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.