2001 resolutions

• Resolution #1: Nursing' Agenda to Shape the Future-for the Profession and for Safe, Quality Care Delivery
• Resolution #2: Reduction of Unnecessary or Duplicative Documentatione
• Resolution #3: Safeguarding the Iowa Board of Nursing
• Resolution #4: Mandatory Overtime: Continuing To Build Safer Heath Care Systemss
• Resolution #5: Collection of Nursing Work Force Data
• Resolution #6: Provision of Information about Health Care Options
• Resolution #7: Nursing Education Articulation Reaffirming
• Resolution #8: Rural Health Care Resources
• Resolution #9: Whistleblower Protection Continuing To Build Safer Health Care Systems
• Resolution #10: Nursing and Human Immunodeficiency Virus (HIV)
• Resolution #11: Nurses Responding To Bioterrorism Threats

Whereas,   At the 2000 Iowa Nurses Association HOD, members recognized the need to address the current impending implications of staffing, as a contributing factor to the nursing shortage and professional practice environment; and

Whereas,   Iowa Council of Nurses (ICON) recently completed the Nursing Shortage Workforce Survey; and

Whereas,   Iowa was recently ranked 50th in the nation on average nursing salaries; and

Whereas,   In 2010 the nursing supply no matter how redistributed or additionally educated will no longer meet projected consumer needs or industry demand; and

Whereas,   Advances in science and technology, coupled with the resources needed to manage chronic illness and aging Iowa population increase the demand for health services; and

Whereas,   Increasing diversity among health care consumers adds another layer of demand for access to care that meets specific cultural needs; and

Whereas,   Much of today's nursing shortage and the professional image of nursing could be improved if health care provider organizations would address specific workplace and professional practice concerns; and

Whereas,   Research has confirmed that sufficient and appropriate nurse staffing assures quality care, minimizes the likelihood of adverse events; and reduces length of hospital stay which ultimately reduces the cost of health care; and

Whereas,   Staff nurses working in acute care environments are increasingly being reassigned to clinical specialty areas for which they may not have current clinical skill and knowledge; and

Whereas,   Nurses and nursing have a strong desire and commitment to create environments that meet the mutually beneficial needs of patients and nurses; and

Whereas,   ANA has issued a Call to the Profession to come together around an agenda to preserve health care's most pivotal resources and commodity, nurses and safe, quality care; and therefore be it

Resolved,   That Iowa Nurses Association participate in new and ongoing efforts with other organizations and groups to assess and outline changes within the work environment, the health care industry, nursing education programs and workforce diversity to promote accessible quality health care delivery; and be it further

Resolved,   That Iowa Nurses Association promote an agenda for focus on nursing' role and value in health care delivery; and be it further

Resolved,   That Iowa Nurses Association continue to identify issues of recruitment and retention of nurses in all roles; and in all settings and be it further

Resolved,   That Iowa Nurses Association support activities to develop guidelines for successful transitions to be used by registered nurses in situations where nurses face reassignment due to nursing shortage

Whereas,   Documentation of patient conditions, treatment, nursing care and outcome is necessary; and

Whereas,   Documentation requirements in all settings come from varied sources: federal and state governments, Medicare and Medicaid conditions of participation, JCAHO and other accrediting groups, Peer Review Organizations (PRO) and state regulatory, health and social services agencies; and

Whereas,   Documentation requirements of these agencies are becoming increasingly duplicative; and

Whereas,   An inordinate amount of nurses' time is spent on documentation, 25% of acute care nurses' time and 50 % of a home care nurses' time is spent attending to documentation not patients; and

Whereas,   Nurses want and need to care for patients not documentation; and

Whereas,   Valuable nurse-sensitive data is essential to making nursing's contribution to health care visible; and

Whereas,   Technology and models of documentation exist to assist efficient and effective gathering of essential data; and

Whereas,   Efforts to reduce duplicative documentation are important, they should not supercede other strategies that are critical in improving the work environment, therefore be it

Resolved,   That the Iowa Nurses Association work to minimize the burden created by unnecessary and inefficient documentation by eliminating individual and non-value added recording and promoting the collection of relevant nursing clinical data, in efficient, retrievable and comparable format.

Whereas,   The Iowa Board of Nursing is established to protect the safety of the public; and

Whereas,   Iowa is focusing on patient safety issues; and

Whereas,   It is in the public interest for the Iowa Board of Nursing to share a mutual interest in public protection and it is in the public interest for the Board of Nursing to serve as a resource to educate nurses and the public about safe practice; and

Whereas,   The Iowa Board of Nursing is directed to set their fees to cover the expenditures for licensure and discipline of nurses practicing in Iowa; and

Whereas,   The Iowa General Assembly has routinely appropriated less than 85% of the fees generated from licensing, renewals and discipline of nurses back to Iowa Board of Nursing; and

Whereas,   There is expected to again be a shortfall in state funds which could potentially further reduce the amount of funds available for licensure and disciplinary services to nurses in Iowa; and

Whereas,   To reduce expenditures, the Iowa Board of Nursing will no longer be mailing licensure renewal notices to Iowa nurses; and

Whereas,   The Governor has named a Redesign Team to oversee the restructuring of state government; therefore be it

Resolved,    That the Iowa Nurses Association advocate for a strong, independent Board of Nursing to protect the citizens of Iowa; and be it further

Resolved,    That the Iowa Nurses Association communicate and partner with like interested organizations and parties on this issue; and be it further

Resolved,    That the Iowa Nurses Association work with the legislature to establish a mechanism for managing the professional nursing fees to adequately fund the direct and indirect expenditures of the Board of Nursing.

Whereas,   Mandatory overtime is defined as compelling or forcing employees to work hours beyond agreed upon assignments by threat of discrimination, dismissal, licensure discipline and /or other sanctions; and

Whereas,    Mandatory overtime is not job-defined or scheduled on-call time or increased staffing for unforeseen crises such as mass causalities or weather-related emergencies; and

Whereas,   The Iowa Nurses' Association passed resolutions during the 2000 Iowa Nurses Association Annual Convention regarding "Adequate and Appropriate Staffing" and "Building Safer Health Care Systems"; and

Whereas,   Medical errors end the life of 44,000 people in United States' hospitals each year (Cook, Woods and Miller, 1998 and Brennan, Leape, Laird, et al 1991; and

Whereas,   Recent research suggests important linkages between nurse staffing and adverse patient outcomes (American Nurses Association, 2000; Korner, 1998); and

Whereas,   Nurses need to know they will be able to utilize the benefits offered them upon acceptance of a position; and

Whereas,   Poor personnel decisions and an irregular distribution of labor, versus an actual shortage, may be the problem underlying the staffing crisis (Congressional Research Service Report, May 18, 2001); and

Whereas,   The majority of nurses in Iowa want to participate in achieving optimum patient outcomes without dramatic and costly strikes; and nurses need to know how to have a stronger presence at the individual organizational level to confront work place issues before they become a major conflict; and

Whereas,   Iowa nurses are working short staffed and caring for sicker patients and observing the consequences on patient care; therefore be it

Resolved,    That the Iowa Nurses Association increase nurses' awareness of the Principles of Nurse Staffing, as published by the American Nurses Association, in advocating for patient safety and effective work environments; and be it further

Resolved,    That the Iowa Nurses Association inform nurses about the "Assignment Despite Objection" (ADO) form; and be it further

Resolved,    That the Iowa Nurses Association encourage nurse administrators and staff nurses, in the work setting, to dialogue proactively about staffing issues during times of nursing shortage; and be it further

Resolved,    That the Iowa Nurses Association oppose mandatory overtime and communicate this position to the Iowa Hospital Association and the Nursing Home Associations.

Whereas,   The 2001 American Nurses Association (ANA) survey, Nurses Concerned Over Working Conditions, Decline in Quality of Care, cited inadequate staffing as a chief way in which the quality of care declined; and

Whereas,   The American Nurses Association and its Constituent Member Association's (CMAs) have outlined a national state legislative agenda to address staffing issues, including mandated collection of workforce and nursing-sensitive quality data so that organizations would be mandated to incorporate nursing research, nursing workforce data and other nursing data into agency reports; and

Whereas,   Nursing workforce data includes (but is not limited to, information such as the numbers of full-time and part-time nursing personnel by specific category, salaries, benefits, length of employment and units and populations served) and its relationships to healthcare quality and outcomes of care are core components of ANA's work on quality and safety; and

Whereas,   The Nursing Management Minimum Data Set is recognized nationally by the American Nurses Association; and

Whereas,   Workforce data serve to assist consumers, policy-makers, administrators; and staff with understanding and clarifying the context of patient care setting, therefore be it

Resolved,    That the Iowa Nurses Association determine an ongoing state strategy to access current or future work force data necessary to substantiate and advance identification of interrelationships between nursing work force and healthcare quality; and be it further

Resolved,    That the Iowa Nurses Association support the collection and/or compiling of workforce data in a uniform manner using the Nursing Management Minimum Data Set developed in cooperation with the Iowa Organization of Nurse Leaders (IONL) and advocate for the assurance of availability of such data; and be it further

Resolved,    That the Iowa Nurses Association educate nurses and administrators about the need for a visible presence in the electronic data base system and the use of the Nursing Minimum Data Set (NMDS) and Nursing Management Minimum Data Set (NMMDS); and be it further

Resolved,    That the Iowa Nurses Association support the collection of nursing workforce data and report at the 2003 Iowa Nurses Association Annual Convention; and be it further

Resolved,    That the Iowa Nurses Association collaborate with the University of Iowa, which is ranked number one in the nation for its Nursing Administration program and has one of the few Nursing Informatics programs in the nation, on the collection of nursing workforce data.

Whereas,   The American Nurses Association's Code for Nurses with Interpretive Statements is premised on the "fundamental principle of respect for the inherent dignity and worth of every client," regardless of the nature of the client's health problem; and economic or social status; and

Whereas,   The role of the registered nurse in providing professional care includes the responsibility of furnishing information and assistance to clients to enable them to make informed decisions regarding their health care; and

Whereas,   Clients must be given all the relevant information necessary for them to make fully informed decisions regarding their health care; and

Resolved,    That the Iowa Nurse's Association support the principal that information about legitimate health care options should be available to all persons regardless of economic or social status; and be it further

Resolved,    That the Iowa Nurses' Association support legislation which would be nondiscriminatory in relation to the provision of information about health care alternatives.

Whereas,   Nurses need to continue their education in order to ensure an adequate pool of nurses who are prepared to cope with changing trends in health care; and

Whereas,   The Iowa Board of Nursing provided the resources to develop a plan to encourage upward educational mobility in nursing without excessive repetition of course work; and

Whereas,   Nursing needs of the general public, health care costs and the ongoing nursing shortage compel the nursing community to assure timely and reasonable educational advancement to nurses who desire to advance their education; therefore be it

Resolved,    That the Iowa Nurses Association take an active role in disseminating information about the articulation process, support efforts to implement the process and consider active involvement to ensure success of this endeavor.

Whereas,   The Iowa Nurses Association has a long-standing commitment to the maintenance and improvement of health for the citizens of Iowa; and

Whereas,   Eighty-nine of Iowa's ninety-nine counties are defined by the census bureau as non-metropolitan (rural); and forty percent of the Iowa population lives in rural areas; and

Whereas,   Iowa's citizens are older than the national average. Iowa is ranked fourth with the percentage of citizens over 65 years of age and second in the nation with the percentage of citizens over 85 years of age; and

Whereas,   Seventy five of Iowa's ninety-nine counties are designated as health manpower shortage areas by Governor's designation, (all of these rural); and

Whereas,   Rural residents are older than urban on the average and characterized by relatively high rates of chronic disease; and

Whereas,   More Iowa children living in small rural counties are poor (>15%) and poverty correlates to poorer health status; and fewer rural families are insured; and

Whereas,   Rural areas have significantly lower physician to population ratio and in 2000, rural areas had an estimated shortage of 45,383 full time nurses in the United States; and

Whereas,   Several rural Iowa hospitals have closed over the last ten years bringing the current number to 116 from 134 in 1985; and therefore be it

Resolved,    That the Iowa Nurses Association direct lobbying efforts to increase state legislator's awareness of deficits in rural health care resources; and be it further

Resolved,    That the Iowa Nurses Association target letters to editor in regions of the state who are not in an under-served area; and be it further

Resolved,    That the Iowa Nurses Association proactively collaborate with groups and organizations working to improve rural resident's access to health care services; and be it further

Resolved,    That the Iowa Nurses Association actively support programs to prepare nurses and advanced practice nurses for rural practice; and be it further

Resolved,    That the Iowa Nurses Association work to inform citizens, legislators and the rest of the health communities of the inequities of rural access to health services and the increased need demonstrated by the demographics of the rural residents; and be it further

Resolved,    That the Iowa Nurses Association educate health care professionals regarding the advanced practice nursing role in rural clinics.

Whereas,   The United States Department of Justice reports that as much as 10% of the nation's health care expenditures may be fraudulent and that over $30 billion is lost annually in fraud of Medicare and other programs; and

Whereas,   Nurses need to know that when conditions are unsafe for patients and they cannot effect change within their facility, they can report unsafe and fraudulent practices to the appropriate agency without fear of reprisal; and

Whereas,   The need for reporting and whistleblowing may be a result of failure of organizational ethics (Fletcher, Sorrell, Silva, 1998),

Whereas,   Iowa nurses need the job protection to express what they observe to harmful to their patients; and

Whereas,   Iowa Code 70A.28 protects state employees with whistleblower protection and Iowa Code 272C.8 protects health professionals filing reports with licensing boards or peer review committees, leaving gaps in whisteblower protection for all nurses in Iowa, therefore be it

Resolved,    That the Iowa Nurses Association increase nurse's awareness of the difference between reporting (internal channels) and whistleblowing (external channels) in advocating for patient's safety; and be it further

Resolved,    That the Iowa Nurses Association support federal and state legislation on whistleblower protections so nurses can fulfill an essential role in correcting the system to decrease errors that result in harm and even death to patients.

Whereas,   Disclosure of HIV test results and/or HIV related conditions may have a direct impact on the rights and well being of the infected person and American Nurses Association policy clearly supports the protection of the civil and human rights of all persons; and

Whereas,   The American Nurses Association Code for Nurses states that "the nurse safeguards the client's right to privacy" and that "nurses act to safeguard the client and the public," and

Whereas,   Standard precautions and appropriate infection control procedures are the means by which nurses can guard against transmission of the disease for both the nurse and client; and

Whereas, Mandatory testing and mandatory disclosure for HIV status of nurses and other nursing personnel will not prevent the transmission of HIV disease and is, therefore, not warranted, therefore be it

Resolved,    That the Iowa Nurses Association join the American Nurses Association in supporting:

• Extension of federal OSHA standards requiring mandatory annual education related to universal precautions and infection control procedures for all personnel in health care settings, including public and private offices, clinics and institutions, community and home health care agencies.
• Continued opposition to mandatory testing and mandatory disclosure of nurses and clients' HIV status but continue to support voluntary, confidential testing and voluntary disclosure of HIV status.
• Continued education of the public regarding risk reduction strategies and the fact the HIV transmission occurs primarily through unprotected sexual activity where body fluids are exchanged and through injection drug use; and that minimal risk of transmission exists from nurses and other nursing personnel and be it further

Resolved,    That the Iowa Nurses Association provide advocacy when requested; and be it further

Resolved,    That the Iowa Nurses Association monitor all legislative and regulatory activities that involve HIV and advocate appropriately.

Whereas,   The recent terrorist attacks in the United States have escalated concerns about the use and dissemination of biological agents to spread illness across the public masses; and

Whereas, Nurses compose the largest group of front-line health care workers; therefore be it

Resolved,    That the Iowa Nurses Association promote educational programs preparing nurses regarding the recognition and treatment of potential agents used in bioterrorism; and be it further

Resolved,    That the Iowa Nurses Association contact the director of Homeland Security in the State of Iowa and offer assistance in the event of a bioterrorism attack; and be it further

Resolved,    That the Iowa Nurses Association strategize with other organizations including the Iowa Department of Public Health, American Red Cross or other identified emergency responders to build an infrastructure to best serve the public.

Back to Voicing Nursing Issues