Middle Tennessee School of Anesthesia (MTSA) has announced the appointment of Richard “Richie” W. Flowers Jr. (pictured, right), DNP, CRNA, CHSE, FAANA, as Program Administrator.

Beginning in January 2025, Flowers will lead MTSA’s flagship program, the Doctor of Nurse Anesthesia Practice (DNAP), bringing a broad range of experience in both the academic and clinical settings. He is also an MTSA alumnus, earning a Master of Science with a focus in Nurse Anesthesia degree in 1997.

“I’m excited to go back to where my journey to becoming a CRNA began 30 years ago next year!” Flowers said. “Having the opportunity to lead such a prestigious program is truly an honor and privilege. It feels like this is where I belong, and I can’t wait to be home.”

Flowers currently is Assistant Professor, Department of Academic Nursing, Wake Forest University School of Medicine, where he has served in various academic and leadership roles since 2015. Prior to that, he worked as a CRNA in numerous clinical practice environments, including owning his own practice.

“We are thrilled to welcome Dr. Flowers ‘back’ to MTSA!” said President Chris Hulin, DNP, MBA, CRNA. “His background in the clinical setting, combined with his experience at Wake Forest as well as serving on non-profit boards and professional organizations, has uniquely positioned him to excel in program administration. We have the utmost confidence in his ability to take MTSA’s program to the next level.”

“I firmly believe that you have to know where you’ve been to fully understand where you are going,” Flowers added. “I’m eager to engage with the staff, faculty, learners, alumni, and stakeholders of MTSA to learn about what makes it such a special place so that our vision for the future embraces the incredible legacy of the past. MTSA has a long history of producing excellent CRNAs, and I look forward to not only continuing this legacy but making sure we are preparing our graduates for the exciting opportunities they will have in the future.”

Flowers earned his Doctor of Nurse Practice (DNP) degree from Baylor College of Medicine, a Master of Science from MTSA, and a Bachelor of Science in Nursing (BSN) from Memphis State University.

MTSA’s Practice Doctorate/DNAP program is a full-time course of study for 36 consecutive months, on the campus of MTSA. It prepares learners to become experts in providing anesthesia care in a wide range of settings, applying evidence-based practices and improving patient outcomes. The program features a rigorous clinical rotation process that offers students a vast array of clinical experiences in the peri-anesthesia setting.

About Middle Tennessee School of Anesthesia
Founded in 1950, Middle Tennessee School of Anesthesia (MTSA) provides graduate-level education and training of nurse anesthetists in a Christian environment born of its Seventh-day Adventist heritage. MTSA is the only independent, fully accredited anesthesia institution of its kind in the nation, instilling excellence through innovative and diverse clinical experience. More than 75% of Middle Tennesseans having surgery entrust their lives to its graduates on a daily basis. A leader in academic, clinical and professional distinction, MTSA is responsive to the needs of its constituents, providing affordable graduate education for students from diverse backgrounds. For more information, visit www.mtsa.edu.

MTSA has engaged in a series of renovation projects throughout the year, providing new facilities for student learning and studying. Due to the MTSA Board of Trustees’ oversight of operations and investment strategies, funding for the projects was achieved without the need for financing.

The following facilities are now open, or will be opening soon:

Anatomy Lab

The addition to the Bowen Building features 1,840 square feet of lab space for ultrasound scanning and cadaveric specimens, including skills/practice labs and regional anesthesia workshops. New equipment provides students more opportunities for hands-on experience and advanced learning. A grand opening with ribbon-cutting ceremony is tentatively scheduled for September.

Student Study Spaces

Renovation of the Bowen Building’s outdoor patio features glass-enclosed, climatecontrolled rooms for all-season study space. In addition, rearranging of staff offices offers additional student study space.

“Martin Family” Board Room

The former Learning Resource Center in the DeVasher Building has been converted into a board room, named for the extended Martin family. The name reflects the contributions made by Board Chairman Vic Martin as well as his sister, Debbie Rose, who worked in MTSA’s financial aid department for many years. In addition, Debbie’s daughter, Melissa Rose Peoples, is an anesthesiologist who has practiced with and educated many MTSA students in our area. The board room will also be available for student study time.

Technology Upgrades

MTSA has installed new wi-fi coverage and other information technology infrastructure, including a complete overhaul to both classrooms and simulation labs.

Middle Tennessee School of Anesthesia has announced the expansion of its Acute Surgical Pain Management Fellowship, offering CRNAs a variety of new and diverse clinical experiences. With the addition of these specialized clinical sites, each coordinated by Fellowship-trained CRNAs, the Fellowship aims to provide unparalleled opportunities for CRNAs to enhance their regional anesthesia skills and develop comprehensive acute pain management services.

Diverse and Specialized Clinical Sites

Crestwood Medical Center

Crestwood Medical Center, a 180-bed hospital in Huntsville, Alabama, has recently joined the MTSA Fellowship. Partnering with SportsMED, a prominent orthopedic group, Crestwood provides extensive experience in ambulatory surgeries, particularly for orthopedic and ortho-spine cases. The site is coordinated by Rachel Foy, CRNA, and John Martin, CRNA, both of whom are current Fellows. CRNAs at Crestwood perform a wide range of regional blocks, significantly enhancing their practical skills. “Recently, a Fellow performed more than 80 regional blocks in his five days with us,” said Foy. “We are excited to have Fellows here to share our enthusiasm for what we’re doing because it’s truly a game-changer for this area.”

Norton Hospital

Norton Hospital in Louisville, Kentucky, provides Fellows with the opportunity to enhance their skillset with truncal blocks. Coordinators Ben Sampedro, CRNA, and Evan Reagan, CRNA, both graduates of the Fellowship, ensure that Fellows receive tailored experiences to refine their techniques in regional anesthesia.

The anesthesia group’s approach to pain management has evolved significantly over the years, shifting from traditional opioid-based monotherapy to multimodal, opioid-sparing techniques, and in some cases, completely opioid-free methods. Fellows gain invaluable experience with truncal blocks primarily through their association with the Leatherman Spine group. Additionally, they handle a diverse range of cases, including orthopedics, breast surgeries, and surgical oncology, further broadening their clinical expertise.

“Fellows rotating at Norton are typically focused on enhancing their expertise in truncal blocks,” Sampedro explained. “Our goal is to customize the experience for each Fellow, ensuring they become highly proficient in patient assessment, identifying suitable candidates for these blocks, accurately placing the transducer to identify the appropriate target anatomy, and refining their needling techniques.”

“One thing we hear repeatedly is how challenging truncal blocks can be,” Reagan said. “Many CRNAs are accustomed to more superficial blocks in the upper or lower extremities. Our approach involves creating a mental checklist for them to consistently identify this challenging anatomy. It’s incredibly rewarding to hear that Fellows who rotate at Norton can successfully integrate what they’ve learned into their own clinical practice.”

SSM Health Bone & Joint Hospital at St. Anthony

Oklahoma City’s SSM Health Bone & Joint Hospital at St. Anthony was the Fellowship’s inaugural clinical site. The 100-bed orthopedic specialty hospital offers a comprehensive range of services, from sports medicine to various surgical interventions. Patrick Myer, DNAP, CRNA, is the Chief CRNA at the hospital as well as the clinical coordinator. He completed the Fellowship in 2018 as part of the first cohort.

While building confidence in regional techniques is a key element of the Fellowship, Myer emphasized that it goes beyond learning to perform blocks: “The Fellowship teaches you how to comprehensively manage acute surgical pain from the preoperative phase through the extended postoperative recovery period, ensuring effective pain management well beyond the immediate perioperative phase. My goal for Fellows is to demonstrate the full scope of our practice, showing them how to set up and run an acute pain service from the ground up.”

Additional Clinical Sites

MTSA’s Fellowship also includes partnerships with:

• Crystal Clinic Orthopaedic Center, Cleveland, Ohio
• Fairchild Medical Center, Yreka, California
• Horizon Health, Paris, Illinois
• Republic Pain Specialists, Bryan, Texas

About the Fellowship

Led by director Christian R. Falyar, DNAP, CRNA, FAANA, and assistant director Nicolette B. Hooge (above left), DNP, MBA, CRNA, MTSA’s Fellowship comprises a comprehensive 12-month curriculum designed to enhance a CRNA’s regional anesthesia skills and provide the tools necessary to incorporate an acute pain service into their practice. The curriculum combines online education, live synchronous events with expert faculty, on-campus hands-on cadaveric intensives, and clinical rotations, ensuring a well-rounded and in-depth educational experience.

Fellows participate in two intensive week-long clinical rotations, where they become integral members of a pain service team, learning directly from Fellowship-trained clinicians. These rotations are packed with hands-on experiences, from assessing patients for regional anesthesia opportunities and performing complex blocks to managing patients in the PACU and rounding on previous surgical cases. This comprehensive training equips Fellows with the skills to revolutionize pain management practices. Graduates take the knowledge and techniques learned from these rotations back to their home practices, where they often become trailblazers, spreading innovative techniques and significantly enhancing patient care.

“One of the key advantages of the Fellowship is the lasting relationships Fellows build with other CRNAs across the country, who serve as invaluable clinical resources long after completion. This network allows them to consult with fellow CRNAs, ask questions, and continuously enhance their practice,” Hooge said.

Preparation and Enrollment

Candidates interested in the Fellowship are required to have experience performing blocks in practice and a foundational understanding of basic regional blocks. To help prepare candidates, MTSA offers the Regional Anesthesia Foundations Class, a 15-week comprehensive course covering essential regional anesthesia techniques, which are reinforced with a cadaveric workshop at the end of the class. This course ensures that candidates have the necessary background and skills to succeed in the Fellowship.

Jennifer Squibbs, CRNA at Crystal Clinic and recent graduate of the class, praised the Fellowship for its beneficial instruction and significant impact on her practice. “The learning and programming at MTSA leads our industry in excellence and performance,” she said.

The application period for MTSA’s next Acute Surgical Pain Management Fellowship cohort will open in late 2024. For more information, visit www.mtsa.edu/fellowship.

From the latest issue of MTSA’s Airways newsletter… As MTSA bids farewell to outgoing Program Administrator Rusty Gentry, DNAP, CRNA, deep appreciation for his servant-hearted leadership at the institution was a recurring theme among faculty, staff and students.

MTSA President Chris Hulin praised Gentry’s efforts in elevating the Doctor of Nurse Anesthesia Practice program; increasing graduates’ National Certification Exam (NCE/boards) pass rates; advancing nurse anesthesia education in Guyana; overseeing the curriculum and program through successful Council on Accreditation (COA) and Southern Association of Colleges and Schools Commission on Colleges (SACSCOC) reaffirmation reviews; and guiding the program through the transition to doctoral education.

Gentry joined MTSA as the Assistant Program Administrator in December 2016 and was made the Program Administrator in January of 2017. Soon after coming on board, the school transitioned to doctoral education, which included a site visit by the Council on Accreditation. Later that year, MTSA was approved and received the maximum length of accreditation. Gentry then oversaw the acceptance of two cohorts within one year – the last master’s cohort and the new doctoral cohort, which enabled clinical rotations to continue with the same start and finish timeframe.

Over the course of his tenure, MTSA bucked the national trend of declining board scores with the move to the doctoral degree, increasing to the most recent graduating class which achieved a 97% first-time pass rate.

“We worked hard to develop better strategies of mentoring students using the board preparation tools to properly prepare them,” Gentry said. “We made several adjustments when going to a doctoral degree, and I think those adjustments have improved the program and quality of the education of the students. One major change was going to all-day clinicals. This provided the students more continuity; instead of coming to class for half a day, they could focus on being in clinical all day. We’ve added classes and rearranged things to better fit the curriculum to optimize student learning and to also incorporate the newest techniques.”

Under Gentry’s leadership, MTSA was one of the first schools that had PoCUS simulation and taught TEE. PoCUS was incorporated into the physical assessment class, and a new clinical evaluation tool was implemented that allows for more robust feedback from preceptors about students’ clinical performance and identification of at-risk students.

“I think it’s confirmation when you see former students and they say, ‘The program wasn’t easy, but I was well prepared to provide safe anesthesia.’ That’s what a program administrator wants to hear, that they can function at the level they desire in the anesthesia community whether that be in Nashville or anywhere else in the country,” Gentry said.

“One of the things I’ll miss is getting to see the growth of an individual obtaining a higher level of confidence in their abilities to perform in one of the most stressful environments in the medical profession,” Gentry added. “I’ve seen all different kinds of students – whether they’re timid or strong – and our job is to get them all the way to the end to be that confident provider.”

In Gentry’s view, the growth of the individual is of greater concern than “perfecting” skills to the highest level. “There’s a lot of satisfaction in seeing students reach the end of the program, walk across that graduation stage and start their career. There’s no ‘easy’ button; spending hours in the operating room is the only way to gather that level of confidence in cases, and the exposure to the different types of anesthetics in clinicals comes with time,” he said.

“We couldn’t have achieved what we did during my tenure if it hadn’t been for the faculty and the clinical partners. We’ve grown the number of clinical sites considerably over the years that I’ve been here, and we partnered with clinical sites that we hadn’t been in for 20 years. Without our clinical partners it would be impossible to do what we do,” Gentry added.

“At MTSA we care about our students in a unique, Christian way. I appreciated being able to pray with our students, having the freedom of a Christian heritage, and incorporating my own values into the way I approached the position,” he said.

During his tenure at the school, Gentry participated in five international mission trips with MTSA, including Haiti twice and Guyana three times. Reflecting on those trips, and the guiding principles of his work, he said his message to students is to “always remember it’s about the patient. I always tell them you have a very limited window of opportunity to gain the trust of someone who’s going to place their life in your hands.”

From all those whose lives he has touched, MTSA wishes Rusty all the best and many blessings in his future endeavors!

MTSA’s latest issue of the Airways newsletter features a synopsis of research by the husband-and-wife team of Keven Keller, CRNA, and Katie Keller, CRNA, both MTSA graduates. Their research was submitted for publishing in the Journal of PeriAnesthesia Nursing and continues the trend of MTSA graduates helping to advance opioid-sparing interventions and promoting evidence-based practice.

“The experience Katie and I had at MTSA put us head-and-shoulders above others we worked with because the clinical situations truly prepared us to be independent CRNAs.” – Keven Keller, CRNA, Class of 2013

TITLE: Short-Term Patient Outcomes after Implementation of Robotic-Assisted Radical Prostatectomy under Opioid Free Anesthesia at an Ambulatory Surgery Center

AUTHORS: Keven Keller, Katherine Keller, Thomas Baribeault, and Kenneth A. Wofford

SYNOPSIS: Opioid free anesthesia (OFA) is associated with decreased risk of postoperative nausea and vomiting (PONV) and need for rescue analgesia, making it ideal for patients anticipating same-day discharge. The purpose of this project was to describe the perioperative care and short-term outcomes for patients undergoing robotic-assisted radical prostatectomy (RARP) under OFA at an ambulatory surgical center (ASC).

A retrospective descriptive design was utilized to examine the perioperative care and short-term outcomes of patients undergoing RARP under OFA at an ASC.

The records of all sequential patients undergoing RARP over an 18-month period were reviewed. Data collected included patient comorbidities, surgical procedures, pre-, intra-, and post- medications administered, verbal numeric rating scale (VNRS) for pain scores, times to oral intake, ambulation, and discharge, patient disposition, and unplanned return to the ER or hospital within 30 days.

Data were extracted from 54 sequential records. Median VNRS scores were zero throughout PACU stay. Fifty-three patients (98.1%) were successfully discharged home, with an average postoperative stay of 250.8 (SD 35.0) minutes. There were no complaints of post-discharge nausea and vomiting or intractable pain at 72 hours after surgery. One patient was transferred to hospital and two patients returned to the emergency room within 30 days.

Conclusions: Although generalizability is limited, these results suggest that carefully selected patients can be discharged home after RARP under a balanced OFA technique. Innovative practices are needed to address the current backlog of patients needing non-emergent surgery.  Discharge home avoids the increase in resource consumption and infection risk associated with hospital admission.

About the Authors

Keven and Katie Keller are the founders and co-CEOs of Keller Anesthesia LLC in Atlanta. Formed in 2016, their group provides services at nine surgery centers in metro Atlanta, all focused on urology and gynecology. With 24 CRNAs on staff, their most common cases include kidney stone treatments, prostate biopsies, bladder tumors, vaginal repairs and hysterectomies.

Keven and Katie met while working as ICU nurses at Atlanta Medical Center. Both applied and were accepted to MTSA at same time, graduating from the Master’s program in 2013 and getting married the same year. They now have two daughters, Brinley, age 5, and Adeline, age 4.

“We managed to make it through anesthesia school together, so we figured this marriage is going to be rock solid,” Keven said. “When it comes to balancing our personal and professional life together, we like to say, ‘teamwork makes the dream work.’”

“We’ve always done everything together. It’s a partnership,” Katie said. “We bounce ideas off each other, and we both have areas of strength that are different but complementary.”

The Kellers’ research began as an attempt to minimize or eliminate opioid usage and enable quicker recovery by surgical patients. They were initially hesitant but, after extensive training, they were able to design an opioid-free ERAS urology protocol. It includes not only pre-op protocols but also steps to take several days prior to help prep patients all the way through the post-op period.

“From our research, we’re the first group to be able to do robotic prostatectomy at an ambulatory surgery center without opioids. For these and other applicable cases, this is a great option because it costs less. Being able to offer this to patients safely and to have better outcomes is a game changer,” Keven said.

One aspect of their research that they found most surprising was the negative sequela associated with opioid use. They recognized the pain reflex was much higher when opioids are used versus none at all. And there are many other negative side effects, such as longer lengths of stay, altered mental status, ileus and respiratory depression.

“It was shocking to realize how we’ve always practiced surgical pain management, when better alternatives are often available. It’s amazing that we can get patients in and out of a surgery center the same day. And the patients are blown away. They come in expecting to hurt and instead then they’re able to get up and leave within a matter of hours,” Katie said.

The Kellers both mentioned their experience at MTSA as a critical element of their success as CRNAs.

“MTSA’s program in general – the fact that we went to so many different clinical sites – gave us a variety of learning environments. I don’t know that we could have accomplished so much early on in our careers without that,” Katie said.

“We’re really grateful to MTSA and President Chris Hulin for giving us the opportunity. The school has done a phenomenal job. The experience Katie and I had at MTSA put us head-and-shoulders above others we worked with because the clinical situations truly prepared us to be independent CRNAs. Also, [MTSA Dean Emerita] Ikey DeVasher was there at the time. She and her husband, Bernard, were strong, faith-based leaders who really set us up for success,” Keven added.

Middle Tennessee School of Anesthesia (MTSA) is joining healthcare providers nationwide in recognizing the unique skills of Certified Registered Nurse Anesthetists (CRNAs) during National CRNA Week, Jan. 22-28.

More information is available at www.mtsa.edu/CRNAweek.

“Comprising more than 50% of all anesthesia providers in the U.S., CRNAs continue to be recognized for their specialized skills, including airway management, intubation and advanced patient assessment. They administer every type of anesthesia in all types of patients in every healthcare setting where anesthesia is delivered,” said MTSA President Chris Hulin, DNP, MBA, CRNA.

According to the American Association of Nurse Anesthesiology (AANA), more than 59,000 CRNAs and student registered nurse anesthetists provide anesthetics to patients in the United States each year, delivering the same safe, high-quality anesthesia care as other anesthesia professionals but at a lower cost, helping to control the nation’s rising healthcare costs.

Due to its significant alumni base in the region, MTSA estimates more than 75% of Middle Tennesseans having surgery entrust their lives to its graduates on a daily basis.

“With a focus on preventative care and a growing demand for more medical services in a variety of settings, advanced practice nurses such as CRNAs are essential to our healthcare system. As nurses, they establish great relationships with patients, helping put them at ease and make them comfortable,” Hulin said.

In addition, CRNAs across the country are actively leading hundreds of initiatives to combat opioid abuse and provide effective pain management. This includes collaborating with professional, governmental and community organizations.

About CRNA Week
National CRNA Week is the AANA’s annual celebration of anesthesia patient safety, helping patients, hospital administrators, healthcare professionals, policymakers, and others become more familiar with the Certified Registered Nurse Anesthetist (CRNA) credential and the exceptional advanced practice registered nurses who have earned it.

About Middle Tennessee School of Anesthesia
Founded in 1950, Middle Tennessee School of Anesthesia (MTSA) provides graduate-level education and training of nurse anesthetists in a Christian environment born of its Seventh-day Adventist heritage. MTSA is the only independent, fully accredited anesthesia institution of its kind in the nation, instilling excellence through innovative and diverse clinical experience. More than 75% of Middle Tennesseans having surgery entrust their lives to its graduates on a daily basis. A leader in academic, clinical and professional distinction, MTSA is responsive to the needs of its constituents, providing affordable graduate education for students from diverse backgrounds. For more information, visit www.mtsa.edu or call (888) 353-MTSA.

More information about the role and value of CRNAs is available from the AANA at www.aana.com.

MTSA’s latest issue of the Airways newsletter features a synopsis of research by MTSA graduate and Acute Surgical Pain Management Fellowship faculty member Stace Dollar, DNAP, CRNA. 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.

Here’s more from our extended conversation with Dollar:

MTSA: How did you decide on this topic for your research?

Dollar: One of the motivations for conducting this research is the fact that the opioid epidemic has become personal to so many people, myself included. Whether it’s family members or friends that have been affected, it’s an important issue that many of us in the medical field are trying to address and solve.

MTSA: Was there anything that surprised you during this process?

Dollar: During the research, I was surprised to find the sheer number of opioid-related deaths reported every day. One recent statistic is that between 2000 and 2019 opioid deaths increased by 255%. Because my research dealt with opioid disposal education, I found it interesting to examine how we as nurses educate patients every day – whether it’s “passive education” where we print information and hand it to the patient, or “active education” where we sit down and explain it to the patients. Another factor is the timing of the education which is usually either pre-operative or post-operative. One thing that I found in the research is that there’s no consistency in opioid disposal education. Many people are unaware of proper storage and disposal so unfortunately they keep them in their medicine cabinet, and that’s how a lot of people have their first exposure – finding them in a friend’s or family member’s medicine cabinet.

MTSA: What outcomes do you hope to see as a result of this research being published?

Dollar: I hope this research has an effect on best practices in terms of educating patients about disposal. In one study I found, the anesthesia provider provided “active” opioid disposal education which resulted in a 74% disposal rate. If we provided consistent active opioid disposal education throughout every phase of care, disposal would become a norm. Also, I believe these rates would be even higher than 74% and have an impact on the opioid epidemic.

MTSA: What other insights did you gain about opioid disposal through your research?

Dollar: Another hurdle in opioid disposal is the patient’s fear of future pain, which causes them not to dispose of their opioids. Patients have many reasons for retaining their opioids. It could be that they have experienced significant pain in the past, or could be that “just in case” they need it for some other form of pain, they decide to hang on to their opioids. Other forms of pain could be the simple headache. I really think fear of future pain would be an important topic for a future study.

MTSA: How did your connections and education at MTSA inform your research?

Dollar: 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. John Edwards and I had this vision for research on disposal since the time we were in the Fellowship, and in our doctoral program at MTSA, Dr. Halle Evans and Dr. Bill Johnson were a huge factor in leading us towards our goal. John and I had published a few articles with a group from the research department at our facility, but we had never actually written a paper start to finish. Dr. Evans and Dr. Johnson were instrumental in that, teaching us not only how to review research but also how to create it, write it and publish it. And our co-author Dr. Jan Odom-Forren has been at the forefront in working on the opioid epidemic and my content expert on this project.

Learn more about MTSA’s Acute Surgical Pain Management Fellowship at https://mtsa.edu/fellowship

MTSA’s latest issue of the Airways newsletter features a synopsis of research by MTSA graduate and Acute Surgical Pain Management Fellowship faculty member Stace Dollar, DNAP, CRNA. 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.

ABOUT THE AUTHORS

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.

It’s a new year, with new opportunities for career growth! MTSA is now accepting applications for a wide range of nurse anesthesia programs to help you excel as a CRNA. Visit mtsa.edu/apply for details.

NEW!
Nurse Educator Certificate Program

MTSA’s Nurse Educator Certificate Program is a 12-month course of study that prepares students to function in the Nurse Educator role. Students learn about the theoretical foundations of nursing education, how to assess educational needs, various evidence-based teaching and assessment strategies, curriculum design and development, and program evaluation. Application deadline: June 1.

Nurse Faculty Loan Program

Admitted students in the Nurse Educator Certificate Program may be eligible for HRSA Faculty Nurse Loan program (FNLP) with a four-year nurse educator employment commitment post-graduation which provides 85% loan forgiveness when this educator employment is completed. Students interested in the FNLP should contact the Grant Director, Bill Johnson, DNAP, CRNA, at bill.johnson@mtsa.edu for eligibility screening.

Doctor of Nurse Anesthesia Practice (DNAP)

MTSA offers the DNAP Practice Doctorate to registered nurses who have met each of the application requirements for admission. The DNAP Practice Doctorate is a full-time course of study for 36 consecutive months. Application deadline: May 31.

The DNAP Completion program is specifically designed with the working CRNA in mind and in an online format. All students accepted into the program must be currently licensed CRNAs. The program can be completed over two years. Application deadline: June 1.

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: June 1.

MTSA offers dual enrollment in the DNAP Completion program along with the ASPM Fellowship or the Nurse Educator Certificate Program, allowing students to complete two academic tracks at once!

Regional Cadaveric Workshops

Registration is now open for MTSA’s 2022 Cadaveric Ultrasound-Guided Regional Anesthesia workshops for CRNAs. These 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!

2022 Workshop Schedule:

March 20 — Basic Course [SOLD OUT]
July 24 — Advanced Course
October 2 — Basic Course
November 13 — Advanced Course

For more information, contact Bill Johnson at (615) 732-7846 or bill.johnson@mtsa.edu.

Advanced Physiologic Foundations Class

Taught by Brett Clay, DNAP, CRNA, this course discusses advanced human physiologic concepts at the system, organ, cellular, and subcellular levels, with the overall goal to enhance the learner’s foundation for nursing practice. This year, a new summer course is available: May 2 – Aug. 11. Application deadline: March 31.