ANA Delegates Take Action On Major Health Issues

Nurses' Voices Heard during Convention in Minneapolis

Washington, DC - Creating a culture of safety, protecting the environment and ensuring advanced practice registered nurses' (APRNs) ability to practice fully - these are just some of the issues that nurse leaders participating in ANA's House of Delegates (HOD) acted on at their June meeting.

The HOD, comprised of 630 nurses, largely from ANA's constituent member associations (CMAs), began June 25 and was held in conjunction with ANA's convention in Minneapolis, MN. This year, as a result of the 2003 bylaws amendments, ANA's organizational affiliates had both voice and votes in the House of Delegates.

"The ANA House of Delegates has spoken with a strong, unified voice not only on a wide-ranging group of issues that will impact the profession of nursing but also on global issues of health care and human rights," said ANA president Barbara A. Blakeney, MS, APRN,BC, ANP.

Protecting practice, patients

In one of its first actions, the HOD approved a measure that builds on the Institute of Medicine's (IOM) recommendations outlined in a report called Keeping Patients Safe: Transforming the Work Environment of Nurses, which addresses needed workplace changes - including maintaining appropriate staffing - to prevent medical errors and ensure quality patient care.

Specifically, delegates called on the national association to use the IOM report recommendations as a guide for establishing research, safety and quality of care policy priorities. The measure also calls for ANA to reaffirm the strategies and objectives that the nursing community identified three years ago in its ground-breaking, strategic document, Nursing's Agenda for the Future.

In another action, delegates agreed with a plan to ensure APRNs' rights to provide care as defined in their scopes of practice. This action was spurred by policies in some health care facilities in which medical staff determines who can have clinical privileges and oversee patient care - essentially preventing some APRNs from practicing fully.

The HOD wants ANA to develop an APRN clinical privileging model that incorporates standards that preserve the professional autonomy and the integrity of nursing practice; recognize the full scope of the APRN's role; integrate with systems mandated by external regulatory and accrediting entities; and be consistent with a clinical staff privileging process that includes APRN participation.

The ANA also is being called on to work with other groups to advance this effort and promote the incorporation of a clinical privileging model into the Magnet™ Recognition Program.

Delegates also discussed the valuable role that technology can play in preventing medical errors. However, they want to ensure that technology does not replace or interfere with RNs' clinical judgment.

Therefore, they passed a resolution asking ANA to support the essential role of the individual RN in maintaining responsibility and accountability for independent decision making related to patient care in accordance with the scope and standards of nursing practice. Further, delegates want ANA to promote RN involvement in the research, development, evaluation and purchase of technological systems that support their critical thinking and decision making. And, these systems must be integrated into the workplace without increasing staff work load or intensity and while improving the safety and quality of patient care.

Environmental issues

The HOD approved two resolutions addressing environmental issues. One centers on the need for ANA to define how nurses and the profession can assume leadership in reducing the burden of environmentally associated disease now and in the future. Delegates called on ANA to provide that leadership by developing environmental health principles based on the "Precautionary Principle." (When using the precautionary principle, health care workers use products and practices that do not harm the environment.)

The other environmental action centers on the agricultural use of antibiotics leading to antibiotic resistance in humans. Specifically, delegates asked ANA to urge Congress, meat and poultry producers and bulk purchasers of meat to promptly phase out the non-therapeutic use of medically important antibiotics and the use of fluoroquinolones ( a class of drugs that includes ciprofloxacin) in poultry.

The health care environment

Delegates voiced their concerns about the need to protect the integrity of the scientific peer-review process from political and ideological forces. The HOD subsequently approved a resolution that ANA oppose any political or ideological interference in the conduct of rigorous, apolitical peer review of research provided by experts in the respective field of inquiry and related funding processes.

In another resolution, delegates addressed the need for patient safety and nursing practice measures to be implemented in light of medication cost-savings efforts, such as the movement to purchase drugs from other countries.

Specifically, delegates want ANA to affirm the need to examine and address the potential patient-consumer safety and nursing practice implications of current efforts to reduce spending on drugs, and to support efforts to raise awareness of the potential impact of pharmaceutical cost-containment efforts on patient safety.

ANA changes

The HOD passed a resolution intended to protect the rights of all CMA nurses to participate in ANA, as well as strengthen CMAs. Specifically, CMAs must continue to pay dues to ANA unless two-thirds of the entire membership votes to discontinue its partnership with the national association.

Delegates approved a request by the ANA Board of Directors that will provide periodic increases in the dues paid to ANA by CMAs -called a "dues escalator" -- that will be tied to the Consumer Price Index-Urban (CPI-U). The increased funding will be used to strengthen ANA initiatives to ensure that it remains the singular, national voice of nurses.

The dues escalator will be calculated on an annual basis, implemented every three years without additional HOD action, and will be rounded to the nearest dollar.

Other actions

Delegates passed a resolution condemning the death sentences handed down to five Bulgarian nurses and a Palestinian physician in Libya. The six health professionals were falsely accused of spreading HIV in a children's hospital in Benghazi, Libya.

In another measure, delegates want ANA to support U.S. ratification of two United Nations treaties: the "Convention on the Rights of the Child" and the "Convention on Elimination of All Forms of Discrimination Against Women."

"Nurses, as the single-largest profession in the complicated, health care picture, have an integral role to play," said ANA chief executive officer Linda J. Stierle, MSN, RN, CNAA,BC. "Our actions at the House of Delegates underscore our commitment to improved health and a stronger nursing profession."

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The American Nurses Association is the only full-service professional organization representing the nation's 2.7 million registered nurses (RNs) through its 54 constituent member associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.

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