# Anesthetic Personnel's Experiences and Perspectives With a National Standard for Safeguarding Anesthesia Practice: A Cross-Sectional Study in Norway

## TL;DR

This study explores how anesthesiologists and nurse anesthetists in Norway experience and use a national standard for safe anesthesia practice.

## Contribution

The study provides insights into the practical application and perceived relevance of a jointly developed national anesthesia standard.

## Key findings

- Approximately two-thirds of respondents found the NSA relevant to their daily work.
- 13 to 30 percent reported using the NSA in root cause analyses of adverse events.
- Statistically significant differences were found between anesthesiologists and nurse anesthetists in their responses.

## Abstract

Background: Globally, anesthesiologists and nurse anesthetists collaborate closely during anesthesia administration. However, there is a scarcity of guidelines detailing the division of tasks and responsibilities between these two professions. The Norwegian Standard for the Safe Practice of Anesthesia (NSA) was developed jointly by the Norwegian Association of Anesthesiologists and the Norwegian Association of Nurse Anesthetists as a consensus guideline to safeguard satisfactory anesthetic practice. This study aimed to explore the experiences and perspectives of anesthesiologists and nurse anesthetists regarding the NSA.

Methods: The study employed a cross-sectional, observational design, utilizing a questionnaire. A purposive sampling strategy was employed, inviting all members of the two associations (N = 3300) to participate in a web-based survey. Data were analyzed using the Statistical Package for the Social Sciences, Version 28. Descriptive statistics and independent samples t-tests were utilized to analyze the data. A two-sided p value of ≤ 0.05 was considered statistically significant.

Results: In total, 823 respondents (24.9%) completed the questionnaire in September 2024. The results indicate several areas for improvement to achieve the recommended standards of anesthetic practice as outlined by the NSA. Statistically significant differences were observed between responses from anesthesiologists and nurse anesthetists. Approximately two-thirds of respondents reported the NSA as relevant to their daily work, and between 13 and 30 percent had experienced or were aware of situations where the standard was utilized in root cause analyses of adverse anesthetic events.

Conclusion: The findings suggest that the NSA is employed in clinical practice. However, assuming the NSA ensures satisfactory anesthetic practice, there are several areas requiring improvement. Given the overlapping roles and responsibilities of anesthesiologists and nurse anesthetists, the NSA may serve as a model for similar guidelines in other countries.