www.aana.com/aanajournalonline AANA Journal  December 2019  Vol. 87, No. 6 441 The National Academy of Medicine recognizes medi- cal errors as a leading cause of death in the United States. Hospitals nationwide have acted to improve patient safety, quality of care, and system processes; however, no standards mandate assessment of the emotional impact of perioperative catastrophes on healthcare professionals. A cross-sectional descrip- tive study using a sample of 196 Certified Registered Nurse Anesthetists (CRNAs) tested the psychometric properties of an adapted version of the Periopera- tive Catastrophes Survey and administered this sur- vey along with the Ways of Coping Questionnaire to measure CRNAs’ perceptions, experiences, and responses associated with perioperative catastrophes. The adapted survey demonstrated acceptable internal consistency reliability (α = .893) and construct validity (factor analysis), with 4 subscales explaining 68.1% of the variance in the measure. The CRNAs scored simi- larly to anesthesiologists in a prior study conducted by Gazoni and colleagues, showing that memorable perioperative catastrophes have a negative emotional, cognitive, and functional impact. On the 8 Ways of Coping Questionnaire subscales, CRNAs with less than 10 years of experience reported significantly higher Escape-Avoidance behaviors compared with more experienced CRNAs (P = .016). Future research must examine perceptions of perioperative catastrophic events and coping mechanisms to identify providers at risk of negative consequences. Keywords: Aftermath, CRNAs psychometric, nurse anesthesia, perioperative catastrophic event. Preliminary Psychometric Evaluation of the Nurse Anesthesia and the Aftermath of Perioperative Catastrophes Survey and the Ways of Coping Questionnaire Maria van Pelt, PhD, CRNA, FAAN Suzanne C. Smeltzer, RN, EdD, ANEF, FAAN Frederick van Pelt, MD, MBA Farnaz M. Gazoni, MD Marcel E. Durieux, PhD, MD Rosemary C. Polomano, PhD, RN, FAAN T he US government, accreditation agencies, and professional organizations have established patient safety as a national priority. 1 Stan- dards have been promulgated and regulations enacted to ensure that healthcare administra- tors and clinicians take appropriate actions to promote safe patient care practices and prevent adverse events. Moreover, systematic analyses of root causes associated with adverse events are recommended to ensure that healthcare system leaders and clinicians learn from actual mishap events and near-misses to reduce risks of further untoward events. 2 Although systems and human-focused prevention strategies are critical to proactive risk reduction of adverse events and errors, patient safety initiatives are only now beginning to address the emotional conse- quences and the impact on clinicians involved in un- anticipated adverse events or errors. Adverse events not only affect patients and the healthcare system but also have negative consequences on the healthcare providers involved in such events. 3 Wu 4 was first to coin the term second victim to describe physicians negatively affected by medical error. Scott et al 5,6 subsequently broadened the term to encompass all healthcare providers involved in adverse clinical events beyond medical errors and studied the impact of the second victim phenomenon. Their findings validated that many healthcare providers (physicians, nurses, allied health professionals, support personnel, and students) are subject to emotional distress after experiencing an adverse event. Studies have explored anesthesiologists’ direct and indirect experiences with perioperative catastrophes. 7,8 However, nurse anesthetists’ experiences, perceptions and responses following perioperative catastrophic events causing serious patient harm or even death have not been adequately investigated. Given the serious nature of critical events and national attention to preventing perioperative mishaps, more research is necessary to understand the extent to which nurse anesthetists expe- rience, respond to, and cope with unanticipated serious