The presidency in review - President's Message

Betty J. Shultz

As I write my last President's message, it is time again to say thank you for giving me the opportunity to serve as the President of AORN. It has been a year that I will never forget, and I am honored to have had the opportunity to serve you. AORN accomplished many goals this year because of your participation, the excellent staff members at AORN Headquarters and a Board of Directors that is dedicated to you and our Association.

ACHIEVING GOALS

Last year at Congress, I laid out the goals to be focused on for the year. I am happy to say that we accomplished many of these goals and a lot more. For example, the Board of Directors developed the following strategic objectives for AORN.

* AORN will be an indispensable resource for the perioperative nursing profession.

* AORN will be the recognized leader of the perioperative nursing profession.

* AORN will have strong, mutually supportive connections with its grassroots members.

* AORN will partner with other perioperative associations and industry to achieve our goals.

We also incorporated four questions for knowledge-based decision making into all Board decisions.

* What do we know about the current realities and evolving dynamics of our organization's environment that are relevant to this decision?

* What do we know about the capacity and strategic position of our organization that are relevant to this decision?

* What do we know about our stockholders' needs, wants, and preferences that are relevant to this decision?

* What are the ethical implications of our choices?

Naturally, the members of AORN have been our top priority. The Board chapter visit program has been a huge success. This year, the program was expanded to include state councils, and a total of 32 visits have been made to date. Since the start of the program, we have visited 89 chapters and state councils, and 10 more visits are scheduled to take place this spring. These numbers do not include chapter visits that were set up by chapters requesting a visit from an individual member of the Board.

NEW OPPORTUNITIES FOR MEMBERS

AORN continues to work to meet member needs through our specialty assemblies. I asked that two new assemblies be created, one for retired nurses and one for members in the military. As I write this in January, these specialty assemblies are in the process of being formed, along with several others. I hope we will be able to announce their approved formation before or during Congress 2004. All of our specialty assemblies will conduct networking groups at Congress. I am pleased to say that an Integrated Health Practices Specialty Assembly was formed in July 2003.

In addition, based on members' input, AORN will hold four multispecialty meetings during 2004 instead of two. These meetings will be held in four different areas of the country to better meet members' needs by bringing AORN education programs closer to individual members.

AORN also developed the AORN Communities web site template for chapters, specialty assemblies, and state councils to help these member groups develop and maintain web sites to communicate with their constituencies and disseminate information. More than 50 member groups already are using this template for their web sites.

New communication resources were implemented for members to report their concerns about the service they receive from AORN. These resources include a new e-mail address (ie, http://www.betterservice@AORN.org); a new toll-free hotline; and a postcard bound into each issue of the AORN Journal for which responses are routed to senior staff members for immediate follow-up. AORN also responded to direct feedback from its members and extended its switchboard and customer service hours from 7:00 AM to 6:00 PM MST.

Although the Board voted to discontinue SSM--Surgical Services Management, new resources for perioperative leaders and managers currently are being developed and will be available to AORN members soon. Information regarding these resources will be provided at Congress and in future AORN publications.

EDUCATIONAL OPPORTUNITIES

A new member benefit program offering educational loans through the Wells Fargo Capital for Knowledge program has been introduced by AORN. In addition to education financing, Wells Fargo offers free online education resources, including scholarships and college search engines. AORN and the University of Colorado Health Science Center School of Nursing, Denver, also are offering preferred tuition rates for an online RN to bachelor of science degree program for AORN members.

The AORN Foundation provided scholarships to a two-person AORN member team that included a perioperative and a materials manager, so they could attend the Georgetown University Healthcare Leadership Institute. The Foundation also is providing grants and scholarships to our members for a variety of educational opportunities.

AORN also completed a Student Resource Kit members can use when talking to schools of nursing and high school and middle school students. The kit includes a PowerPoint presentation that can be used when talking to students about perioperative nursing as a career. In addition, a new chapter award for promoting perioperative nursing at the high school level will be given at Congress this year. This award is designed to encourage grassroots efforts to attract high school student to careers in perioperative nursing.

HEALTHCARE LEGISLATION

Although we were not successful in acquiring Medicare reimbursement for certified RN first assistants (CRNFAs), our reimbursement legislation went down to the wire as an amendment to the federal Medicare bill. Unfortunately, it was dropped in the final, highly partisan negotiations between the House and Senate over prescription drug benefits. Congress instead approved a study of the reimbursement issue. AORN is continuing to work within the legislative and regulatory process, with a goal of ultimately achieving reimbursement for CRNFAs.

The Board launched a proactive legislative and regulatory initiative to ensure that there will be a registered perioperative nurse in the circulator role for each patient undergoing surgery or an invasive procedure in all 50 states. Staff members in AORN's Government Affairs department are focusing their efforts on seeking legislation or regulatory change to require registered perioperative nurses in the circulator role. In addition, AORN will be offering $500 scholarships for one individual from each state to attend the 2004 Advocacy Day held in Washington, DC, Sept 21, 2004.

With the assistance of AORN's lobbyist, legislative committee, state coordinators, and Government Affairs staff members, the governor of New York signed a Specialist Assistants Bill ($5518) into law. This bill amends the public health law in New York, in relation to the registration of a specialist assistant and closed a loophole that previously allowed licensure of assistive personnel.

GUIDELINES AND RECOMMENDED PRACTICES

The following new or updated statements or recommended practices are available in AORN's 2004 Standards, Recommended Practices, and Guidelines:

* AORN Guidance Statement--Safe Medication Practices in Perioperative Practice Settings,

* AORN Latex Guideline,

* Recommended Practices for Electrosurgery,

* Recommended Practices for Laser Safety in Practice Settings,

* Recommended Practices for Product Selection in Perioperative Practice Settings,

* Recommended Practices for Surgical Tissue Banking,

* Standards of Perioperative Professional Practice, and

* Recommended Practices for Surgical Hand Antisepsis/Hand Scrubs.

A guideline for bariatric surgery has been developed and is scheduled to be available at the 2004 Congress. The Ambulatory Surgery Principles and Practices study guide also has been completed. In addition, a revised RNFA position statement and a new patient safety position statement both will be taken to the 2004 House of Delegates for approval.

PARTNERING

A major goal during the past year has been to promote unity within the perioperative arena. In July, AORN hosted an executive symposium titled Envisioning the Future of Surgery. Fifty health care professionals representing the surgical arena gathered to discuss what the future holds for perioperative practice. Along with AORN member perioperative nurses, the group included leaders from perioperative nursing, the American College of Surgeons (ACS), The American Society of Anesthesiologists (ASA), hospital administrators, educators, representatives of ambulatory surgery centers and specialty hospitals, and industry leaders. The focus of the meeting was to identify key factors for the future of surgical practice. At the conclusion of the symposium, attendees pledged to work together to address workforce issues and improve teamwork in the perioperative setting. This meeting was extremely successful, and it set the stage for further collaboration.

As an outgrowth of this symposium, AORN, ACS, and ASA will be hosting a perioperative summit meeting with the leaders of the American Association of Nurse Anesthetists, the Association of Surgical Technologists, the Association of periAnesthesia Nurses, and the American Association of Surgical Physician Assistants to begin a collaborative effort to improve perioperative practice. Only by working together will we have the power and influence to effectively make a difference in patient and workplace safety, as well as in legislative issues.

In addition, AORN was invited by ACS to serve on a steering committee for an ACS Patient Safety Institute. We also participated in a workshop on high-reliability organizations at the invitation of the Anesthesia Patient Safety Foundation.

PATIENT SAFETY

The AORN Presidential Commission on Patient Safety has been very active. SafetyNet was launched by AORN in January 2003. This is a voluntary reporting system to capture data about close calls and near misses in the surgical arena. During the ensuing months, the Commission has been evaluating the aggregate data to deduct patterns that may lead to new guidelines, procedures, and educational programs to improve patient safety. The Commission also focused on correct site surgery and the new JCAHO Universal Protocol. A toolkit to assist perioperative team members in understanding and following the JCAHO protocol currently is in development and will be announced during Congress. Patient Safety also will be the focus of several Congress education sessions, and AORN has developed several new patient safety resources, including a series of audio-conferences and new teaching modules.

RESEARCH

During the past year, AORN conducted surveys on perioperative nurse staffing levels and compensation. Results of these surveys were published in AORN Connections and the AORN Journal. Complete survey reports can be obtained from AORN's Perioperative Bookstore and will be available in the bookstore at Congress. These surveys will be repeated periodically to provide members with current information about the effect of the nursing shortage and changes in compensation patterns.

Plans to conduct pilot studies at several surgical facilities to evaluate the impact of aviation-style training on communication and teamwork in the perioperative setting became a reality this year. A framework for these clinical demonstration projects was developed, pilot sites were selected, and the Foundation initiated fundraising efforts to support the studies, which will commence during the coming months.

BYLAWS CHANGES

A task force was created to address a motion that was approved by the 2003 House of Delegates to examine the definition and purpose of members-at-large and e-Chapter members and, in this context, examine delegate allocation. The Member-at-Large/e-Chapter Task Force developed two recommendations that will go to the 2004 House of Delegates for approval. These recommendations will help clarify who qualifies for member-at-large status and also will provide equal representation of members-at-large in the House of Delegates, using the same criteria and calculation for delegates as is used for chapters. The recommendations were published in the January 2004 AORN Journal.

The Board of Directors also recognized that our bylaws did not state how AORN chapters should select delegates. This led to allowing chapters to structure their chapter bylaws to fill their delegate quotas with anyone who is an active member of AORN if they so choose. This will give chapters that have been unable to seat all of their delegates the opportunity to have their chapter fully represented at the House of Delegates.

In addition, a Board task force was created to investigate the implementation of a Perioperative Nursing Data Set balanced scorecard model. Although this is not yet complete, information will be available soon.

CONCLUSION

As you can see, AORN has been actively working for you during this year. Although I cannot put everything we have accomplished in this article due to limited space, more information will be available during Congress 2004 in San Diego. Thanks to each and every member who has helped make this a successful year. I have had the time of my life, and I owe it all to you! Thank you!

Editor's note: PowerPoint is a registered trademark of Microsoft Corp, Redmond, Wash. Universal Protocol is a trademark of the Joint Commission on Accreditation of Healthcare Organizations.

COPYRIGHT 2004 Association of Operating Room Nurses, Inc.
COPYRIGHT 2004 Gale Group