THE VOICE FOR GLOBAL NURSE ANESTHESIA

Jackie Rowles
DNP, MBA, MA, CRNA, ANP-BC, NSPM-C,
FNAP, FAANA, FAAN
IFNA President, US CNR
THE INTERNATIONAL FEDERATION OF NURSE
ANESTHETISTS

 The voice for global Nurse Anesthetists

 Founded in 1989 with 11 member countries
 Currently 44 member countries (2 Associate) with members in all 6 WHO regions
 Early years: building our foundation
 Later years: external involvement
 Member countries pay dues
 Resources are a challenge
 Structure: each country has 1 delegate to the Council of National Representatives
(CNR)
 Elected Officers and Executive Committee
 3 standing committees: Congress Planning, Education, Practice
OBJECTIVES

 To promote cooperation between

nurse anesthetists internationally.
 To develop and promote educational
standards in the field of nurse
anesthesia.
 To develop and promote standards of
practice in the field of nurse anesthesia.
 To provide opportunities for continuing
education in anesthesia.
ANESTHESIA
IS A KEY
THE NEED FOR
COMPONENT
OF SURGICAL
NURSE
ACCESS
ANESTHETISTS
THE 10,000 FOOT VIEW
(WORLD HEALTH ORGANIZATION (WHO), UNITED NATIONS (UN), G4 ALLIANCE, LANCET COMMISSION)

 Five billion people do not have access to safe, affordable, timely surgical
care and anesthesia when needed.
 In 2010, 16.9 million lives were lost due to untreated surgical conditions.
 Surgical conditions represent 28 percent to 32 percent of the global
burden of disease.
 The poorest one-third of the world population only receives 6.3 percent
of all surgical procedures
 Anesthesia mortality is three times higher in LMICs.

Meara JG, Leather A, Hagander L, Alkire BC: Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development.
The Lancet 2015 Vol 386, August 8th. doi:10.1016/S0140-6736(15)60160-X
THE 10,000 FOOT VIEW
(CONT.)

 Surgical deficit is approximately 143 million procedures per year.

 A UN report found that surgical care has a 1:10 cost-benefit ratio. For every
$1 spent on strengthening local surgical capacity, $10 is generated through
enhanced health and increased productivity.
 The cost of increasing surgical capacity is $350 billion.
 The cost of NOT investing in essential surgical/anesthesia care $12.3 trillion.
 A 2018 study Mortality due to low-quality health systems in the universal health
coverage era: a systematic analysis of amenable deaths in 137 countries showed
more deaths with access to poor quality healthcare (5 million) than no care at all
(3.6 million).

Kruk et al. Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. Lancet. 2018
Nov 17;392(10160):2203-2212. doi: 10.1016/S0140-6736(18)31668-4. Epub 2018 Sep 5. Erratum in: Lancet. 2018 Sep 20;: PMID: 30195398; PMCID:
PMC6238021.
WHAT DO WE NEED TO BEST SERVE OUR
PATIENTS?

 Recognition and understanding of Nurse Anesthetist

expertise as Advanced Practice Nursing role
 Proper education and title protection
 Respect and trust for our APN role/status
 Support from decision makers/regulators - Government,
Ministries, Parliament, Insurance, Public
 To be included in discussions concerning decisions about
our specialty education, credentialing and practice
IFNA’S BELIEF

“If nurses are utilized for preoperative or

postoperative preparation of the patient
and if they perform venous and arterial
cannulation, induction and emergence of
anesthesia, intubation, and extubation, and
if they are left alone for any reason, they
should be appropriately educated.”
IFNA ACTIVITIES TO DEMONSTRATE & ADVANCE
QUALITY CARE

Standards: such as Education, Practice, Monitoring,

Ethics (since 1991)

Anesthesia Program Approval Process: global

accreditation of educational programs

Model curriculum for nurse anesthesia educational

programs (certificate, bachelor, master)

Continuous Professional Competency model

Nurse Anesthesia experts to help define and

implement quality nurse anesthesia care globally
IFNA
KEY
COLLABORATIONS
INTERNATIONAL COUNCIL OF NURSES

IFNA was the second affiliate organization

ICN/WHO published the State of the World’s Nursing

Report for publication 2020. ICN published a nursing
toolkit and featured NA in Kenya as a case study

IFNA asked to partner in development guidelines on

APN role of global nurse anesthetists. Published 2021
EUROPEAN SOCIETY OF ANAESTHESIOLOGY
AND INTENSIVE CARE MEDICINE

 Used to be the ESA and now ESAIC

 Formerly IFNA was included on 2 joint ESA committees 2012 – 2020?
 IFNA representative Dr. Arvid Steiner (Norway) is a member of the ESAIC
Patient Safety Committee since 2018
 IFNA was a partner in the 2020 ESA Patient Safety Summit (Brussels)
 Meeting with EASIC President Professor Bühre in May (The Netherlands)
THE G4 ALLIANCE

 The G4 Alliance is dedicated to

building political priority for surgical,
obstetric, trauma and anaesthesia care
as part of the global development
agenda.
 Through the member organizations, G4
provides a collective voice in support
of increased access to safe surgical
care for all. (80% of the world’s
population by 2030)
 IFNA was first nursing organization
member and Rowles served on the
first Board of Directors, elected
Treasurer for 3 years
  Used to attend the WHO Global Initiative for
Essential and Emergent Surgical Care (GIEESC)
which disbanded in 2020

WORLD HEALTH  Attendance at World Health Assembly

ORGANIZATION
 Networking and relationship building occurred via WHO GIEESC and the
G4 Alliance meetings
WORLD
FEDERATION
 OF 2018 First SAFE T Summit (Safe Anesthesia For
IFNA attended WFSA
Everyone Today)
SOCIETIES OF 2019, IFNA President Rowles invited speaker at the 2
nd

SAFE T Summit. Topic: The Provision of Anesthesia Worldwide to Narrow the

ANAESTHESIOL
Safety Gap
OGISTS
 First meeting of IFNA/WFSA Leadership WFSA Headquarters, April 6 , th

London, 2019. 2020/2021 meeting canceled due to COIVD. 2022 not

scheduled. 2023 meeting was March 21st, in London. Discussions for future
meetings have occurred recently with the new WFSA President Daniela
Filipescu (Romania)
 IFNA President Rowles invited to speaker WFSA World Congress for
Anaesthesiologists, 2020, Prague, Czech Republic – postponed 2021 – went
virtual 2021 Topic: Solving the Manpower Shortage:Working Together for Success
 WFSA President Dr. Adrian Gelb, speaker at the 2022 World Congress for
Nurse Anesthetists in Croatia
 IFNA President Rowles and Executive Director Rod serve on WFSA Global
Manpower Committee (2020-2023 survey) with the article accepted for
2024 publication in Anesthesia and Analgesia
IFNA 2021 - NOW
HISTORICAL CONTRIBUTIONS TO HELP MOVE GLOBAL
NURSE ANESTHESIA FORWARD
UNITED NATIONS GLOBAL SURGERY ELEARNING
HUB PROJECT

“Surgery for all who need it; when they need it; and wherever they need it!”

 “Development of the existing

and future surgical care
workforce, through training and
education, is key”
 Online education for: surgeons,
anesthesia providers, peri-
operative nurses
UNITED NATIONS
GLOBAL SURGERY
LEARNING HUB
PROJECT

 ICN was asked to nominate nominate nurses for consideration of

committee selection
 December 2022, Rowles selected to Content Committee, 2-year
appointment, option to extend term. First meeting 02/06/2023
 Task: create criteria for inclusion of curriculum for online learning for
surgeons, anesthesia providers, perioperative nurses. Review and approve
proposed content for UN online learning portal
 Rowles elected Committee Vice-Chair (8 surgeons, 1 anesthesiologist
voting)

VERY IMPORTANT to have Nurse Anesthetists recognized by the UN and

included in this project!
 ICN Advanced
Practice Nursing
Guidelines: The
Nurse Anesthetist
THE IFNA HISTORY BOOK: 4 years in the
making: documentation of 30+ years of service
IFNA History Book

Sandra Ouellette, USA chair/editor

Betty Horton, USA, chair/editor
Jackie Rowles, USA, editor
Hermi Lohnert, Switzerland
Pascal Rod, France
Susan Caulk, USA
ICN BOOK “NURSE PRACTITIONERS AND NURSE
ANESTHETISTS: EVOLUTION OF THE GLOBAL ROLES 2023
ICN TOOLKIT ADVANCED PRACTICE NURSES
2024

 Rowles asked to write the chapter Establishing and Maintaining a Professional

Organization
 Authors for Nurse Anesthesia exemplars in education, accreditation, certification,
credentialing, practice
 ? Publication September 2024: ICN APN network meeting, Abderdeen, UK
GLOBAL WORKFORCE SURVEY 2024 ANESTHESIA
AND ANALGESIA (MARCH, ONLINE AHEAD OF PRINT)
IFNA
EDUCATIONAL
CONGRESSES
PAN AFRICAN NURSE
ANESTHETISTS CONGRESS
NAIROBI, KENYA REGIONAL CONGRESS
JUNE 18-20, 2024
BRISBANE May 7-9, 2026