Growing leaders in a professional membership organization.

AIMS: This study describes the background, development and delivery of an innovative approach to prepare elected state association leaders for their new leadership roles in their respective state organizations. BACKGROUND: State-based professional associations face unprecedented threats to scope of practice in the current volatile healthcare environment. In 2009 the American Association of Nurse Anesthetists (AANA) began offering a Leadership Development 'Boot Camp' for all nurse anesthetist state association presidents-elect designed with the intent of providing the participants with information, resources and tools they need in their new role. METHODS: An organizational assessment examined the philosophy of and need for leadership development across the entire organizational structure. RESULTS: Recommendations from the assessment included the need for intensive leadership development at the state level. A 3-day intensive workshop was designed and implemented. Adult learning theory was used for its development. CONCLUSIONS: The success of this programme has lead to its implementation as part of leadership development of the AANA. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers and elected volunteer leaders in state-based professional associations face similar challenges requiring sound leadership ability. Principles applied to the development of the AANA programme can be applied to leadership development for new nurse managers.

Acupressure and postoperative nausea and vomiting.

Despite great strides during the preceding 3 decades, the ability to consistently eliminate postoperative nausea and vomiting (PONV) continues to elude anesthesia practitioners. The occurrence of PONV related to anesthesia and surgery prolongs hospital stays and increases healthcare costs. Protracted recovery times place constraints on patients, healthcare systems, and healthcare financiers. Many pharmacological antiemetics have been developed and are in use in the attempt to alleviate PONV. Side effects and cost profiles of many of these interventions, however, reinforce the broadly held belief that there remains opportunity for improvement. Because the Western culture almost exclusively favors evidence-based scientific practice and interventions, the search continues for an ideal, cost-effective, safe, and efficacious pharmacological agent to prevent PONV. Eastern culture, on the other hand, relies heavily on naturopathic remedies whose successful use has spanned thousands of years. Increasing attention has been given to the potential benefits of nonpharmacological intervention for the prevention of PONV in association with anesthesia care. Therefore, the purpose of this AANA Journal course will be to focus attention on what is known and what is unknown in the literature regarding use of the nonallopathic remedy of acupressure as a nonpharmacological alternative to commonly utilized antiemetic prophylaxis.

An evaluation of anesthesia patient satisfaction instruments.

The purpose of this study was to systematically review the instruments used to obtain anesthesia-specific patient satisfaction data and to determine the degree to which each instrument controlled for measurement error bias, such as poor survey design. By using an assessment and evaluation tool developed for the present study that held proven internal reliability and construct validity, we analyzed and scored each instrument according to the presence or absence of measurement error in survey design. We found that a paucity of anesthesia-specific patient satisfaction studies exists and that patient satisfaction studies dealing with anesthesia care were erratically defined, nonstandardized, and imprecise regarding intent and method. Moreover, the simple rating forms used in most of the reviewed studies were inadequate to achieve the goal of measuring the quality of anesthesia care. One instrument, the Iowa Satisfaction With Anesthesia Scale (ISAS), developed by Dexter et al (1997), was the first found to inculcate scientifically accepted psychometric item construction algorithms, an indicator of measurement reliability. Although the ISAS holds substantial potential for future application in this realm, we recommend that it be refined further and that the search for a superlative instrument to obtain anesthesia-specific patient satisfaction continue.