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Western Journal of Nursing Research
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Methodological Issues in Explaining Maternal Outcomes

Anesthesia Provider Characterizations and Resource Variation

Ann F. Minnick

Vanderbilt University, Ann.Minnick{at}vanderbilt.edu

Jack Needleman

University of California -Los Angeles

Anesthesia provider models were characterized based on responsibilities and technique privileges and the distribution of clinical resource and process variables using a survey of 1,135 hospitals offering obstetric care in eight representative states. The resulting models were then analyzed by resource availability. In the 40% of hospitals where certified registered nurse anesthetists (CRNAs) and anesthesiologists both practiced obstetric anesthesia, three models emerged based on consistency of privileges within the institution and permission to initiate procedures. Hospitals in which only anesthesiologists practice and those in which CRNAs practice was most restricted had more resources than other hospitals surveyed. Traditional characterizations of provider fail to capture differences in technique privileges. Clinical resource variables and the scope of technique privileges should be included in the study of anesthesia provider credentials on outcomes.

Key Words: research design • maternal outcomes • outcome assessment • anesthesia

This version was published on November 1, 2008

Western Journal of Nursing Research, Vol. 30, No. 7, 801-816 (2008)
DOI: 10.1177/0193945907311323
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