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Research focusing on the scope of practice by nurse anesthetists (NAs) is limited. The purpose of this study was to examine NAs' scope of practice in Norway and to explore whether and how this has changed during the period from 1979 to 2018. The study had a repeated cross-sectional design. All members of the Norwegian Association of Nurse Anesthetists at the four time-points (1979, 1989, 1999 and 2018) were invited to participate in a questionnaire study. Inclusion criteria were education and work as an NA and currently working in Norway. Data were analyzed using the Statistical Package for the Social Sciences (SPSS). Findings indicate that the scope of NAs' practice in Norway has been increasingly restricted from 1979 to 2018 (N = 2171, P < .007,). Additionally, the presence of an anesthesiologist when performing anesthesia had significantly increased during that time (39% in 1979 vs 90% in 2018). However, NAs' independent practice significantly increased in some areas, such as handling of acute situations, (i.e., handling of laryngospasm/bronchospasm [41% in 1979 versus 54% in 2018]). International and national standards underline the independent role of NAs. The development shown in our results should be addressed to avoid further restrictions of NAs' scope of practice.
Keywords: nurse anesthetist, repeated cross-sectional study, scope of practice
The specialty of nurse anesthesia began over 170 years ago, when nurses were selected by surgeons to care for anesthetized patients shortly after the discovery of an effective anesthetic drug. As of 2021, the identification and context of nurses working in anesthesia varies in different parts of the world, and the profession is dynamic with changes to education, regulation, and nursing practice responding to healthcare needs and changes to the provision of healthcare services. In the period from 1996 to 1999, the International Federation of Nurse Anesthetists (IFNA) and the USA Council on Recertification of Nurse Anesthetists sponsored a three-phase research study to identify countries where anesthesia was administered by nurses, and to document information about nurse anesthesia care. The study discovered that nurses were administering anesthesia in 107 countries in the world, and nearly all anesthesia was provided by nurses in many countries. McAuliffe and Henry found that the use of nurses to provide anesthesia was not related to a country's level...