost solution to ensuring veterans have access to timely care and reduced wait times in the VA system," she said. There are currently about 6,000 advance practice nurses working in the VA system, Cooke told MedPage Today; of those, 4,800 are nurse practitioners and 900 are CRNAs.

Cooke added that as far as whether physicians should head every healthcare team, "In my opinion, the patient should be at the center of every decision we make and should be directing where the care goes …. I don’t know that there’s any clinician that has to be the head of the team; I think we [all] have to be an integral part of that team."

Robert Frank, USAF (Ret.), CEO of the Air Force Sergeants Association, in Suitland, Md., also spoke in support of the idea. "Our bottom line is, our veterans have to be at the center of this topic," he said. "When you put the veteran at the center and say, ‘I want to provide that care for veterans … How could you not have this in place?"

Marla Weston, PhD, RN, who is CEO of the American Nurses Association, in Silver Spring, Md., noted that the proposal is very consistent with evidence-based recommendations advanced by the National Academy of Medicine (formerly the Institute of Medicine) in its 2010 report on the future of nursing. "It clearly stated that advance practice registered nurses should be allowed to practice to the full extent of their education and training," said Weston, who was formerly deputy chief officer at the Veterans Health Administration.

Despite such evidence, there has been a lot of pushback from organized medicine on the proposal, she continued. "This assertion that APRNs are underqualified or undereducated … is harmful to veterans having access to care. They’re putting veterans at risk. The evidence is clear: nurses deliver care with high quality and high patient satisfaction when they are allowed to [practice at the top of their license], so there is no need for any supervision."

Asked whether the VA’s proposal, if enacted, would spur advance practice nurses to lobby more states to enact independent practice laws, Weston said, "I do think [the VA’s needs] mirror the needs that a lot of people have in the public, and we all know that that conversation will have to happen state by state by state. And that conversation is happening now. … So I’m not sure this will change the fact that this conversation is rolling out."

last updated 06.29.2016
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3 weeks ago  ·  

EpiPen Price Skyrockets, Lack of Competition

Meg LaTorre-Snyder

For people who suffer from allergies and anaphylaxis, it appears the price of EpiPens are on the rise—with many people attributing the increased cost to lack of competition.

For more than 25 years, the EpiPen auto-injector has been the most prescribed epinephrine auto-injector in the U.S.

"EpiPen is like Kleenex. Doctors write [prescribe] EpiPen," said Don Bukstein, an Allergist at Allergy, Asthma and Sinus Center. "There was some competition in the field and then one of the devices went off the market."

Sanofi voluntarily recalled all Auvi-Q (epinephrine injection) on the market in October 2015, including both the 0.15 mg and 0.3 mg strengths for hospitals, retailers, and consumers. The recall was due to an inaccurate dosage delivery, which could include failure to deliver the drug. According to one source, Sanofi may be inclined to terminate Auvi-Q—leaving EpiPen with even less competition than before.

Local pharmacists have reported the injectable form of EpiPen has increased by approximately $170, totaling $550 for a single order. Previously, the EpiPen costed $100-$150, but, due to this sudden monopoly on the market, the cost continues to rise. One doctor said that his patients are paying $400 to $500 per device since Auvi-Q was pulled from the market.

“There is no other supply so they are able to charge that money," said Dr. Douglas McMahon. “It’s actually a very cheap medicine it only costs a couple cents for the amount to stop a severe reaction.”

Mylan, the manufacturer of EpiPen, has been increasing the prices on all of their medicines, including a 15 percent price increase for EpiPen as well as a 400-500 percent increase on some of their other medications, such as ursodiol (a gallstone medication) which increased 542 percent.

Wells Fargo’s David Maris called the price increases “beacons for scrutiny."

Mylan issued a statement in response to the higher costs:

Mylan has worked tirelessly over the past years advocating for increased anaphylaxis awareness, preparedness, and access to treatment. As the leaders in this space, our efforts are aimed at benefiting those living with potentially life-threatening (severe) allergies, and we take this leadership position seriously.

Mylan does not set the final retail cost of its products charged to patients. One would have to look across the many parties that constitute the distribution channel as they all play a role in the ultimate access and retail price of prescription drugs in the marketplace.
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3 weeks ago  ·  

JCARR to Hear Pharmacy Board Rules on Consult Agreements

The Joint Committee on Agency Rule Review (JCARR) will meet Monday to review its agenda, which includes rules from the Ohio State Board of Pharmacy that align with legislation on pharmacist consult agreements. JCARR will hear the State Board of Pharmacy’s draft rule package that includes six rescinded rules, two new rules and two amended rules aimed at aligning with HB188 (Manning-Huffman). The bill, which went into effect in March, specifies that under a consult agreement with a physician, pharmacists can manage a patient’s drug therapy and can prescribe drugs or administer them without a prescription. "HB188 requires the board to adopt rules to create a single process for consult agreements and the management of drug therapy by a pharmacist. Previously, consult agreements were based on whether the patient’s drug therapy was managed within or outside a hospital or long-term care facility, but now the content and process of consult agreements must be uniform," according to the Common Sense Initiative (CSI) analysis of the proposed rules. JCARR Executive Director Larry Wolpert noted that the committee and staff do not anticipate any testimony at the upcoming meeting nor have they found any JCARR prong issues with proposed rules. The committee meets at 1:30 p.m. on Monday, June 27 in the Senate Finance Hearing Room.
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4 weeks ago  ·  

Nurses and Doctors Convened to Discuss Scope of Practice

Politico, a political journalism organization, recently convened a working group of high-level voices to look at changes in scope of practice. The discussion focused on the roles of physician assistants (PAs) and nurses, particularly nurse practitioners, and barriers to access and opportunities for practitioners. Participants included doctors, nurses, PAs and researchers. Karen Scipio-Skinner, executive director of the District of Columbia Board of Nursing, participated in the discussions. Participants helped identify trends and policy options around scope of practice, and detected changes unfolding as a result of new health care delivery models.

A Politico article summarizes the responses to the discussion questions, including:

What is behind the push to change scope of practice?
Who decides scope of practice?
Should states remove barriers to scope of practice?
Should psychologists be allowed to prescribe?
Should federal government reimbursement cover more practitioners?

The article also summarizes the policy proposals which demonstrated a consensus among the discussion participants.

Study Finds that Scope of Practice Restrictions and Physician Supervision do not Increase Patient Safety
According to the first study to focus on the effects of state scope of practice laws and anesthesia delivery models on patient safety, scope of practice restrictions and physician supervision requirements for nurse anesthetists have no impact on anesthesia patient safety. To test whether the odds of an anesthesia complication vary by scope of practice model (certified registered nurse anesthetist [CRNA] only, anesthesiologist-only or a team of both), researchers examined a database of 5.7 million anesthesia-specific procedures from 2011-2012.

Researchers found that there was no statistically significant difference in the risk of anesthesia complications based on the degree of restrictions placed on CRNAs by state scope of practice laws. Additionally, there was no evidence that the risk of complications varies by delivery model. Researchers did find strong evidence of differences in anesthesia complications by patient characteristics, patient comorbidity and the procedures for which anesthesia was administered.

Based on these findings, researchers conclude that, while state scope of practice restrictions and physician supervision do not increase anesthesia safety, unnecessary restrictions can reduce patient access to quality care, particularly in underserved areas, and increase the cost of providing care.
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1 month ago  ·  

 

Health Care Professions…

 

COHCA – Partnering

in Patient Care

COHCA, a interprofessional group, are partners in patient care: better care, lower costs, a partnership that will help improve the quality, safety, and affordability of health care for all Ohioans. Nationally, healthcare initiatives are fostering partnerships in patient care.


 

COHCA Health Policy Update!!  Senate Bill 83  APN Schedule II - Read More…

COHCA’S FIRST SUSTAINING ORGANIZATIONAL SPONSOR - Cleveland Clinic's Zielony Nursing Institute

COHCA Health Policy Update!!  Senate Bill 83  APN Schedule II - Read More…

COHCA’S FIRST GOLD SPONSOR AND A FOUNDING MEMBER - Dr. Jeri Milstead PhD, RN, NEA-BC, FAAN 

COHCA Health Policy Update!!  Senate Bill 83  APN Schedule II - Read More…

COHCA’S FIRST PLATINUM ORGANIZATIONAL SPONSOR - The Southern Ohio Chapter of the American College of Nurse-Midwives 

COHCA Health Policy Update!!  Senate Bill 83  APN Schedule II - Read More…

COHCA PLATINUM ORGANIZATIONAL SPONSOR - Ohio Chapter of the National Association of Pediatric Nurse Practitioners (NAPNAP)

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