Capturing Original Preanesthetic Comprehensive History and Physical Assessments with the use of Video Telehealth: A Quality Improvement Project for Student Nurse Anesthetists

Purpose: Beginning January 1, 2022, the Council on Accreditation is requiring student registered nurse anesthetists (SRNAs) matriculating into nurse anesthesia programs to track preanesthetic comprehensive history and physical (H&P) assessment completion numbers. This quality improvement (QI) project aimed to create a new clinical rotation for SRNAs to practice their preanesthetic H&P assessment skills through video telehealth. Design: A quality improvement project. Methods: Likert-style and free-text surveys were administered to both the SRNA students and the expert provider to assess for improvements, viability, and effectiveness of the clinical rotation. SRNAs used a curated library of evidence-based resources and instructions for conducting their assessments. Expert guidance was provided through a single experienced provider. Findings: Eight SRNAs performed one preanesthetic telehealth H&P assessment and four of the eight performed a second assessment. Pre-QI surveys indicated 75% were not comfortable with their ability in performing a competent assessment. Initial post-QI surveys indicated 88% were more comfortable with their abilities and 100% of those who completed a second-time post-QI survey 100% were more comfortable. Provider feedback indicated full-day clinical rotations were feasible and important. Conclusions: Results revealed SRNAs desire and need for more preanesthetic comprehensive H&P appointments. Expansion into full-scale, full-day, and in-person assessments was also indicated. QI projects at other clinical sites can determine if similar rotations can also create similar clinical rotations.