Compliance With Opioid Disposal Following Opioid Disposal Education in Surgical Patients

This issue features a synopsis of research by MTSA graduate and Acute Surgical Pain Management Fellowship faculty member Stace Dollar, DNAP, CRNA (above right). His research was recently published in the Journal of PeriAnesthesia Nursing and represents one of the ways MTSA’s focus on acute surgical pain management and opioid-sparing interventions supports and promotes student scholarship that helps fight the opioid crisis.

“My education at MTSA has played an important role in this research. Starting several years ago, my enrollment in the Acute Surgical Pain Management Fellowship helped set this in motion.” –Stace Dollar, DNAP, CRNA

TITLE: Compliance With Opioid Disposal Following Opioid Disposal Education in Surgical Patients: A Systematic Review

AUTHORS: Stace Dollar, DNAP, CRNA; Hallie Evans, DNP, CRNA; John M. Edwards, III, DNAP, CRNA; Jan Odom-Forren, PhD, RN, CPAN, FASPAN, FAAN; and Bill Johnson, DNAP, CRNA

SYNOPSIS: The present opioid epidemic in the United States is a significant cause for concern in healthcare. In 1995, the concept of pain was introduced as the fifth vital sign. Since then, the sales of opioids have increased dramatically, as have the number of opioid deaths. The misuse and diversion of retained opioids following surgical procedures contribute to the problem. The objective of this project was to review the latest scholarly work and evaluate the findings related to patient education and disposal of opioid medications to decrease opioid misuse and increase disposal.

The systematic search strategy included PubMed, Ovid Technologies (OVID), and Cumulative Index of Nursing and Allied Health Literature (CINAHL) electronic databases.

A total of four randomized controlled trials (RCTs), two quasi-experimental studies, and two quality improvement projects met the criteria for inclusion. The studies found that as many as 92% of patients had leftover unused opioids. The retention rate of opioids among surgical patients was found to be 33 to 95%. When educational material was provided about disposal, the studies found that the disposal rate was as high as 71%.

Conclusions: Patient education about opioid misuse, diversion, and disposal are essential topics that need to be addressed with patients and caregivers.


Stace Dollar, DNAP, CRNA is a faculty member for MTSA’s Acute Surgical Pain Management Fellowship and a CRNA at Baptist Health Lexington.

Hallie Evans, DNP, CRNA, is an Associate Professor at MTSA.

John M. Edwards, III, DNAP, CRNA is a faculty member for MTSA’s Acute Surgical Pain Management Fellowship and a CRNA at Baptist Health Lexington.

Jan Odom-Forren, PhD, RN, CPAN, FASPAN, FAAN, University of Kentucky College of Nursing, Lexington, KY.

Bill Johnson, DNAP, CRNA, has served as the Director of the Acute Surgical Pain Management Fellowship at MTSA.

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President's Message: Efficiency-driven Anesthesia Modeling

Chris Hulin

Being an “evangelist” for CRNAs is one of the most important aspects of my role as President of MTSA. Recently, I had the opportunity to showcase the unique value of our profession at three major gatherings of influencers: the American College of Healthcare Executives Annual Congress, Becker’s Healthcare Annual Meeting, and the Annual Republican Governors Association Conference.

The focus of my message was “Efficiency-driven Anesthesia Modeling,” which is an outgrowth of the work done by the AANA’s Reimbursement Task Force, of which I’m a member.

Efficiency-driven Anesthesia Modeling challenges us to rethink how anesthesia care is delivered across all types of facilities, from the biggest hospitals to the smallest clinics. Rather than placing “billing” as the pivot point for staffing decisions, our focus is on variables unique to an individual healthcare facility or health system as well as improving cost effectiveness and accessibility. Three areas help address these concerns:

Effectiveness. Studies show that increasing CRNA involvement and reducing restrictions on CRNA-provided services results in care as safe and equitable to that delivered by physician anesthesiologists or in more restrictive models.

Efficiency. Because Efficiency-driven Anesthesia Modeling uses CRNA providers, it may reduce (or even eliminate) the financial burden placed on facilities, help reduce unnecessary healthcare spending and reflect appropriate anesthesia staffing to meet a facility’s patient and surgical needs.

Equity. CRNAs provide most anesthesia services in rural America and often work in areas with vulnerable populations. CRNA care may result in cost savings and reallocation of budget dollars to additional coverage for anesthesia services and/or other crucial healthcare areas.

Drawing on my experience as a hospital administrator, together with my current view of nurse anesthesia and public policy, I’m honored to be able to communicate directly with C-suite executives and policymakers about how CRNAs can benefit our healthcare system. I invite you to learn more about our messaging at and to reach out if you’d like to help in our advocacy on behalf of CRNAs in your state or community!

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Continuing Education

TITLE: Ultrasound-Guided Fascial Plane Blocks for Acute Rib Fracture Pain in a Level IV Trauma Center: A Literature Review and Introduction of an Evidence-based Analgesia Algorithm for Uncomplicated Rib Fractures

AUTHORS: Michelle Stotts, DNAP, CRNA; Hallie Evans, DNP, CRNA, APRN; Christian Falyar, DNAP, CRNA; Bill Johnson, DNAP, CRNA.

Click here to access CE article»

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Service in Action

Service Award Given to MTSA

MTSA was honored to receive the “Live Like Gilda” Community Service Award at FiftyForward Madison Station’s recent Whistlestop event. MTSA President Chris Hulin accepted the award on behalf of the school (pictured right).

The award commemorates the life and service of Gilda York, a longtime friend, and supporter of countless communities, including Madison and FiftyForward. MTSA has supported Whistlestop for the past five years and worked with FiftyForward Fresh, its meal delivery service, to assemble emergency food bags that are distributed to older adults experiencing food insecurity. Hulin fondly recalled his time working with Gilda York and expressed great gratitude for the recognition of his team and their call to serve the community.

In addition, MTSA faculty, staff and students volunteered at the event, helping with set up, registration, and serving of food and drinks.


Service Day at King’s Daughters

MTSA faculty and staff recently spent a morning at King’s Daughters Daycare, helping with weeding, mulching, and cleaning up flower beds around the property.


Meals Delivered to Children of Vietnam

The meals from MTSA’s Rise Against Hunger experience during last November’s Service Week have been shipped in a container totaling 285,120 meals. The meals will be received by Rise Against Hunger’s in-country partner, Children of Vietnam. Thanks again to all who participated. Your service has made a positive impact on those in need!

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Student Standouts

MTSA SRNAs receive hands-on experience at a variety of clinical sites, but they also have the opportunity to make an impact on the patients they serve. We are pleased to share these comments received from clinical sites showcasing the skill and compassionate care of these SRNAs.

Matthew Hall

Med Center Health – Bowling Green

“Matthew explained thoroughly the procedure and stayed with me when needed. Treated me as if one of the family. Made me totally relaxed.” –Comment card from patient


Maecey Pearson

Vanderbilt University Medical Center

“Even though she had class today, she stayed a little later to help out since we had a lot of patients today. She did a great job masking and looked up the entire 15-patient lineup the night before.” –Supervisor feedback


Timothy Creps

Vanderbilt Children’s Hospital

“The anesthesia team was especially incredible. Timothy, SRNA, deserves special recognition. He connected particularly well with our daughter, easing her discomfort prior to surgery.” –Comment card from patient’s parent

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Guests Welcomed for Family Day and New Facility Opening

MTSA Class of 2024 students, faculty and staff recently gathered for Family Day, providing a special opportunity for students to come together as a group and learn from a variety of presenters about graduate school life and school policies. Attendees enjoyed a delicious BBQ meal and games on the lawn.

In addition, guests were invited to the official unveiling of the new Student Learning Resources Center in the Magan Building, which was designed for collaboration among students and colleagues, providing an environment where research can be conducted and shared to advance CRNA practice.

The facility includes the new library, small group study rooms, eat-at tech bar, student lounge area with fireplace, conference room, and an outdoor patio area. The $2 million project was funded by school operations, donor contributions, and a CARES Act federal grant.

Guests were also able to view the new Creation Wall, which was designed by artist Nathan Greene and serves as a reminder of MTSA’s Seventh-day Adventist heritage.

“It was such a privilege to be commissioned to paint the series ‘The Seven Days of Creation,’” Greene said. He added that the paintings reflect “a carefully executed master plan that included logic, order, symmetry, diversity, complex composition, and most of all beauty. Within the series I have depicted the recorded creations of each day. Superimposed across many of the paintings are the formulas, diagrams, and equations representing what God planned for our earth to make it an environment to sustain life. The crowning events of the creation week were when God created man in His own image and set aside the seventh day for us to commune with Him and remember Him, our Creator.”

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MTSA Celebrates 8th Annual Mission & Awards Gala

Middle Tennessee School of Anesthesia hosted the 8th annual Mission & Awards Gala, presented by Anesthesia Medical Group, on May 5 at the Frist Art Museum. The evening of celebration, dining and silent auction benefited advancing nurse anesthesia in Guyana, raising funds for medical supplies, education curricula, and other needed items for mission activities in this underdeveloped country.

The event began with a welcome from Gala Chair Alison Martin, DNAP, CRNA, followed by comments by MTSA President Chris Hulin, who explained the School’s efforts with the nurse anesthesia program at Georgetown Public Hospital System in Guyana.

“Part of MTSA’s vision is to ‘reflect Christ in a culture of service, inclusion, and diversity.’ One of the main ways we do that is through our commitment to mission endeavors in a variety of settings. This is funded 100% by the generous support of alumni and friends. Thank you for sharing in this important work,” Hulin said.

MTSA Class of 2023 student Rob Mathias then provided additional context for the Mission Initiative in Guyana, explaining the great need for healthcare providers, followed by an invocation.

During the award presentations, the School recognized the following individuals for their unique achievements:

  • Mary Elizabeth “Ikey” DeVasher Alumni Distinguished Service Award: Eric Callan, CRNA, DNAP
  • Mission & Heritage Award: William O.T. Smith, MD
  • Clinical Excellence Award: Michael Heck, CRNA
  • Nevin Downs, MD Leadership Award: Rob Taylor, MD

Event sponsors included:

Presenting Sponsor: Anesthesia Medical Group, PC
Reception Sponsor: NorthStar Anesthesia
Mission & Heritage Award: Kentucky-Tennessee Conference of Seventh-day Adventists
Nevin Downs, MD Leadership Award: Myrtianne Downs


Eric Callan, CRNA, DNAP

Mary Elizabeth DeVasher Distinguished Alumni Service Award

Eric Callan, CRNA, DNAP, serves as chief executive officer and owner of LifeLinc Anesthesia, an anesthesia management company with extensive experience in operating, managing and building anesthesia departments. LifeLinc Anesthesia is headquartered in Memphis and currently operates in 11 states. As CEO, Callan oversees the strategic growth and development of LifeLinc while cultivating both clinical and administrative relationships with each client. His acumen plays a critical role in ensuring that each anesthesia team properly aligns their goals and success measures with those of the facility they service. His passion is developing anesthesia teams of the highest quality that are service-oriented and cost-efficient.

Callan developed his expertise in the healthcare industry through years of clinical anesthesia experience in both the hospital and ambulatory surgery setting. He began his nursing career in 1993 and has practiced in a variety of clinical settings, from ambulatory surgery centers to tertiary care teaching hospitals. He earned a Bachelor of Science degree in Nursing from the University of Tennessee Health Science Center, later continuing his studies there, graduating with a Master of Science in Nursing with a focus in adult health and anesthesia. He completed his Doctor of Nurse Anesthesia Practice at MTSA.

“I was completely surprised and honored to be nominated for this award,” Callan said. “I met a lot of great people during my time at MTSA. Since then, I’ve tried to instill a sense of leadership and ownership at our company and to build future leaders. To me that’s what it’s all about, and I’m truly grateful to be recognized for the work that we’ve accomplished.”

Callan is married to his wife Erica and said he “wouldn’t be anywhere without her. She has supported me in all my endeavors.”

The Mary Elizabeth DeVasher Distinguished Alumni Service Award is awarded to a MTSA Alumnus in honor of this MTSA Alumna and former Dean/Vice President/Program Administrator to celebrate and honor her years of dedicated work and distinguished service to the institution. It is given to an alumnus of MTSA who has demonstrated a deep commitment to servant-leadership and for dedicating themselves to excellence in all that they do.


William O.T. Smith, MD

Mission & Heritage Award

Dr. Smith is the longest tenured President of MTSA, who took on leadership of the school – then known as the School of Anesthesia at Madison Hospital – from its founder, Bernard Bowen, in 1973. Out of his devotion to the mission of training nurse anesthetists, when the hospital intended to close the school in the 1980s, Dr. Smith led the creation of an independent school, MTSA. The core team of Dr. Smith, Dr. Nevin Downs, and Ikey DeVasher worked successfully together for many years.

In addition to his duties as President of MTSA, Dr. Smith worked full-time as a staff anesthesiologist at Madison Hospital and Tennessee Christian. This gave him the optimal environment to teach his students both in the classroom and the OR. Training nurse anesthetists to excel in a wide variety of clinical settings and situations was his passion.

In 1981, Dr. Smith started a business with his wife, Bonnie, which combined continuing education for anesthesia providers with travel. Holiday Seminars continues to be a thriving business and is now operated by his youngest daughter, Jenny.

Between his work with MTSA and Holiday Seminars, Dr. Smith is considered to have trained and educated more than 10,000 CRNAs – more than any other physician in the world.

Dr. Smith retired from clinical practice with the closing of Tennessee Christian in 2006 and from MTSA soon after. He continues to be the Medical Director of Holiday Seminars and enjoys finding the very best presenters in new and best practices in anesthesia for these meetings.

Dr. Smith is a devoted husband, father of three daughters, and grandfather. He is famous for his many and varied hobbies, which have included model airplanes and helicopters, ham radios, bluegrass music, reading, travel, horses/barrel racing, and magic tricks. Affectionately known as “O.T.,” it is suspected that those initials stand for either “Over Time” or “Out of Town.”

The Mission & Heritage Award is awarded to an individual who embodies and exemplifies the Heritage, Mission, and Core Values of MTSA.


Michael Heck, CRNA

Clinical Excellence Award

Michael Heck, CRNA, graduated with a BSN from Troy University in Alabama on a Track and Field scholarship. He graduated from MTSA in 2010. During his tenure at MTSA he was elected as the TANA representative for his class. He also presented a case report at the annual TANA meeting with John Shields, CRNA, DNP, during his senior year.

From 2010-2013, Heck worked at Vanderbilt University Medical Center and had the opportunity to teach pharmacology to the perfusion program students at VUMC with Mary Peters, CRNA. He then moved to Kentucky and worked at the Medical Center at Bowling Green for three years, which included teaching cadaveric workshops for ultrasound-guided regional anesthesia (USGRA). After serving as a solo CRNA practitioner in Nevada for 18 months, he returned to the Medical Center, where he continued teaching USGRA as well as transthoracic echocardiogram (TTE) and Point-of-Care Ultrasound (POCUS) courses with Dr. Shields.

Heck currently practices independently with a focus on cardiac and USGRA. He started a business that involves TEE and POCUS education called Through the pandemic he has increased his students’ exposure to independent clinical practice. This fall the group will have its own cohort of students.

“Many of the previous winners of this award are people I look up to clinically. I’m thankful to be included in such a prestigious group of individuals and practitioners. I’m also thankful for the support I have received from my wife, Heather,” Heck said. “MTSA fosters not only collaboration between providers but also clinical excellence. Many alumni are leaders in anesthesia – from POCUS and cardiac anesthesia to leadership positions in various settings. The ability of MTSA to develop anesthesia providers at such a high quality is special, and it says a lot about the school’s mission.”

The Clinical Excellence Award is awarded to an Anesthesia Provider (Anesthesiologist or CRNA) or Clinical Site (Hospital, Clinic, etc.) that provides a nurturing and exemplary atmosphere with true eagerness to instruct, train, and educate MTSA students. The recipient will embrace the MTSA mission and core values.


Rob Taylor, MD

Nevin Downs, MD Leadership Award

Rob Taylor, MD, has practiced as an anesthesiologist in the Nashville area for the last 21 years. Early on he worked at Tennessee Christian Medical Center in Madison for five years, where he became involved with MTSA. He then went on to spend a brief time at Nashville General Hospital and currently practices at Sumner Regional Medical Center in Gallatin, Tenn., where he has worked for the last 14 years.

Taylor earned his Bachelor’s degree from Southern Adventist University and his Doctor of Medicine degree from Loma Linda University in California, where he also completed his four-year residency. After moving to Tennessee, he joined MTSA’s faculty in 2001, teaching classes on pharmacology and anesthesia machines, as well as lectures on various topics. He continues to serve as a medical consultant and clinical faculty for MTSA as well as participate on the Interview and Evaluations committees. He has had the opportunity to travel with MTSA faculty and students on mission trips to Haiti. He enjoys challenging students, helping to apply classroom learning to the clinical setting.

“It’s humbling to be given this award,” Taylor said. “I love being clinical faculty at MTSA. I’ve worked with students in clinicals all 21 years of my career. My hope has always been to train CRNAs to have a strong work ethic and clinical competence. I pride myself in taking a personal interest in students and holding them to high standards, and mentoring where I can. To help carry on the legacy of Dr. Downs is quite an honor.”

Taylor and his wife, Jennifer, have been married for 26 years. They have two children: their daughter, Courtney, is an ICU nurse in Chattanooga; and their son, Colton, is studying at Southern Adventist University.

The Nevin Downs, MD Leadership Award is awarded to an Anesthesia Provider (Anesthesiologist or Certified Registered Nurse Anesthetist) who personifies the integrity, honesty, fairness, and exemplary leadership with which Dr. Downs served the profession including his advocacy of Nurse Anesthesia and MTSA.

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Nurse Anesthesia Programs Open for Enrollment

MTSA is now accepting applications for a wide range of nurse anesthesia programs to help you excel as a CRNA. Visit for details.

Acute Surgical Pain Management Fellowship

From medical management approaches, such as multimodal therapies and opioid sparing strategies, to advanced interventional techniques, including continuous catheter utilization, CRNAs acquire the knowledge to treat patients with confidence and skill at MTSA’s Acute Surgical Pain Management (ASPM) Fellowship. Application deadline: Nov. 1, 2022

Regional Cadaveric Workshops

MTSA’s Cadaveric Ultrasound-Guided Regional Anesthesia workshops for CRNA are hands-on training courses utilizing cadavers and “live” scanning models, state-of-the-art ultrasound technology, and a comprehensive approach to regional anesthesia techniques for surgery and acute pain management. Space is limited, so register today!

Workshop Schedule:

October 2 — Basic Course [SOLD OUT]
November 13 — Advanced Course

For more information, email

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MTSA Fundraising Events

Register now for MTSA’s upcoming fundraising events! Visit

19th Annual MTSA Golf Classic

Thursday, Sept. 22

* Please note the date for this event has changed from previously published information.

Benefitting MTSA’s Mission Initiative in Guyana.


6th Annual MTSA Sporting Clay Tournament

Sunday, Nov. 13

* Please note the date for this event has changed from previously published information.

Supporting MTSA’s opioid reduction initiative.

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MTSA Calendar

Sept. 22 – 19th Annual MTSA Golf Classic
Oct. 2 – Basic Cadaveric Ultrasound-Guided Regional Anesthesia Workshop
Nov. 1 – Deadline to apply to MTSA’s Acute Surgical Pain Management Fellowship
Nov. 13 – 6th Annual MTSA Sporting Clay Tournament
Nov. 13 – Advanced Cadaveric Ultrasound-Guided Regional Anesthesia Workshop

For additional details, visit

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Nathan Greene Paintings at MTSA

The halls of the Magan building, connecting to the new Student Learning Resources Center, feature the “Days of Creation” painting series, by artist Nathan Greene. These studio canvas giclées are the closest possible reproduction to Nathan’s original artwork, displayed exactly like the original oil paintings.

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