Proven safe, proven cost-effective: CRNAs are the access-to-care answer.
Certified Registered Nurse Anesthetists are advanced practice registered nurses (APRNs) who are the primary providers of anesthesia care throughout South Dakota. These anesthesia experts provide anesthesia in every S.D. hospital and ambulatory surgery center where anesthesia care is required for surgery, labor and delivery, trauma stabilization, and pain management. In rural and other medically underserved counties, CRNAs are the sole anesthesia professionals serving their communities.
S.D. Anesthesia by the Numbers
- 509 licensed CRNAs in S.D.
- 41 of the 66 counties in South Dakota have anesthesia services; CRNAs are the sole providers in 34 of the 41 (83%)
- CRNAs provide anesthesia in all S.D. counties that have anesthesia services; there are no anesthesiologist-only counties
- In 2005, South Dakota became the 13th state to opt out of the Medicare physician supervision rule for CRNAs; there are now 17 opt-out states*
*In 2001, the Centers for Medicare & Medicaid Services (CMS) changed the federal physician supervision rule for nurse anesthetists to allow state governors to opt out of this facility reimbursement requirement (which applies to hospitals and ambulatory surgical centers) by meeting three criteria: 1) consult the state boards of medicine and nursing about issues related to access to and the quality of anesthesia services in the state, 2) determine that opting out is consistent with state law, and 3) determine that opting out is in the best interests of the state’s citizens. To date, 17 states have opted out of the federal physician supervision requirement, including: Iowa, Nebraska, Idaho, Minnesota, New Hampshire, New Mexico, Kansas, North Dakota, Washington, Alaska, Oregon, Montana, South Dakota, Wisconsin, California, Colorado, and Kentucky. Additional states do not have supervision requirements in state law and are eligible to opt out should the governors elect to do so.
Research Confirms CRNA Safety and Cost-Effectiveness
All significant anesthesia-related research published since 2000 has confirmed the safety and cost-effectiveness of anesthesia care delivered by Certified Registered Nurse Anesthetists.
- Nursing Economic$ (2010/2016): Cost Effectiveness Analysis of Anesthesia Providers (a CRNA working solo is the most cost-effective anesthesia delivery model, with no reduction in patient safety)
- Health Affairs (2010): No Harm Found When Nurse Anesthetists Work Without Supervision by Physicians (anesthesia care is equally safe when provided by a CRNA working solo, a physician anesthesiologist working solo, or a CRNA and anesthesiologist working together)
In South Dakota, 83 percent of counties with anesthesia services are CRNA-only. Based on the research, patients who undergo surgical and other procedures in hospitals and ambulatory surgery centers in these counties can rest assured that they will receive the safest, most cost-effective anesthesia care available.
Regulation of CRNAs in the U.S.
- CRNAs are educated and trained to provide anesthesia care using the full range of techniques and medications, including prescribing anesthetic and other drugs they administer to patients.
- CRNAs care for patients of all ages, in every type of healthcare setting, and for every type of procedure that requires anesthesia.
- CRNAs work collaboratively with all members of the patient care team to maintain the patient’s comfort and safety.
- CRNAs are highly qualified to handle all types of emergencies that may occur during anesthesia for surgery and other procedures.
- 40 states and the District of Columbia allow CRNAs to practice without mandated physician collaboration; 26 states grant prescriptive authority to CRNAs.
CRNA Regulation in S.D. Border States
- CRNAs practice without mandated physician collaboration or supervision.
- They prescribe and order anesthetics and other drugs.
Benefits of more Flexible Practice Laws for CRNAs in S.D.
Improves Patient Access to Care:
- Greater access, especially in rural and medically underserved areas
- Enables CRNAs to work with all types of healthcare providers including dentists and podiatrists
- Enables CRNAs to prescribe/order anesthetics and other drugs they administer to patients
- Improves CRNA recruitment and retention for a more robust workforce
- Managed care plans recognize CRNAs for delivering high-quality anesthesia care at less cost
- CRNAs’ cost-efficiency helps control escalating healthcare costs
- Removing outdated requirements for physician collaboration as a condition of CRNA practice would create a more efficient, effective healthcare system.
- Allowing CRNAs to practice to the full extent of their education, training, certification and licensure would promote a competitive marketplace where patients and employers have access to providers of their choice.
CRNA Education and Training
Total education and training:
- 7-8 ½ years of nursing and anesthesia education and training
- More than 9,000 clinical hours
Prior to entering nurse anesthesia program:
- Attain bachelor’s degree in nursing, RN license, minimum 1 year of critical care experience
- Average critical care experience: 2.9 years (CRNAs are the only anesthesia professionals who start their anesthesia education knowing how to manage critical events)
Prior to becoming a CRNA:
- Graduate with master’s or doctorate degree from accredited nurse anesthesia educational program
- Pass National Certification Exam
CRNAs embrace life-long learning, maintaining their certification through continuing education.
Learn more about CRNAs