“The American Nurses Association is extremely vital to our national image in nursing, and I think that all new nurses, all existing nurses who aren’t members should be members mostly to lobby for nurses; it’s the only united voice that we have, and it’s the mother of all our organizations put together. It’s an important part of our future.”— Lori Lioce, AL, ANA member since 1998

From the ANA President

Dear Colleagues:

It’s an exciting time in history for the American Nurses Association. I am very proud to represent you. This annual report gives you the opportunity to look back at 2006 and the many achievements of the ANA and our 54 constituent member associations. If you are already familiar with us, you may know the ANA has strategic imperatives that defi ne the organization’s vision. It’s interesting to look at these imperatives because they represent the areas in which ANA works for you.

As you read this report, I hope you will gain insight into specific accomplishments surrounding our core issues: the nursing shortage, appropriate staffi ng, workplace rights, workplace health and safety, and patient safety and advocacy. It also underscores our cornerstone work, specifi cally what we do to increase patient safety in the arena of ethics and nursing standards.

We’ve engaged in so many efforts this past year that we are unable to include them all in this top-level report. But let us provide you with key accomplishments that demonstrate ANA’s capability to respond to opportunities and challenges arising from the dynamic nature of its professional environment.

The ANA is the only organization that can represent all registered nurses, regardless of where they work, or regardless of what they do. Our membership is very diverse and we represent individuals that work across all settings. The association refl ects a partnership between the state nurses associations and ANA. We are dedicated to working together and gaining the momentum of the greater good of our association and our profession. ANA’s global and overarching goal -- “To be the unifying force to advance quality health for all” is big and audacious. It is nursing at its finest.

As you reflect on the highlights included in this report, I hope that you will agree that much was accomplished and that you will be inspired to continue to help us build on these efforts through your support in the coming years.

With best regards,

Rebecca M. Patton, MSN, RN, CNOR
President

ANA Strategic Imperatives

1. Professional practice and excellence ANA successfully champions professional nursing excellence through standards, code of ethics, and professional development, such as credentialing and lifelong learning.
   
   
2. Healthcare and public policy ANA is an acknowledged leader in the formulation of effective healthcare and public policy as they affect the profession and the public.
   
   
3. Knowledge and research ANA is the recognized source for accurate, comprehensive health policy information based on knowledge from research.
   
   
4. Unifi cation ANA facilitates unifi cation and advancement of the profession.
   
   
5. Advocacy for Work force and Workplace ANA with its partners and through its organizational relationships is a leader in promoting improved work environments and the value of nurses as professionals, essential providers and decision makers in all practice settings.
   
   

Core Issues:

• Nursing Shortage
• Appropriate Staffi ng
• Workplace Rights
• Workplace Health and Safety
• Patient Safety / Advocacy

From the ANA Chief Executive Officer

Dear Colleagues:

ANA is spearheading critical issues that affect all of the nation’s 2.9 million registered nurses and, ultimately, patients. Every nurse has a stake in the issues that are relevant to this profession, and the ANA provides us a vehicle to get involved and to make a difference. Throughout this report you will read highlights from 2006 demonstrating ANA’s relevancy and success in advancing the nursing profession.

The ANA is just as relevant today as it was 111 years ago when it was formed. A century ago, nurses recognized that they needed to have an organization that would ensure that the profession was being advanced. It is still true today. All nurses continue to benefi t from ANA’s cornerstone work: scopes and standards of practice and the Code of Ethics for Nurses with Interpretive Statements.

No other nursing organization has the political infl uence and reach of ANA. State nurses associations, also collaborate with ANA and develop nationwide state legislative agendas focusing on the important issues facing us all, moving issues across the states to create a national movement.

ANA is one of the very few nursing organizations that brings together more than 600 elected delegates to discuss the systemic and generic issues of the profession, the work of the association, and to determine the future of nursing. ANA would not be what it is today without so many dedicated professionals working to determine our positions on a multitude of issues, to identify policy direction, and to implement our vision for the profession.

We work closely with nursing specialty societies, many of whom comprise the ANA’s 16 organizational affi liates. Often, they thank us for making them aware of proposed regulatory changes that would directly affect their members, and for working with them to craft amendments.

The ANA gives nurses a voice, an opportunity to shape policy, and ensures that our messages are heard. Strength in our numbers allows us to be best positioned to advocate on behalf of our profession and for the public that we serve.

If you are not already a member, I hope that this report encourages you to become one or to refer us to a nurse friend, colleague or loved one. Enclosed is membership information. ANA-- through its 54 constituent member associations, individual member division, associate organizational members, organizational affi liates and individual affi liates--looks forward to collaborating with you individually and collectively on the many issues important to our chosen profession.

Sincerely yours,

Linda J. Stierle, MSN, RN, CNAA, BC
Chief Executive Officer

The Goals of the Association

The ANA Enterprise

The ANA Enterprise includes the American Nurses Association, American Nurses Credentialing Center, the American Nurses Foundation, the American Academy of Nursing and the American Nurses Association Political Action Committee (ANA-PAC).

American Nurses Association (ANA)

The American Nurses Association, founded in 1896, is the only full-service professional organization representing all registered nurses in the nation and is the parent organization of the ANA Enterprise. From the halls of congress and federal agencies to hospitals and other health care facilities, ANA is the strongest voice for the nursing profession. The Association represents the interests of the nation’s 2.9 million registered nurses together with its constituent member associations (CMAs). Dedicated to ensuring that an adequate supply of highly skilled and well-educated nurses is available, ANA is committed to supporting nurses in meeting the health care needs of consumers across America.

American Nurses Foundation (ANF)

Founded in 1955 as the research, education and charitable arm of the ANA, the American Nurses Foundation (ANF) raises funds and develops and manages grants to support advances in research, education and clinical practice. The Nursing Research Grants program provides funding for beginning and experienced nurse researchers in both clinical and academic settings. More than 950 nurse researchers have benefi ted from more than $3.5 million in grants, which have supported research in such areas as health outcomes and the delivery of care.

The American Academy of Nursing (AAN)

The American Academy of Nursing was established under the aegis of the ANA in 1973. The mission of the American Academy of Nursing (AAN)--which comprises more than 1500 nursing leaders from education, management, research and practice sectors--is to serve the public and nursing profession by advancing health policy and practice through the generation, synthesis and dissemination of nursing knowledge. The Academy Fellows include university professors and deans; research scientists; hospital chief executives and vice presidents; clinicians in a variety of settings; and state and federal political appointees and government staff.

American Nurses Credentialing Center (ANCC)

The American Nurses Association established the ANA Certifi cation Program in 1973 to provide nurses tangible recognition of professional achievement in a defi ned functional or clinical area of nursing. In 1991, the American Nurses Credentialing Center (ANCC) became a subsidiary of ANA. Today ANCC is the largest and most prestigious nursing credentialing organization in the United States and its certifi cations are highly regarded across the nation by federal, state and local agencies. The American Board of Nursing Specialties and the National Commission for Certifying Agencies, both well recognized throughout the certifi cation health care credentialing community, accredit most of ANCC’s examinations and processes.

The American Nurses Association Political Action Committee (ANA-PAC)

The American Nurses Association Political Action Committee, ANA-PAC, was established in the early 1970s to promote the improvement of the health care system in the United States by raising voluntary funds from members and contributing the funds to support worthy candidates for federal offi ce who have demonstrated their belief in the legislative and regulatory agenda of the American Nurses Association. ANA-PAC is bipartisan and works directly with both national parties to recruit and support candidates.

Financial Information

2006 Revenue

2006 Expenses

ANA Strategic Imperatives

STRATEGIC IMPERATIVE #1

Professional Practice and Excellence

“The ANA benefits nurse educators and nurse researchers in myriad ways, through leadership on national initiatives such at the Quality and Safety initiative and by providing up-to-date standards, resources and tools for educators and researchers. A prime example is the National Database for Nursing Quality Indicators, which represents a tremendous investment by the ANA and which holds great promise for research advances, practice improvements and contributions to nursing knowledge.”

— Eileen Lake, PA, ANA member

During 2006, ANA continued to set the benchmarks for professional practice and excellence. Our outreach through the year underscored the association’s commitment to enhancing the nursing profession. Efforts included:

• Providing a wide variety of continuing nursing education (CNE) opportunities on important and timely topics for nurses in all practice settings and specialties, through live, print and online activities. Each CNE activity awards nursing contact-hour credit for successful completion, which can be used for re-licensure, re-certifi cation or requirements of employment.
  
  
• Supporting the Institute for Health Care Improvement’s (IHI) efforts to improve health care quality by actively promoting the “Saving 100K Lives” campaign to our members. ANA created detailed information about the campaign and a site for documenting “near miss” situations on NursingWorld.org. Additionally, ANA provided new information about the “5 Million Lives Campaign,” which promotes the adoption of improvements in care that can save lives and reduce patient injuries.
  
  
• Being proactive through the ANA’s Center for Ethics and Human Rights, which continued to address the issues in the fi eld of genomics. The center continued participation in the genomics initiative to establish a competencebased education framework for nurses by hosting a next steps strategies meeting. ANA is in the process of formulating strategies to implement the competencies for practicing nurses. The center revised two position statements in 2006: Risk and Responsibility, and Privacy and Confi dentiality. Supporting information on the Center for Ethics and Human Rights is located on ANA’s Web site, NursingWorld.org.
  
  
• Being actively involved during the past two years in the activities initiated by the American Association of Colleges of Nursing (AACN) to design a future model of advanced practice registered nursing (APRN) regulation that could create a cohesive and well-conceived process of education, accreditation, certifi cation and regulation of APRNs. ANA and AACN jointly sponsor opportunities for periodic feedback from the larger stakeholder community.
  
  
• Taking an active role in national quality efforts as a member of the National Quality Forum (NQF), which was created to develop and implement a national strategy for measuring and reporting health care quality. In addition, ANA serves on the Hospital Quality Alliance, which oversees the hospital quality reporting efforts of the CMS Hospital Compare Web site. ANA is also a founding member of the National Coordinating Council for Medication Error Reporting and Prevention.
  
  
  

  “When I came out of school, I really felt like a lot of people. I thought, ‘I’m going to go get it. I’m going to get the world. I’m going to do this great job.’ Then you get out into the real world of nursing and you realize that there are all these issues facing our profession and that you really can’t take on those things just as one person. Being part of the ANA and my state nurses association and being active in both, I have a chance to work on solving these problems and combating those issues. Also, it’s a chance to fi nd out what’s going on around the rest of the country.” — Erin Peterson, MN, ANA member since 2003

• Aggressively monitoring and addressing information systems, computer-based patient records, electronic health records, standardized terminologies, confi dentiality and security of data and information, and associated issues and content. Based upon expressed interest by the Department of Health and Human Services on implementing health care information technology solutions, ANA has become even more crucial in providing nursing’s voice at the tables where these decisions are being made.
  
  
• In the fall of 2006, serving on the planning committee and co-sponsoring the TIGER (Technology Informatics Guiding Education Reform) Summit. ANA President Rebecca M. Patton, MSN, RN, CNOR; CEO Linda J. Stierle, MSN, RN, CNAA,BC; and Senior Policy Fellow Carol J. Bickford, PhD, RN, BC, participated as well as representatives from more than 40 nursing organizations, who collaborated with colleagues from key federal agencies, other professional health care organizations, and the private sector to create a vision for the future of nursing that enables nurses to use informatics in practice and education to provide safe, quality care. The meeting goal was to create a plan to bridge the quality chasm between information technology in education and in practice settings.
  
  

STRATEGIC IMPERATIVE #2

Healthcare & Public Policy

ANA works to expand governmental support of nursing and quality patient care at the federal and state levels and has tracked more than 3,000 bills out of the approximately 157,000 bills that were introduced in state legislatures in 2006. ANA monitors legislative trends in state legislatures related to the practice of registered nurses. Highlights of these efforts included:

• Completing the eighth year of participation by hospitals across the country in collecting data about patient outcomes and their relationship to nurse staffi ng. The National Database for Nursing Quality Indicators (NDNQI)®, established in 1998, grew in 2006 to include participation by more than 1,000 hospitals, representing 20 percent of the hospitals in the United States.
  
  
• Continuing to provide the leadership regarding the overall preparedness of our nation to respond to a disaster, as well as the preparedness of registered nurses. ANA serves at several national tables in order to provide nursing’s voice on vulnerable populations, personal protective equipment, legal protections for nurses who respond, and mechanisms for preparing, contacting and aiding deployment during disasters. To this end, ANA continues to work on a number of different fronts including examination of the critical health infrastructure; working to create a better legal environment for health professionals who respond during a disaster; participating in event specifi c planning, like pandemic infl uenza; and enhancing mechanisms for registered nurses who choose to respond during an emergency.
  
  
• Maintaining a partnership with the National Conference of Commissioners on Uniform State Laws (NCCUSL) to develop recommended uniform state legislation designed to create a better legal environment for registered nurses and other health professionals to respond during a disaster. In July, ANA participated in the annual meeting of the NCCUSL where the commissioners approved the legislative language for the Uniform Emergency Volunteer Health Practitioners Act.
  
  
• Educating and endorsing bi-partisan efforts to support nursing issues. ANA’s Political Action Committee (ANA-PAC) and complementary political education are key to ANA’s legislative successes in the U.S. Congress. During the 2005-2006 election cycle, the ANA-PAC endorsed 112 candidates for federal offi ce and had an 89 percent winning record. ANAPAC raises money to support candidates who understand and advocate for nursing issues. ANA-PAC is bi-partisan and works directly with both the Republican and Democratic national parties to recruit and support candidates. As activism increases, so will thevoices and victories of nursing with ANA’s federal legislative agenda.
  
  
  

  “The best return on your investment as a member of
  the American Nurses Association in addition to
  continuing education opportunities, is having
  someone represent you all the time. You don’t have
  to look for them; they are always out there working
  for you and on your behalf. The American Nurses
  Association was very instrumental in helping us
  shape policy that was related to legislation and
  patient safety. And in Illinois, we were successful
  in passing legislation that reiterated that it
  was important for nurses to be in control of
  direct care in Illinois. Similar legislation is
  being passed across the country.”

  — Mary Maryland, Illinois, ANA member since 1977

• Joining Senate Minority Leader Harry Reid (D-NV), Sen. Ted Kennedy (D-MA), Sen. Debbie Stabenow (D-MI), and Rep. Hilda Solis (D-CA) in calling for meaningful health care reform at a press conference in February. Isis Montalvo, MBA, MS, RN, ANA’s manager of policy and practice, spoke at the event, providing nursing’s view of the growing health care crisis.
  
  
• Sponsoring a congressional briefi ng with the House of Representatives Nursing Caucus in May to highlight the importance of safe patient handling and movement (SPHM). More than 30 representatives from House and Senate offi ces attended to learn about how a SPHM program can provide a secure way to move patients and decrease injuries both for nurses and their patients.
• Sponsoring a congressional briefi ng with the House Nursing Caucus to highlight the importance of including nurse staffi ng as a quality indicator for America’s hospitals.
  
  
• Participating in a congressional rally to urge Medicare to eliminate the penalty that benefi - ciaries will be forced to pay if they sign up for prescription drug coverage after May 15.
  
  
• Convening constituent member association (CMA) lobbyists from all over the nation for the seventh annual ANA/CMA Lobbyist Meeting - “Think Nationally, Act Locally” in Alexandria, Virginia. The group met to discuss strategies and develop legislative solutions for the critical issues facing nurses and patients in today’s challenging health care environment.
  
  
• Hosting leaders of state and national environmental health organizations and mapping out strategies for working together toward the common goal of chemicals policy reform.

STRATEGIC IMPERATIVE #3

Knowledge and Research

Research is the cornerstone for advancing knowledge of current nursing issues. ANA produces and maintains an extensive repository of information, services, and educational tools. Meeting the needs of nursing students as well as veteran nurses, these sources maintain the most up-todate information to provide a framework for a breadth of knowledge. ANA has several vehicles to educate and support nurses such as:

• The American Nurse, the offi cial newspaper of ANA, published six times a year and mailed to all members of the ANA. The American Nurse includes a balance of important news including workplace issues, job security and career trends, nursing practice issues, health care policy and legislative updates. The publication also includes updates on happenings at ANA and the CMAs. The ANA president has a regular column in each issue.
  
  
• The OJIN: Online Journal of Issues in Nursing. OJIN was fi rst published in June 1996, making it the fi rst free of charge electronic journal dedicated to nursing, as well as one of the few online scholarly nursing journals. In 2006, ANA purchased OJIN from the Kent State University College of Nursing. OJIN, which is hosted and posted on ANA’s Web site, was pleased to announce the continued service of Harriet V. Coeling, PhD, RN, as OJIN’s editor-in-chief. OJIN averages 100,000 user sessions and more than 150,000 page views per month.
  
  
• NursingWorld.org, the offi cial Web site of the ANA and nursing’s most popular Web site, attracts more than 500,000 visitors monthly. The Web site hosts a Career Center, Continuing Education and Nursesbooks. org. The Members Only section of ANA’s Web site offers an array of exclusive content and member discounts. Since its inception in June 2004, more than 20,000 members have established online accounts to access this special section of NursingWorld.
  
  
• ANA remains an excellent resource for the media for information on nursing practice and policy, as well as legislation. Some of the issues that ANA was instrumental in bringing to public and media attention include:
  
  
• Concerns over the National Labor Review Board’s decision to broaden the defi nition of ‘supervisor,’ thereby blocking nurses’ freedom to unionize as known by “the Kentucky River Community Care, Inc. Case”;
  
  
• The ANA initiative to create the National Database of Nursing Quality Indicators (NDNQI®) that has resulted in more than 7,000 nursing units improving patient outcomes; and
  
  
• Advocating, through litigation, that the Department of Health and Human Services should not allow hospitals that fail to meet federal nurse staffi ng requirements to participate in Medicare.
  
  
• In October, ANA launched the inaugural issue of American Nurse Today, a peer-reviewed journal for ANA members and other practitioners in the nursing community. The monthly journal, published by HealthCom Media, serves nurses as a reliable information source and provides vital clinical content, educational articles, editorial from and about nurses and their professional experiences, as well as news and insight from authoritative experts. ANA and Health Com Media were also pleased to announce the appointment of Pamela F. Cipriano, PhD, RN, FAAN, as the editor-in-chief.

STRATEGIC IMPERATIVE #4

Unification

To advance the profession, ANA reaches out to all nurses, including those in its 54 constituent member associations (CMAs) around the country, as well as health professionals, organizational af- fi liates, patients, families, members of the media, and the general public. Efforts throughout 2006 included:

• Releasing a video on the benefi ts of membership that the CMAs and nursing schools used to educate nursing students and the public on national issues that affect nurses around the world – safe patient handling, staffi ng principles and safe needle handling.
  
  
• Offering the CMA Elected Leader Series on topics chosen by the state nursing society leaders. The series strengthens leadership skills and knowledge of ANA resources available for their use. Conference calls in this series included: Board Roles in Recruiting and Retaining New Members; Finance 101 for Treasurers and Presidents; and Engaging New Leaders. Segments of the series were recorded and made available to CMA leaders on the Members Only Continuing Education site.
  
  
• Joining with the International Council of Nurses (ICN) to advocate to the United Nations (UN) that a new agency for women be established to address the signifi cant gender equality issues that exist throughout the world.
  
  
• Granting offi cial ANA organizational affi liate status to 16 nursing specialty organizations (a 200 percent increase from last year) that met criteria established by the ANA House of Delegates.
  
  
• Facilitating the sharing of knowledge between ANA’s 54 CMAs, ANA hosted calls and posted a variety of documents on a protected Web site to increase synergy between and among the organizations working on similar issues. CMAs shared information on legislative, operational, membership, marketing and communications topics as well as their programmatic work on a variety of issues.
  
  
• Co-hosting one-day “ANA Coming to You” seminars with CMAs across the country to educate the local nurses on a variety of issues including staffi ng and delegation, safety in the workplace, and nursing competence in aging.
  
  
• Funding 55 nursing specialty organizations through a fi ve-year grant from The Atlantic Philanthropies to increase the competence of nurses around the country in caring for older adults.

“The American Nurses Association helps every nurse regardless of what avenue you’ve taken in professional nursing whether clinician, administrator, educator or researcher. Our data from the National Database of Nursing Quality Indicators demonstrated that our current delivery model — that being our RN to patient care ratios — had very positive effects on patient outcome.”

— Kimberly Palazzo Howe, OH, ANA member since 1980

STRATEGIC IMPERATIVE #5

Advocacy for Workforce and Workplace Rights

The highlights captured on this page provide an overview of the extent of ANA’s ongoing advocacy throughout 2006. Efforts included:

• Participating in a working group to prepare strategies to address the short-term goals of improving infl uenza vaccination rates of health care workers in the 2006-2007 infl uenza season. The working group was formed following the June meeting of the National Infl uenza Vaccine Summit.
  
  
• Presenting a session entitled, “Changing the Curriculum for Patient Handling in Schools of Nursing” at the Sixth Safe Patient Handling and Movement Conference.
  
  
• Working with the National Institute of Occupational Safety and Health and the Tampa Veterans Administration Patient Safety Center of Inquiry, the Association of Perioperative Registered Nurses (AORN) and others to prepare a background document for safe patient handling and movement algorithm guidelines for the March AORN 2006 Congress.
  
  
• Participating in an important working group organized by the AARP Foundation to develop recommendations and best practices for more effectively engaging and retaining workers over the age of 50. ANA was part of the Environment and Tools Task Force Committee.
  
  
• Hosting the meeting with chemical policy experts to address policy reform in the United States. ANA met with leaders of state and national environmental health organizations to discuss, develop and map out strategies for working together toward the common goal of chemicals policy reform.
  
  
  

  Kim and Sonya have both had to miss work due to their injuries. Kim works in labor and delivery and says her heaviest patients can range from 200 to 500 pounds. To help nurses like Kim and Sonya, who alone can’t make a difference, ANA created the Handle with Care Campaign aimed at preventing injuries through greater education and training and using safe patient handling equipment like ceiling lifts, hover jacks, and friction reducing and lateral transfer devices.

  In 2006, ANA worked with the Washington State Nurse’s Association to help Washington become the second state to sign safe patient handling legislation into law. The new law gives nurses a defi ned role through required steering committees and offers tax incentives to hospitals to buy new lifting equipment.
  
  — Kim Armstrong and Sonya Miller,
  WA, ANA members since 1989 and 1997 respectively.

• In September, presenting About the Handle with Care® campaign and (Safe Patient Handling and Movement (SPHM) at the New Jersey State Nurses Association (NJSNA) “Nurse in Trenton” day at the New Jersey Statehouse. Workplace violence information was included in the presentation as well, due to workplace violence legislation pending in New Jersey.
  
  
• Participating in the Infl uenza Virus Vaccine Scientifi c Advisory Board meeting sponsored by CSL Biotherapies, Inc. The primary goal of the meeting was to provide guidance and recommendations for educational programs and initiatives to support the introduction of a new infl uenza virus vaccine by CSL Biotherapies.
  
  
• Attending a retreat with State Alliance for Federal Chemical Policy Reform that focused on coordinating state environmental activities and supporting national comprehensive chemicals policy reform.
  
  
• Continuing involvement in environmental health related issues partially funded through a grant received from the Beldon Fund. The work supported by the grant included hosting a meeting for lobbyists with a special session devoted to environmental health education, updating the speaker’s bureau, and forming environmental task force committees to advance environmental health issues in the states.
  

  “I joined the American Nurses Association because I saw that as my responsibility to the profession and to the organization that supported me. I became a nurse as part of a calling and it’s just something that’s very natural for me. My mother was a nurse, and I think you’re very blessed in life, you get to do something that you’re good at and I’ve been very fortunate.”
  — Jeff Watson, Texas, ANA member since 2003

  
  
  
• Participating in the workgroup on staff nurse work design at the Georgia Institute of Technology in Atlanta, sponsored by The Robert Wood Johnson Foundation and the Agency for Healthcare Research and Quality, which met on the impact of building design on nurses, staff and patient safety in addition to the current state of the “pipeline” work from research to application.
  
  
• Participating in the Healthcare and Social Assistance Sector (HCSA) work group for the National Occupational Research Agenda (NORA). ANA led the discussion for the HCSA workshop held during the National Occupational Research Agenda Symposium 2006: Research Makes a Difference held in Washington, DC.
  
  
• Reviewing and providing comment on a draft document on the use of surgical masks and respirators during an infl uenza pandemic. ANA was invited by the Mask Use Working Group to review and provide comments to a document that provided recommendations on surgical mask and respirator use in healthcare and community settings. The revised guidelines were released in October.