A national survey of certified registered nurse anesthetists' knowledge, beliefs, and assessment of herbal supplements in the anesthesia setting.

This study explored Certified Registered Nurse Anesthetists' (CRNAs') knowledge about 8 common herbal supplements that potentially cause perioperative complications, beliefs regarding herbal supplement-anesthesia interactions, and preoperative assessment practices. A multiple-choice descriptive survey was mailed to a random sample of CRNAs from the American Association of Nurse Anesthetists (AANA). Although response was low (19%, N = 191), respondent demographics corresponded to AANA 2002 CRNA membership. The mean knowledge score of adverse interactions was 21%; 17% of CRNAs indicated confidence in their familiarity with herbal supplement-anesthesia interactions. Of the participants, 23% correctly identified the ASA recommendation to discontinue herbal supplements 2 weeks before surgery. CRNAs agreed that herbal supplement use should be assessed preoperatively (92%), they are medically active (88%), and they can have an impact on surgical outcomes (87%). Nearly 4 in 10 respondents used herbal supplements themselves, but only 5% recommend supplement use to patients. Most CRNAs (93%) wanted more educational opportunities on anesthesia and herbal supplements. The low knowledge scores and lack of confidence in familiarity with herbal supplement-anesthesia interactions highlight the need for further CRNA education. Nurse anesthesia educational curricula and continuing education programs should be reviewed and updated to ensure adequate instruction on herbal supplements.