Here we are, at the start of another ANNA year! For over 1,000 of us, this year started with all the excitement of our National meeting. Those who were able to come to Orlando saw many starfish, and heard the story of the starfish: a parable of making a difference “one at a time.” My “theme” for this year is really about making a difference – doing things that matter to take ANNA forward.
Our Mission Statement says we will promote excellence by advancing nephrology nursing practice and positively influence outcomes for individuals with kidney disease. Are these just words, or do we really mean it? If we mean it, and I believe we do, then we have some opportunities for improvement – areas where we can do some work this year to take ANNA forward.
Membership. For the past several years, our membership numbers have been decreasing. At this point, we have barely 10,000 members. How can this be? While we don’t know how many nephrology nurses there are out there, we do know there are more than 30,000 nurses working in outpatient dialysis alone! That does not count nephrology nurses who work in transplant, CKD, acute care, and other areas. We know that many of the hospital-based programs in the northeastern US that have been a mainstay for the support of professionalism in nursing are disappearing, so even more loss of members could occur. One opportunity we have as an association is to more effectively partner with dialysis providers. Our major “customer” is the outpatient dialysis nurse. We must find ways to make our Association more attractive to this customer and to his/her employer. We need your ideas on how to do this. Please feel free to email those to us at firstname.lastname@example.org.
Networking. One way to bring more nephrology nurses into active membership is to offer ready access to current practice trends. I’m so proud that an idea born in Donna Painter’s term made its debut at this year’s National Symposium with the launch of the Specialty Practice Networks (SPNs)! The SPNs will provide a virtual community for each of our major clinical and functional practice areas and offer more resources and timely responses to important questions.
Each SPN has a facilitator to coordinate the work and three team leaders: one each for Education, Best Practice, and Publications. Every ANNA member may sign up for one, two, three, or even all eight SPNs. The team leaders will be calling on members of their SPN for ideas and help with projects. I hope everyone will sign up to participate in these online communities that will be “spinning” with new ideas, answers to clinical questions, and guidance to best practices.
Electronic Resources. We are committed to increasing the availability of our resources in electronic format. The Nephrology Nursing Scope and Standards of Practice is now available in e-Book format and it is fabulous! The Online Library now includes an archive of all Nephrology Nursing Journal content back to 2000 in an easily searchable format. We promise more to come in this area. Our recent survey showed tremendous interest in electronic versions of our classic references. We’ll explore those options.
Health Policy. Nephrology nurses need a voice! Our goal is to be actively engaged at every level. On the federal level, we’ll be using our Federal Health Care Consultant and our representative to Kidney Care Partners to be sure that the messages from nephrology nurses are brought forward. We have struggled with having an effective presence in state health policy. Just knowing something is happening in time to participate is a challenge! This year we are refocusing our Health Policy Advisors to monitor state issues, and we are exploring ways to be more proactive in our responses to state issues. We will be asking our chapter health policy representatives to be active partners with us on state issues. For example, to make contact with all the State Boards of Nursing to educate them about the value ANNA can bring to the table when questions about nephrology come up. We also will be participating in state health policy coalitions to have an ANNA voice at the state level: speaking up for our patients and our nurses.
Reshaping ANNA for the Future. If the membership approves a change to the ANNA Bylaws this fall, we will reshape the ANNA organizational structure to reflect a national focus, with each member of the Board of Directors elected nationally. This is not a new idea; most nursing organizations completed this change years ago. Mary Ann Gould suggested it to ANNA during her Presidency in 2001-02; Sandy Bodin brought it up again in 2007-08. Your Board of Directors believes now is the time. More information is already on our website at www.annanurse.org/future and will be updated as the year moves along.
While allowing more Board of Director time and energy to be focused on moving ANNA forward, we cannot and will not forget that support of our local chapters is critical. This plan will establish a chapter support team that will provide a larger number of volunteer leaders than we currently have allotted to assist chapters in forming and maintaining strong local organizations.
Improving Patient Outcomes. Most of these opportunities focus on advancing nephrology nursing practice, but many also have potential to positively influence outcomes for individuals with kidney disease, which really is the heart of nephrology nursing. Here are some areas of focus where we hope to improve patient outcomes:
- Patient Engagement: The only way to make a difference for fluid management in dialysis and for weight management and medication adherence in transplant is to engage patients as active partners in their care. If you were not able to attend the National Symposium or did not get to Tuesday’s breakfast session entitled Patient Transitions in CKD and Chronic Dialysis: Achieving Patient-Centered Care, I would highly recommend you take the time to view that session in our Online Library.
- Communication: Effectively communicating with patients is one of the hardest things we do. We are already working on several projects that will result in tools for use in patient education and are open to ideas for more.
- Using Knowledge We Already Have: We need to find ways to ensure our newer nurses have the benefit of the lessons we already learned. The Acute Care Hemodialysis Orientation Manual and Assessment Tools published this year is a start on these “tools you can use.” We are committed to providing more in this area.
- Building a More Evidence-Based Practice: We will focus on supporting research into basic nephrology nursing so we really know what works and what doesn’t. Our Research Committee has a project in process looking at catheter site care. Stay tuned for these results.
Nurse-Sensitive Outcomes. With the dialysis payment system now including a Quality Incentive Payment (QIP) provision in which poor performance on specified quality measures results in payment reduction, the Board of Directors has recently authorized a task force, being led by Carolyn Latham, to develop nurse-sensitive outcomes for nephrology. Nurse-sensitive outcomes in hospitals include patient falls and hospital-acquired pneumonia. This task force is charged with defining nephrology nurse-sensitive outcomes in outpatient dialysis. Once the task force completes their work, the next step could be to propose one or more of those outcomes as a quality measure for the QIP. Just imagine: a nurse-sensitive outcome as a QIP measure.
Your Commitment Is Needed! ANNA can do better and can be better, but it is hard work and none of us can do this alone. It will take each of us working hard together to truly make the difference – for our patients, for nephrology nurses, and for our association. The accomplishments of ANNA depend on ALL of us working together to take ANNA forward. Thanks for the work you have done and will be doing as we work through this exciting year together.
Glenda Payne, MS, RN, CNN
ANNA President, 2012-2013