Policy on Evidence-based Process for Practice-related Documents
Purpose
To integrate systematic, evidence-based methodology into the development or revision of practice-related documents.
To describe the project prioritization process for the development of new or revision of existing evidence-based documents.
Process
Evidence-based nurse anesthesia practice entails the integration and synthesis of research evidence with clinical expertise and patient values in order to optimize the care of patients receiving anesthesia services.1
The AANA Practice Committee employs a systematic evidence-based review process to analyze current literature and research to develop or revise practice-related documents (e.g., standards, guidelines, practice considerations). Two methodologies are used for the assessment of literature: Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess quantitative research and the Rosalind Franklin Qualitative Research Appraisal Instrument (RF-QRA) to evaluate qualitative research.2,3
Member Comment
Draft practice-related documents will be made available to solicit feedback from AANA members for a two-week open comment period. The open comment period will be announced on the AANA website and various communication channels. The Practice Committee and Professional Practice Division staff will document the review and resolution of submitted comments prior to finalizing the document for recommendation to the Board of Directors for adoption.
Document Development and Revision
The Practice Committee reviews selected practice documents to determine what type of revision, if any, is needed and to make recommendations for the next fiscal year Practice Committee charges. The committee recommends whether to:
1. Affirm as written (no changes).
2. Archive the document.
3. Postpone reassessment for 1 or more years.
4. Conduct a focused reassessment limited to a portion of the document.
5. Conduct a full reassessment
If the committee recommends actions 1 or 2, the document will be recommended with that action to the Board of Directors.
If the committee recommends action 3, no further action will be taken, and the document will be reassessed by a subsequent committee.
If the committee recommends action 4 or 5, the document will go through the AANA project prioritization process (see below).
Document Publication
Practice related documents approved by the AANA Board of Directors, such as guidelines. practice and policy considerations will be published in the AANA Journal to support broad and open access to the AANA Practice Committee work. An abbreviated version of these documents (e.g., an infographic) will be published on the Professional Practice Manual webpage to facilitate easy access to information affecting nurse anesthesia practice. Since position statements may be subject to frequent change, they will only be published on the AANA Professional Practice Manual webpage.
Concepts of Healthcare Disparity, Health Equity, and the Social Determinants of Health
Certified Registered Nurse Anesthetists (CRNAs) have an important role in understanding and recognizing healthcare disparities to effectively address patients’ needs from diverse racial and ethnic backgrounds. In collaboration with the AANA Diversity, Equity, and Inclusion (DEI) committee, the Practice Committee will incorporate, as needed, the concepts of healthcare disparity, health equity, and the social determinants of health as part of the Practice document development and revision.
Recommendation of Content
AANA members can recommend new practice documents or revision of existing documents by emailing the Professional Practice Division at practice@aana.com Member recommendations for new practice documents or revision of existing documents will be reviewed by the Practice Committee and, if approved, will proceed through the AANA’s project prioritization process.
The AANA Board of Directors or the Practice Committee can recommend new practice documents or revision of existing documents at their discretion, based on developing healthcare-related issues. These requests will proceed through the AANA’s project prioritization process.
Document Prioritization Process
All recommended practice documents are submitted through the AANA’s project prioritization
process to be assessed with all the AANA’s work for the current and upcoming fiscal year. The determination of whether and when (e.g., this fiscal year, next fiscal year, etc.) a document will be created or revised is made by the AANA Project Steering Committee.
References
1. Sackett DL, Straus SE, Richardson WS, Rosenberg W, and Haynes RB. Evidencebased Medicine. Edinburgh: Churchill Livingstone; 2000.
2. Viswanathan M, Ansari MT, Berkman ND, et al. Agency for Healthcare Research and Quality Methods Guide for Comparative Effectiveness Reviews. Assessing the risk of bias of individual studies in systematic reviews of health care interventions, 2012. AHRQ Publication No. 12-EHC047-EF. www.effectivehealthcare.ahrq.gov/. Accessed June 20, 2012.
3. Henderson R, Rheault W. Appraising and incorporating qualitative research in evidence-based practice. Journal of Physical Therapy Education. 2004;18:35- 40.
AANA Board of Directors
May 31, 2008
Revised: August 3, 2012
September 12, 2014
July 15, 2017
November 2, 2017
June 27, 2018
February 19, 2021