2021-22 Graduate Catalog


Nursing Practice - Anesthesia, DNAP

Description of Program

The Doctor of Nurse Anesthesia Practice (DNAP) is an innovative, solutions-focused program designed to prepare nurse anesthesia students for solving complex healthcare issues and developing new healthcare opportunities, specifically in the context of nurse anesthesia practice. The program builds on TCU's mission - "Learning to Change the World" - and charges post-baccalaureate registered nurse DNAP students with "Making a Difference in Healthcare".

Mission

The DNAP provides the terminal academic preparation for nurse anesthesia practice with advanced, specialized knowledge and skills to meet the health needs of diverse populations. The purpose of the DNAP program is to prepare nurse anesthetists who are equipped to assume clinical leadership positions in a variety of healthcare, business, government and educational organizations.

Objectives

Upon completion of the DNAP curriculum, graduates should be able to:

 

Patient Safety

  1. Be vigilant in the delivery of patient care.
  2. Refrain from engaging in extraneous activities that abandon or minimize vigilance while providing direct patient care (e.g., texting, reading, emailing, etc.).
  3. Conduct a comprehensive equipment check.
  4. Protect patients from iatrogenic complications.

Perianesthesia

  1. Provide individualized care throughout the perianesthesia continuum.
  2. Deliver culturally competent perianesthesia care.
  3. Provide anesthesia services to all patients across the lifespan.
  4. Perform a comprehensive history and physical assessment. 
  5. Administer general anesthesia to patients with a variety of physical conditions. 
  6. Administer general anesthesia for a variety of surgical and medically related procedures. 
  7. Administer and manage a variety of regional anesthetics. 
  8. Maintain current certification in ACLS and PALS. 

Critical Thinking

  1. Apply knowledge to practice in decision-making and problem solving.
  2. Provide nurse anesthesia services based on evidence-based principles. 
  3. Perform a preanesthetic assessment before providing anesthesia services. 
  4. Assume responsibility and accountability for diagnosis. 
  5. Formulate an anesthesia plan of care before providing anesthesia services. 
  6. Identify and take appropriate action when confronted with anesthetic equipment-related malfunctions. 
  7. Interpret and utilize data obtained from noninvasive and invasive monitoring modalities. 
  8. Calculate, initiate, and manage fluid and blood component therapy. 
  9. Recognize, evaluate, and manage the physiological responses coincident to the provision of anesthesia services.
  10. Recognize and appropriately manage complications that occur during the provision of anesthesia services.
  11. Use science-based theories and concepts to analyze new practice approaches. 
  12. Pass the national certification examination (NCE) administered by NBCRNA.

Communication

  1. Utilize interpersonal and communication skills that result in the effective exchange of information and collaboration with patients and their families. 
  2. Utilize interpersonal and communication skills that result in an effective interprofessional exchange of information and collaboration with other healthcare professionals. 
  3. Respect the dignity and privacy of patients while maintaining confidentiality in the delivery of interprofessional care. 
  4. Maintain comprehensive, timely, accurate and legible healthcare records. 
  5. Transfer the responsibility for care of the patient to other qualified providers in a manner that assures continuity of care and patient safety. 
  6. Teach others. 

Leadership

  1. Integrate critical and reflective thinking in his or her leadership approach.
  2. Provide leadership that facilitates intraprofessional and interprofessional collaboration.

Professional Role

The graduate must demonstrate the ability to:

  1. Adhere to the Code of Ethics for the Certified Registered Nurse Anesthetist.
  2. Interact on a professional level with integrity. 
  3. Apply ethically sound decision-making processes. 
  4. Function within legal and regulatory requirements. 
  5. Accept responsibility and accountability for his or her practice. 
  6. Provide anesthesia services to patients in a cost-effective manner. 
  7. Demonstrate knowledge of wellness and chemical dependency in the anesthesia profession through completion of content in wellness and chemical dependency.
  8. Inform the public of the role and practice of the CRNA. 
  9. Evaluate how public policy-making strategies impact the financing and delivery of healthcare. 
  10. Advocate for health policy change to improve patient care.
  11. Advocate for health policy change to advance the specialty of nurse anesthesia. 
  12. Analyze strategies to improve patient outcomes and quality of care. 
  13. Analyze health outcomes in a variety of populations. 
  14. Analyze health outcomes in a variety of clinical settings. 
  15. Analyze health outcomes in a variety of systems. 
  16. Disseminate research evidence. 
  17. Use information systems/technology to support and improve patient care. 
  18. Use information systems/technology to support and improve healthcare systems. 
  19. Analyze business practices encountered in nurse anesthesia delivery settings.

DNAP Curriculum

Minimum coursework requirements are as follows:

Spring I or Summer I (Online)

NRAN 81123Biostatistics for the Advanced Health Practitioner (3)

3

NRAN 80113Research in Nurse Anesthesia (3)

3

Summer I or Spring I (Online)

NRAN 81153Emerging Sciences, Complexity & Innovation in Health Care (3)

3

NRAN 81233Decision Science and Informatics (3)

3

Fall I (Face-to-face)

NRAN 81243Translational Research (3)

3

NRAN 80323Physical Science in Nurse Anesthesia (3)

3

NRAN 80334Advanced Pharmacology (4)

4

NRAN 80346Advanced Anatomy, Physiology, and Pathophysiology I (6)

6

Spring II (Face-to-face)

NRAN 80435Advanced Anatomy, Physiology and Pathophysiology II (5)

5

NRAN 80413Advanced Anatomy, Physiology and Pathophysiology III (3)

3

NRAN 80424Pharmacology of Anesthesia Agents (4)

4

NRAN 81443Advanced Health Assessment: Anesthesia Focus (3)

3

Summer II (First Session) (Face-to-face)

NRAN 80516Principles of Anesthesia Practice I (6)

6

Summer II (Second Session) (Face-to-face)

NRAN 80526Principles of Anesthesia Practice II

6

Fall II

NRAN 80672Advanced Pathophysiology and Clinical Management I

2

NRAN 88080Advanced Project (3)

3

NRAN 80683Clinical Residency I

3

Spring III

NRAN 80672Advanced Pathophysiology and Clinical Management I (2)

2

NRAN 88080Advanced Project (3)

3

NRAN 80783Clinical Residency II (3)

3

Summer III

NRAN 81353Health Care Policy and Politics

3

NRAN 80882Clinical Residency III

2

NRAN 88080Advanced Project (3)

3

Fall III

NRAN 80972Clinical Concepts

2

NRAN 80983Clinical Residency IV

3

NRAN 88080Advanced Project (3)

3

NRAN 81153, NRAN 81123, NRAN 80113, NRAN 81233, NRAN 81243 are online courses

Due to the nature of the curriculum, courses outside of TCU are not transferrable, nor to be used in lieu of courses in the School of Nurse Anesthesia Curriculum.

Clinical Residency (minimum 16 months)

Upon completion of the initial 20 months of the program, students must immediately enter the clinical residency, which begins in late August and lasts approximately 16 months. During this time the student's learning is built on the material covered previously and comes primarily in a clinical residency although the student also returns to the classroom virtually on a weekly basis for extensive clinically related study. The clinical residency ends in December. The graduate receives a Doctor of Nurse Anesthesia Practice degree and is eligible to write the National Certifying Examination (NCE) for Nurse Anesthetists administered by the National Board of Certification and Recertification of Nurse Anesthetists (NBCRNA). Graduates who successfully complete this written exam are certified registered nurse anesthetists (CRNAs).


The clinical residency consists of administering general and regional anesthesia alongside a qualified clinical instructor (anesthesiologist or CRNA). Weekly classroom sessions are clinical conferences; journal clubs; and seminars dealing with current topics including, but not limited to, respiratory, cardiovascular, thoracic, neurosurgical, regional, obstetrical, pediatric and special areas of anesthesia. Various projects and competency examinations are required/administered throughout this phase.

Courses during clinical residency are offered in concurrent sequences. Each set, e.g., NRAN 80672 and 80683, must be taken together and successfully completed prior to beginning the next set.

DNAP to MHSc Degree Option

Students enrolled in the School of Nurse Anesthesia DNAP, who choose to transfer to the MHSc degree program, must have the recommendation of the faculty and have complied with the School of Nurse Anesthesia and TCU Code of Ethics and Professional Standards and Behavior. No direct admission is allowed to the MHSc.

Degree Requirements

Completion of the following coursework:

Spring Semester - 6 Hours

NRAN 80113Research in Nurse Anesthesia (3)

3

NRAN 81123Biostatistics for the Advanced Health Practitioner (3)

3

Summer Semester - 6 hours

NRAN 81113Complexity and Innovation in Health Care

3

NRAN 81233Decision Science and Informatics (3)

3

Fall Semester - 16 hours

NRAN 80323Physical Science in Nurse Anesthesia (3)

3

NRAN 80334Advanced Pharmacology (4)

4

NRAN 80346Advanced Anatomy, Physiology, and Pathophysiology I (6)

6

NRAN 81243Translational Research (3)

3

Spring Semester - 12 Hours

NRAN 80413Advanced Anatomy, Physiology and Pathophysiology III (3)

3

NRAN 80435Advanced Anatomy, Physiology and Pathophysiology II (5)

5

NRAN 80424Pharmacology of Anesthesia Agents (4)

4

AA-C (Certified Anesthesiologist Assistant) to DNAP Program Track, School of Nurse Anesthesia

Mission: To prepare Certified Anesthesiologist Assistants (AA-C's) to practice anesthesia as nurse anesthetists and to sit for the National Certification Examination (NCE) administered  by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

Alternate Admission Requirements for AA-C's

Full admission is accomplished in two steps. The first is Conditional Admission; the second is Full Admission.

Conditional Admission:

AA-C candidates must meet the following requirements:

  • Bachelor of Science (BSN) or Associate Degree in Nursing (ADN)
  • Unencumbered licensure as a Registered Nurse (RN)
  • Master's degree from an accredited school or college in the United States
  • Current certification  as an Anesthesiology Assistant (AA-C)
  • Submission of clinical transcript from AA program documenting  a minimum of 300 cases and 1,000 clinical hours
  • A minimum of 5 years experience as an AA-C

Additional Requirements (either 1 or 2 below):

1. Evidence of experience as an AA-C in a variety of complex cases caring for critically ill patients as documented by:

  • Curriculum Vita
  • Personal essay describing how the AA-C has developed critical decision-making and psychomotor skills, competency in patient assessment, and the ability to use and interpret advanced monitoring techniques consistent with the COA's definition of critical care experience. *
  • Validation of 5 years of experience in a variety of complex cases from a departmental Chief CRNA or an anesthesiologist who has medically directed the AA-C.
  • Submission of a case log from each practice site the AA-C has been employed since graduation.
    • The case log must include: Type of case and method and anesthesia for each case performed.

2. Or a minimum of one year current Critical Care experience as an RN

  • AA-C candidates will be conditionally admitted to begin the curriculum with the 12 online hours offered each spring and summer semesters.

Critical care experience - Critical care experience must be obtained in a critical care area within the United States, it's territories or a US military hospital outside of the United States. During this experience the registered professional nurse has developed critical decision making and psychomotor skills, competency in patient assessment, and the ability to use and interpret advanced monitoring techniques. A critical care area is defined as one where, on a routine basis, the registered  professional nurse manages one or more of the following: invasive hemodynamic monitors (e.g., pulmonary artery, central venous pressure, and arterial catheters), cardiac arrest devices, mechanical ventilation, and vasoactive infusions. Examples of critical care units may include but are not limited to: surgical intensive care, cardiothoracic intensive care, coronary intensive care, medical intensive care, pediatric intensive care, and neonatal intensive care. Those who have experiences in other areas may be considered provided they can demonstrate competence with managing unstable patients, invasive monitoring, ventilators, and critical care pharmacology.

Full Admission:

Successful completion of the initial 12 online hours.

Spring I or Summer I (Online)

NRAN 81153Emerging Sciences, Complexity & Innovation in Health Care (3)

3

NRAN 81123Biostatistics for the Advanced Health Practitioner (3)

3

Summer I or Spring I (Online)

NRAN 80113Research in Nurse Anesthesia (3)

3

NRAN 81233Decision Science and Informatics (3)

3

Fall I

NRAN 81243Translational Research (3)

3

NRAN 80323Physical Science in Nurse Anesthesia (3)

3

NRAN 80334Advanced Pharmacology (4)

4

NRAN 80346Advanced Anatomy, Physiology, and Pathophysiology I (6)

6

Spring II

NRAN 80435Advanced Anatomy, Physiology and Pathophysiology II (5)

5

NRAN 80413Advanced Anatomy, Physiology and Pathophysiology III (3)

3

NRAN 80424Pharmacology of Anesthesia Agents (4)

4

NRAN 81443Advanced Health Assessment: Anesthesia Focus (3)

3

Summer Semester

NRAN 80516Principles of Anesthesia Practice I (6)

6

NRAN 80526Principles of Anesthesia Practice II (6)

6

NRAN 81353Health Care Policy and Politics (3)

3

Fall II

NRAN 80672Advanced Pathophysiology and Clinical Management I (2)

2

NRAN 88080Advanced Project (3)

3

NRAN 80683Clinical Residency I (3)

3

Spring III

NRAN 80772Advanced Pathophysiology and Clinical Management II (2)

2

NRAN 88080Advanced Project (3)

3

NRAN 80783Clinical Residency II (3)

3

Requirements for the Summer III and Fall III terms

The requirement for the following two semesters is dependent on the individual's progression in the Clinical Residency. A minimum of 900 cases are required (300 may be documented by transcript from their Anesthesiology Assistant Master Degree program).

Summer III

NRAN 80882Clinical Residency III (2)

2

NRAN 88080Advanced Project (3)

3

Fall III

NRAN 80972Clinical Concepts (2)

2

NRAN 80983Clinical Residency IV (3)

3

NRAN 88080Advanced Project (3)

3

Online courses: NRAN 81153, NRAN 81123, NRAN 80113, NRAN 81233, NRAN 81243, NRAN 81353, NRAN 80672, NRAN 80772

Traditional face-to-face courses may be taken via Zoom technology, essentially making the program, with exception of clinical experiences, all online.

Each Advanced Clinical Project course is for three (3) credit hours. A minimum of two must be taken: NRAN 88080

Courses may be taken face-to-face in our TCU classroom OR synchronously via Zoom technology include: NRAN 80323, NRAN 80334, NRAN 80346, NRAN 80435, NRAN 80413, NRAN 80424, NRAN 81443, NRAN 80516, NRAN 80526.

The AA-C may receive credit examination for a maximum of 40 credit hours. Eligibility is determined by the AA-C's SEE results. A score of 450 or higher is required, as is approval by course faculty. Courses that may be tested out include: NRAN 80323, NRAN 80334, NRAN 80346, NRAN 80435, NRAN 80413, NRAN, 80424, NRAN 81443, NRAN 80516, NRAN 80526.

Not required if case requirement is met (900 cases): NRAN 80972.