Written Testimony (Essay Sample)

Written Testimony Student's Name Institutional Affiliation Course Number and Name Instructor's Name Due Date Written Testimony Good morning, honorable chair Mills, representative Graves, members of the Health and Welfare Committee, fellow certified registered nurse anesthetists (CRNAs), members of the panel, and the public attendees. My name is Ms. Janele Sparkese. I am a CRNA with over six years of practice providing safe anesthesia services at Ochsner Medical Center in Baton Rouge, Louisiana, where I live. I am a member of the American Association of Nurse Anesthesiologists (AANA) through the Louisiana Association of Nurse Anesthetists (LANA). AANA, a network of about 59,000 CRNAs, provides members with current evidence-based information on patient safety, nurse anesthesia practice, continuing education opportunities, professional resources, and other benefits (AANA, n.d.). Thank you for the opportunity to testify before this committee in support of SB175. SB175 seeks to amend Louisiana's collaborative practice agreement rules by providing the conditions for exempting CRNAs from supervision requirements (Louisiana State Legislature, 2022). The bill proposes that advanced practice registered nurses who hold valid, unrestricted, and unencumbered practice licenses in Louisiana, are not subject to any disciplinary actions, have completed a recognized and accredited academic course, and have over 1,000 hours of clinical collaborative practice experience can be exempted from entering into collaborative practice arrangements at the discretion of the LSBN (Louisiana State Legislature, 2022). This bill will be essential to promoting the safety and quality of anesthesia care while improving the work life of CRNAs. Although nurse anesthetists have been essential anesthesia providers in the U.S. for over 150 years, their credentialing only started in 1956, and direct Medicare reimbursement began in 1986. Additionally, the specialty has experienced numerous legislative and regulatory changes, such as the alteration by the Centers for Medicare and Medicaid (CMS) of the federal rule requiring CRNAs' supervision by physicians, effectively permitting states to opt out of the reimbursement requirement (AANA, 2022). Since then, 22 states have withdrawn from the supervision requirement. Nevertheless, peer-reviewed studies show that CRNAs in opt-out states continue to provide safe, affordable, and high-quality anesthesia care despite the lack of physician supervision. Accordingly, the extant literature recommends permitting CRNAs to practice to the full range of their education, training, and clinical experience (AANA, 2022). Therefore, supporting the enactment of SB175 is an ideal solution to the rising healthcare costs and supports the current reform efforts to improve the quality and safety of patient care. CRNAs are prolific care providers who administer safe anesthesia to over 50 million patients nationally every year. Indeed, recent polls rank CRNAs among the most trusted specialties in the U.S. (AANA, 2022), signifying the public's confidence in practitioners' competence. Therefore, CRNAS must be allowed to practice to the full extent of their education, training, and clinical expertise to promote the safety, quality, and affordability of healthcare in line with the Institute of Medicine's (IOM) healthcare aims of maximizing healthcare safety, quality, effectiveness, timeliness, patient-centeredness, efficiency, and equitability. Specifically, CRNAs can improve healthcare access in rural areas where underserved populations mainly reside. According to Mills et al. (2020), CRNA-only anesthesia models are common in rural regions, where CRNAs provide most anesthesia care to low-income, underinsured, and uninsured communities. CRNA's ability to serve in a broad range of practice settings, including ambulatory surgery centers, the typical surgical suites, obstetrical delivery rooms, pain management services, and plastic surgery practices (Vitale, 2021), justifies the assertion that independent CRNA practice can maximize healthcare access to meet the unique anesthesia-related needs of virtually all types of practices. Moreover, staffing mixes comprising of CRNAs only have been proven more cost-effective than those with physician anesthesiologists, partly due to the comparatively lower wages for CRNAs. Moreover, all-CRNA frameworks effectively eliminate service duplication and bolster efficacious human resource utilization (Mills et al., 2020), ultimately reducing anesthesia-related costs. Various factions have cited reasons to oppose the bill's proposals. Such claims include the practitioners' allegedly lesser academic attainment than physicians, the lack of standardized nursing certification and accreditation processes, and limited training in clinical decision-making, diagnostic interpretations, differential diagnoses, and medical interventions (Bae & Timmons, 2022). However, these arguments are fundamentally flawed. Specifically, graduate nurses must meet stringent academic and work-related experience requirements before becoming CRNAs, including seven to eight calendar years of education and training, during which they amass about 9,369 hours of clinical experience (Bae & Timmons, 2022). Accordingly, CRNAs can offer various services, r...