About the Program

Program Terminal Objectives

At the completion of the didactic and clinical curriculum, the student will be able to demonstrate the ability to:

1. Perform a pre-anesthetic interview and physical assessment.
2. Discuss the anesthesia plan with the patient, thus establishing rapport and preparing the patient psychologically for the anticipated surgery.
3. Evaluate a patient's history, physical and request appropriate laboratory and x-ray data.
4. Formulate a comprehensive anesthesia care plan suitable for the specific needs of the patients.
5. Conduct a safe general anesthesia for patients of all ages and categories using a variety of techniques and agents.
6. Administer and safely manage regional anesthesia care.
7. Utilize and interpret the data from a variety of monitoring modalities including: electronic monitors (EKG), arterial pressure and central venous pressure (CVP), PA lines and mass spectrometry.
8. Calculate and manage fluid therapy within a medical plan of care.
9. Institute appropriate treatment of complications occurring during anesthesia management, referring to a physician those beyond the scope of the nurse anesthetist's management.
10. Evaluate quality of anesthesia care and institute appropriate actions to improve this care.
11. Position patient safely to assure optimal physiologic function.
12. Demonstrate the safe and effective use of anesthesia equipment and monitoring devices.
13. Provide consultation pertaining to respiratory care in acute care areas.
14. Interpret blood gas determinations.
15. Function as a team leader or member in cardiopulmonary resuscitation.
16. Utilize appropriate principles of basic and behavioral sciences in protecting patients from iatrogenic complications.
17. Function within the appropriate legal requirements and standards of care as a licensed professional accepting responsibility for his/her own practice.
18. Conduct a terminal project approved by the Program Director, which benefits the profession, anesthesia community, or program.
19. Participate in the education of patients and the community of interest.
20. Function as a safe, independent, clincally competent anesthesia practitioner in a variety of practice settings.
21. Satisfy terminal clinical practicum requirements.
22. Integrate theoretical, research-based, scientific, and clinical knowledge in an area of advanced practice nursing or nursing administration to provide nursing care to diverse clients.
23. Practice independently and collaboratively to deliver direct care and indirect care services in various types of health care systems.
24. Use research findings from nursing and other disciplines as a basis for clinical decision-making to improve practice and to formulate health policy.
25. Use ethical decision-making to promote the well being of clients, families, health care professionals, and the community at large.
26. Utilize caring, effective interventions, in accordance with standards of advanced practice nursing, to improve the health status of individuals, families, groups, communities, and populations.
27. Value lifelong learning and continuous professional development.
28. Demonstrate communication skills, including computing and health information management that enhance the quality of care provided at the individual and aggregate level.
29. Demonstrate safe, effective assessment, planning, implementation, and evaluation skills in caring for individuals and groups.
30. Provide culturally competent care to all persons regardless of race, sex, sexual orientation, age, socioeconomic status, culture, health care beliefs, and religion.
31. Function as a leader and change agent in nursing and in health care delivery systems particularly to insure quality care for vulnerable and underserved populations.

Length of Course

Because the study of anesthesia requires superior knowledge and proficient technical skills, the course of study is 27 months. At the end of 27 months, upon satisfactory completion of the course program and meeting the terminal objectives of the program, the student will be awarded a certificate from the School of Anesthesia and a Master of Science Degree in Nursing from La Salle University School of Nursing and Health Sciences. Upon recommendation of the Program Director, the student will be permitted to take the National Certification Examination to gain CRNA Certification.

Expenses (For the Incoming Class 2008)

1. Tuition:
   
   • Clinical Practicum: 27-month program
     (Montgomery Hospital Medical Center 29 credits)
     • Year 1: $12,420.00
     • Year 2: $12,420.00
     • Year 3: $6,210.00
   • Academic Affiliation:
     (La Salle University 21 credits MS)
     
     • $13,755.00
   • Total (Tuition Montgomery Hospital Medical Center and La Salle University) = $44,805.00
2. Certification Examination Fee: $750.00
   Each student is responsible for payment of the fee which must accompany the application to take the National Certification Examination upon graduation.
3. Textbooks: $1,000.00
   An invoice is issued to the student's home from our supplier for the required textbooks. Upon remittance, the books are sent directly to the student, approximately three months prior to the start of the academic year.
4. Administrative Fee: $2,000.00
   Includes copy charges, lab coat patches, precordial stethoscope heads, "Anesthesia Brain" book, graduation dinner, graduation fees, parking & facility fees, Sim Lab usage fees, Sim Lab maintenance fees, lab fees (PPD, immunizations, physical, drug screens, etc.)
5. Total Program Tuition and Fees (bullets 1 - 4): $48,555.00
6. A.A.N.A. Membership Fees: $100.00
   Dues for Associate Membership in the American Association of Nurse Anesthetists.
7. Lab Coats: Students are required to purchase one long white lab coat. Operating room attire is provided and laundered by the Hospital at no cost to the student.
8. Equipment: Students are required to purchase precordial monitoring equipment including a personal molded earpiece.

Financial Aid

1. Loans, Grants or Scholarships: Loans, grants or scholarships are not available from the Hospital.
2. Guaranteed Student Loan Program: The Guaranteed Student Loan Program is provided through the Financial Aid Office at La Salle University. All student loans are distributed and monitored through the La Salle University Financial Aid Office (For additional information please contact the La Salle University Financial Aid Office at (215) 951-1070.)

Student Employment

Student employment is not recommended but students may work with the Program Director's approval. Outside employment must have approval from the Program Director of the School of Anesthesia. Under no circumstances may any student administer (or assist) anesthesia either with or without remuneration in any other medical or dental facility outside the School of Anesthesia.

Liability Insurance

Professional liability insurance is provided for each student by the Hospital.

Vacations, Holidays, Sick Leave

1. Allowable Time Off: 35 days throughout the length of the Program.
2. Hospital Holidays: Number of days will be determined by the Director, but shall not exceed five days per year for first year students. Senior students will participate in holiday and weekend call rotations.
3. Leave of Absence: Only by special arrangement and approval from the Director.
4. Students who exceed the allowable time off must make up all excess missed time at the end of the 27 month program of study.

Calendar for New Classes

1. A new class of students commences annually (September).
2. Students are expected to report on duty no later than 6:30 A.M. each morning and are generally dismissed by 3:30 - 4:00 P.M. Adequate time for lunch and breaks is provided.
3. Total committed time does not exceed 64 hours per week.
4. Students participate in a rotating call schedule in order to gain clinical experience in management of emergency cases.

Student Rights and Responsibilities

1. The student has the right to withdraw from the program at any time.
2. Student responsibilities include: attendance, interest and completion of satisfactory didactic and clinical work, and indication of a willingness to take study and learning seriously. To benefit to the greatest degree possible, a student must assume his/her share of responsibility to the patient, the anesthesia staff, and the entire surgical team to ensure proper order and safety. Any student who does not maintain didactic or clinical standards as prescribed by the program may be dismissed. Grievance and Due Process Procedures are available for every student.

Program Curriculum - Clinical Practicum

Students enrolled in the program begin their didactic education by participating in the "shared curriculum." "Shared curriculum" utilizes a variety of clinical, didactic and administrative faculty from anesthesia programs throughout the Philadephia region. Didactic instruction in anatomy, physiology, pharmacology and anesthesia techniques is incorporated into the initial 9-12 month period of enrollment within the school. Students complete the remainder of the didactic program at Montgomery Hospital Medical Center participating in classroom instruction one day per week in their senior year.

Clinical instruction is provided under the direct supervision of a certified nurse anesthetist and/or staff anesthesiologist. Students gain experience increasing in complexity, employing all of the commonly utilized anesthetic agents and techniques. Upon completion of the course, the student will have acquired clinical experience with various anesthetic agents, techniques, surgical procedures and the clinical experience required to sit for the National Certification Examination. Call duty is required to provide the student an opportunity to participate in emergent surgical procedures and airway management.

During the clinical curriculum the student will gain clinical experience with the following:

1. Agents Used
   1. Nitrous Oxide
   2. Halothane
   3. Isoflurane
   4. Desflurane
   5. Sevoflurane
   6. Diazepam, Midazolam
   7. Tranquilizers
   8. Intravenous narcotics/analgesics
   9. Muscle relaxants
   10. Drug antagonists
2. Methods and Techniques Employed:
   1. Inhalation Methods
      1. Endotracheal
      2. Mask cases
      3. LMA
   2. Intravenous
   3. Regional
      1. Management of all types of regional anesthesia and administration of spinal and epidurals
      2. Topical administration
      3. Perfusion block administration (Bier Block)
   4. Intravenous and intramuscular anesthesia
   5. Special techniques
      1. Arterial blood gas sampling
      2. Hypothermia
      3. Hypotensive anesthesia
      4. Electronic Monitoring
3. Types of Surgical Procedures
   Extensive experience is gained in all types of surgical procedures. In addition to meeting requirements for all types of surgical procedures, the clinical experience extends into the specialty areas of pediatrics, obstetrics, geriatrics, emergency surgery and psychiatry. Overall, the student performs an excess of 750 anesthetic cases involving over 1,000 clinical hours.

Assistance and consultation are always available to the student from a CRNA and/or anesthesiologist.

Montgomery Hospital Medical Center Coursework (27 credits)

1. The Practice of Anesthesia
   This orientation course is designed to acquaint the new student with the physical plant and surgical suite. School of Anesthesia requirements as well as those of the Council on Accreditation of Nurse Anesthesia Educational Programs are presented and reviewed. A Broad Field Orientation to clinical practice is presented and includes preoperative patient assessment, airway management, patient positioning, substance abuse, and medical legal considerations in anesthesia practice.
   
   
2. Anesthesia Pharmacology I
   A detailed course of the pharmacologic effects of anesthesia agents and their adjuncts are presented. An introduction to anesthesia pharmacology course is presented. In addition, regional anesthesia and techniques of administration and inhalational anesthesia course is included in Pharmacology I.
   
   
3. Anatomy, Physiology and Pathophysiology in Anesthesia Practice I
   A general review of anatomy and physiology is presented with intense emphasis on the respiratory, cardiovascular systems and cell physiology are highlighted. Anatomical abnormalities and physiological conditions which may influence the conduct or choice of anesthesia are highlighted.
   
   
4. Anesthesia Chemistry and Physics I
   This course provides a review of inorganic chemistry, patient monitoring, and anesthesia equipment. The physical laws as they apply to anesthetic practice are discussed. The components of the anesthesia machine, utilization of the anesthesia machine (Narkomed, Ohmeda), in the perioperative setting as well as the FDA checklist are highlighted.
   
   
5. Anesthesia Pharmacology II
   Local anesthetics, intravenous agents, and muscle relaxants are presented in detail for the student. Drug classification, mechanism of action, dosage and administration are presented for all local anesthetics, intravenous anesthetics and muscle relaxants utilized in anesthesia practice.
   
   
6. Anatomy, Physiology, Pathophysiology in Anesthesia Practice II
   This course gives the student an in-depth review of the anatomy, physiology and pathophysiology of the excretory, respiratory, cardiovascular, endocrine, hepatic systems, and the autonomic nervous system. Clinical case presentations are incorporated into the cardiovascular and respiratory segment of this course, which is a continuation of NUR 682.
   
   
7. Anesthesia Chemistry and Physics II
   This course presents the student with gas laws and the flow of fluids as applied to related anesthetics and oxygen delivery systems. The incorporation of basic electrical safety is incorporated for the anesthesia practitioner. Application to the perioperative environment is highlighted.
   
   
8. Advanced Principles of Anesthesia Practice
   An in-depth presentation of advanced principles of anesthesia practice. Special emphasis is placed on pediatric, geriatric, and obstetrical, cardiothoracic, neuro, trauma, burn, orthopedic, plastic surgical anesthesia. In addition, students participate in active clinical practice in the pain management center at Montgomery Hospital Medical Center.
   
   
9. Professional Aspects of Anesthesia Practice
   This course has been designed to help the student make a smooth transition from student to nurse anesthetist to that of a graduate nurse anesthetist practitioner. The following course content is presented:
   - Medical Legal Considerations in Anesthesia Practice
   - Seminar Workshops
   - Journal Club
   
   
10. Clinical Practicum
    This clinical course is offered to award academic credits for clinical practicum experience.

La Salle University School of Nursing and Health Sciences Core Courses (21 credits)

1. Research and Theory I
   This course explores the relationships among research, theory, and practice. Students examine the integration of theory clinical, educational, and administrative areas of nursing. Critique of published research focuses students on the findings and methods of studies and the applicability of research findings to practical situations. Students develop a research question guided by a critical review of the literature. Various research designs are contrasted.
   
   
2. Research and Theory II
   This course is a continuation of Research and Theory I. The student develops a research proposal that originates in a question derived from clinical practice. This course examines treatment of variables, sampling, measurement theory, probability theory, qualitative and quantitative analysis, and the use of the computer in data analysis. The research consumer and participant roles are emphasized.
   
   
3. Advanced Practice Nursing and Administration
   This course examines the evolution of advanced nursing practice and administration in the context of changing health care delivery systems. Students investigate health care policy development and examine systems of delivering patient care in relation to financial, ethical, legal, social, legislative, political, and professional concerns. Program development, informatics, fiscal management of health care services, budgeting, and reimbursement issues are emphasized. Students explore interdisciplinary networking and coalition-building in leadership roles extending beyond the traditional health care environment. This course meets the standards of care and professional performances as published in the Scope and Standards of Advanced Practice Registered Nursing.
   
   
4. Population Based Care and Advanced Practice Nursing
   In this course students investigate the roles of advanced practice nurses in meeting the health care needs of diverse populations. Health promotion, disease prevention, resource utilization, and health education responsibilities are examined. Students utilize basic epidemiological concepts and needs assessment for vulnerable populations. They examine the diverse needs of different ethnic and racial groups in a community or clinical setting.
   
   
5. Assessment of the Adult Health and Illness
   This course addresses the health assessment of clients using a framework of physiologic, psychosocial and physical examination data. Students explore history taking methods and principles of physical assessment to determine the client's potential and actual health problems. The purpose of the course is to enable the student to develop skills necessary to evaluate the holistic health status adults. It combines the principles and generalizations of nursing and other sciences with the nursing care of patients. Clinical problems are analyzed. Students advance in knowledge, clinical judgement, differential diagnosis and decision-making skills.
   
   
6. Pharmacology
   The purpose of this course is to expand and study the actions and effects of drugs on the human system. The student will analyze the scope of legal and professional nursing responsibilities related to pharmacology in an expanded nursing role. The student will study principles of drug therapy, mechanism of action, and selections of pharmacologic agents in clinical practice.
   
   
7. Pathophysiology
   This course integrates physiological principles and clinical practice and correlates physical manifestation with pathological interference. It focuses on recognizing changes in client status, interpreting physiological data, and utilizing this information in formulation nursing care plans. Nursing implications of current diagnostic studies and pharmacological treatments will be addressed.

Program Enrichment

An ongoing assessment of the program in Nurse Anesthesia may result in modifications and/or revisions from time to time in the light of changing needs, scientific advancements and new standards of accreditation.