RHODE ISLAND BOARD OF EDUCATION 80 WASHINGTON STREET, SUITE 524 PROVIDENCE, RHODE ISLAND Rhode Island Board of Education

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1 RHODE ISLAND BOARD OF EDUCATION 80 WASHINGTON STREET, SUITE 524 PROVIDENCE, RHODE ISLAND EVA MARIE MANCUSO, ESQ. CHAIR PATRICK GUIDA, ESQ. VICE CHAIR COLLEEN A. CALLAHAN, ED.D. SECRETARY ANTONIO BARAJAS, M.D. MICHAEL BERNSTEIN KARIN FORBES JO EVA GAINES MICHAEL GRANDE, CPA WILLIAM MAAIA, ESQ. LAWRENCE PURTILL MATHIES SANTOS, LT. COL. (RET.) TO: FROM: RE: Rhode Island Board of Education Ray M. Di Pasquale, Interim Commissioner of Higher Education Approval of Saint Joseph Hospital School of Anesthesia for Nurses as a Rhode Island Post Secondary Proprietary Program In accordance with the RIBGHE Regulations Governing Proprietary Schools in Rhode Island, the Rhode Island Office of Higher Education granted Associates in Anesthesia, Inc. (AIA) authorization in March 2013 to apply for initial approval from the Rhode Island Board of Education to operate the St. Joseph Hospital School of Anesthesia for Nurses (SJHSAN) as a post secondary proprietary school in Rhode Island. On May 30, 2013, AIA submitted a full application for initial certificate approval to operate SJHSAN. The Office of Higher Education has reviewed this lengthy application carefully. AIA has met all necessary conditions for certification as outlined in the regulations, including posting Bond number in the amount of $10,000 on April 25, At this time, the OHE staff recommends: Enclosure 2f July 11, 2013 THAT Associates in Anesthesia, Inc. be granted initial Board of Education approval to operate the St. Joseph Hospital School of Anesthesia for Nurses as a post secondary proprietary school in Rhode Island. BACKGROUND INFORMATION St. Joseph Hospital School of Anesthesia for Nurses (SJHSAN) is a post secondary educational program that is run under the auspices of Associates In Anesthesia, Inc. (AIA), a private medical practice located at Our Lady of Fatima Hospital in North Providence, RI. The program was founded by AIA in 1962 for the purpose of providing formal clinical training for Nurse Anesthetists. In 1990, SJHSAN implemented a more progressive academic trajectory by offering the opportunity for nurses to become Certified Registered Nurse Anesthetists by earning a Master of Science in Nurse Anesthesia from the University of New England. Telephone (401) Fax (401) TTY (401) Website: The Board of Education does not discriminate on the basis of age, sex, sexual orientation, gender identity/expression, race, color, religion, national origin, or disability.

2 Board of Education July 11, 2013 Work Session Page 2 In April 2013, the Rhode Island Board of Education approved a proposal from Rhode Island College to add a nurse anesthesia program option within the Master of Science in Nursing degree program. In 2014, RIC will contract with SJHSAN to provide the clinical training necessary for a M.S.N. in Nurse Anesthesia and for professional licensure. To date, SJHSAN has enrolled over 360 students from throughout the country. SJHSAN graduates represent a large portion of the working nurse anesthetists in Rhode Island. More information is available in SJHSAN s student brochure at MISSION STATEMENT St. Joseph Hospital School of Anesthesia for Nurses aims to enhance and expand the knowledge, attitude, and skills of the professional nurse in a graduate framework so that he/she, as a nurse anesthetist, can function safely and effectively in any setting with patients of all ages. This is accomplished through application of educational principles, methodology, theory, and practice in the range of activities related to anesthesia through optimum utilization of clinical and other learning resources. This is guided by the values of respect, compassion, responsibility and teamwork. ACCREDITATION STATUS SJHSAN is fully accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), 222 S. Prospect Avenue, Park Ridge, IL Telephone: (847) The certification pass rate for SJHSAN first time takers (2010) is 90%. The pass rate for second time takers (2010) is 100%. All graduates secure employment within six months of graduation and most secure employment before graduation. The SJHSAN attrition rate for the class of 2010 is 9%. SJHSAN has been fully accredited since 1962 and last received full ten year accreditation in 2006 and maintains this status until the next review cycle in THE FIELD: CERTIFIED REGISTERED NURSE ANESTHETISTS (CRNAs) Nurse anesthetists have been providing anesthesia care to patients in the United States for more than 125 years. The credential CRNA (Certified Registered Nurse Anesthetist) came into existence in CRNAs are anesthesia professionals who safely administer approximately 30 million anesthetics to patients each year in the United States, according to the American Association of Nurse Anesthetists (AANA) 2006 Practice Profile Survey. CRNAs are the primary anesthesia providers in rural America, enabling healthcare facilities in these medically underserved areas to offer obstetrical, surgical, and trauma stabilization services. In some states, CRNAs are the sole providers in nearly 100% of the rural hospitals. According to a 1999 report from the Institute of Medicine, anesthesia care today is nearly 50 times safer than it was 20 years ago. Numerous outcomes studies have demonstrated that there is no difference in the quality of care provided by CRNAs and their physician counterparts.

3 Board of Education July 11, 2013 Work Session Page 3 CRNAs provide anesthesia in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified healthcare professionals. When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by an anesthesiologist, it is recognized as the practice of medicine. Regardless of whether their educational background is in nursing or medicine, all anesthesia professionals give anesthesia the same way. As advanced practice nurses, CRNAs practice with a high degree of autonomy and professional respect. They carry a heavy load of responsibility and are compensated accordingly. CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. military, Public Health Services, and Department of Veterans Affairs healthcare facilities. Nurse anesthetists have been the main providers of anesthesia care to U.S. military men and women on the front lines since WWI. Nurses first provided anesthesia to wounded soldiers during the Civil War. Managed care plans recognize CRNAs for providing high quality anesthesia care with reduced expense to patients and insurance companies. The cost efficiency of CRNAs helps control escalating healthcare costs. CLINICAL INSTRUCTION Currently, didactic core courses such as physiology, pharmacology, and physics are provided by the University of New England and next year by Rhode Island College. Courses in Anesthesia will be given at both RIC and at SJHSAN. For a full listing of required coursework, please consult the attached application. St. Joseph Health Services of RI, a Charter CARE Health Partner, includes Our Lady of Fatima Hospital in North Providence, RI. The Fatima Unit is where the school is based and serves as the students primary clinical site. Anesthesia is administered for all types of surgical procedures, excluding open heart surgery, organ transplantation and obstetrics. In addition, St. Joseph Hospital School of Anesthesia for Nurses has clinical rotations at five affiliated sites: Rhode Island Hospital (Providence, RI) for extended experiences in neurosurgical, cardiovascular and thoracic anesthesia. Hasbro Children's Hospital (Providence, RI) for experience in pediatric anesthesia. St. Vincent Hospital (Worcester, MA) for experience in obstetrical anesthesia. MetroWest Medical Center (Framingham, MA) for experiences in general and regional anesthetic techniques. Boston Veterans Administration Medical Center (West Roxbury, MA) for experience in general anesthesia, cardiac anesthesia and regional anesthetic techniques.

4 Board of Education July 11, 2013 Work Session Page 4 SJHSAN awards a clinical certificate to students who have completed 2,000 to 3,000 required clinical hours. PROGRAM PERFORMANCE DATA Graduation Year # of Students # of Graduates # of Students Who Returned After Withdrawal Attrition Rate % of Grads that Passed NCE # that Passed NCE on First Attempt # that Passed NCE Employment on Rate Second Attempt % % % % % % % % % % % % SUMMARY AIA has successfully complied with all the required documentation to obtain initial approval as a proprietary school in Rhode Island. SJHSAN is in excellent standing and is to be commended for its 50 years of service to the anesthesiology profession in Rhode Island. The RI Office of Higher Education recommends that the Board of Education approve SJHSAN as a proprietary school.

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