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The Norwegian standard for the safe practice of anaesthesia was first published in 1991, and revised in 1994, 1998, 2005, 2010 and 2016 respectively. The 1998 version was published in English for the first time in Acta Anaesthesiologica Scandinavica in 2002. It must be noted that this is a national standard, reflecting the specific opportunities and challenges in a Norwegian setting, which may be different from other countries in some respects. A feature of the Norwegian healthcare system is the availability, on a national basis, of specifically highly trained and qualified nurse anaesthetists. Another feature is the geography, with parts of the population living in remote areas. These may be served by small, local emergency hospitals. Emergency transport of patients to larger hospitals is not always achievable when weather conditions are rough. These features and challenges were considered important when designing a balanced and consensus‐based national standard for the safe practice of anaesthesia, across Norwegian clinical settings. In this article, we present the 2024 revision of the document. This article presents a direct translation of the complete document from the Norwegian original. [ABSTRACT FROM AUTHOR]

Lack of moral courage may lead to moral stress for healthcare personnel and to unethical behavior or adverse events for patients. Hospital operating room (OR) teams include surgeons, OR nurses, Certified Registered Nurse Anesthetists (CRNAs), anesthesiologists, and student registered nurse anesthetists (SRNAs). Due to the multidisciplinary work in a stressful, high-technology and high-risk environment, the OR is the context for most of the unethical behavior reported in hospitals. The purpose of this study was to explore SRNA experiences of moral courage in the OR. We used a critical incident technique, utilizing 40 SRNA narratives of situations including moral courage/lack of moral courage. The narratives were analyzed using thematic analysis. Findings indicate that unethical behavior potentially leading to patient safety or work environment issues could be avoided when OR personnel showed moral courage by speaking up for patients or for colleagues. Lack of moral courage was indicated by tacit acceptance of unethical behavior or lack of collaboration. SRNAs need not only to learn about the CRNAs' professional obligations and tasks but also to develop moral courage to be able to respond to unethical behavior or communication in the OR. Hence, students should be introduced to such issues during their education., Competing Interests: Name: Anne-Marie Gran Bruun, RN, NA, MNSc Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Berit T. Valeberg, RN, NA, PhD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Ann-Chatrin L. Leonardsen, RN, NA, PhD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. The authors did not discuss off-label use within the article. Disclosure statements are available for viewing upon request., (Copyright © by the American Association of Nurse Anesthetists.)

Traditionally, anesthetic records were in paper format. An increasing volume of complex data, legislation, and quality improvement initiatives related to clinical documentation have promoted the transition to digital records. Anesthesia information management systems (AIMS) have been designed to directly extract patient information from the anesthesia workstation and transmit the data into documentation systems and databases. The purpose of this review was to explore existing literature on anesthesia personnel's experiences with digital AIMS. Literature searches were conducted in PubMed, Cumulative Index to Nursing & Allied Health Literature, Embase, and The Cochrane Database of Systematic Reviews. A total of 473 records were identified, of which 40 records were read in full-text. Seven records underwent quality appraisal, representing research from 1991 to 2018, all with a quantitative design. In total, 379 anesthesia personnel were included. Five studies were conducted in the United States; 1, in Korea; and 1, in Germany. Results were collated into the themes user satisfaction, technical aspects, physical placement of the system, paper-based vs electronic data entry, quality of care, and suggestions for improvement. Findings indicate both positive and negative effects of AIMS. Anesthesia personnel's experiences should be included in the planning, development, and implementation of digital data entry systems., Competing Interests: Name: Ann-Chatrin L. Leonardsen, PhD, RN, NA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Partly supported by the Department of Anesthesiology, University of Minnesota. Name: Anne Marie Gran Bruun, MNSc, RN, NA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: Partly supported by the Department of Anesthesiology, University of Minnesota. Name: Berit T. Valeberg, PhD, RN, NA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. The authors did not discuss off-label use within the article. Disclosure statements are available for viewing upon request., (Copyright © by the American Association of Nurse Anesthetists.)