Pascal Rod Executive Director IFNA The Hague Netherlands

Pascal Rod, Executive Director IFNA The Hague, Netherlands, June 2010

Benin Democratic Rep. of Congo Gabon Ghana Ivory Coast Morocco Nigeria Tunisia Uganda

Cambodia Indonesia Taiwan Republic of China South Korea

Austria Belgium Croatia Denmark Finland France Germany Hungary Iceland Italy Luxembourg Netherlands Norway Poland Slovenia Spain Sweden Switzerland United Kingdom

Jamaica U. S. A

Membership Conditions • To be the most representative association, organization or branch of nurse anesthetist in the country. • Nurse anesthetist: generic word for nurses specialised or « involved » in anesthesia services with formal program of education or in process to developp one • One association per country, • One voice in IFNA • Non nurse anesthesia providers associations can apply for associate membership

Countries not represented • Many countries had a recruitment for nurses at the age of 16, without achieving secondary education. • Nurse Anesthesia practice requires higher education, beyond secondary education. • Health technicians: higher education • Lack of national organizations • Lack of « official » recognition of nurses practicing in anesthesia

IFNA organization Officers Elected for 2 years Executive Director Meeting Twice every year Council of National Representatives CNR 1 per country member Meeting once every 2 years Congress Planning Committee Executive Committee 6 Elected delegates + 4 Officers Meeting once every other year Education Committee 5 members appointed by President Meeting once a year CPC +Officers and Executive Director Meeting twice a year Practice Committee Appointed by President Meetig once a year

Congress Planning Committee CPC • Standing Committee of the IFNA in charge of organizing the World Congress • Composition: – Chairperson of the immediate past Congress Chair of the CPC – Chairperson of the current Congress – Chairperson of the next Congress – Officers – Executive Director • Meeting twice a year

Education Committee • First IFNA Committee • Composition: – Nurse anesthesia Program Directors or Teachers Dr. Betty Horton , USA, Chairperson Ms. Jennifer Hui-Ju Yang , Taiwan Dr. Karin Bjorkman-Bjorkelund, Sweden Mrs. Susanna Anang, Ghana Mrs. Marianne Riesen , Switzerland • Activities: – Developping and reviewing Standards of Education, Program guidelines, Master’s guidelines – Developpment of Accreditation program and reviewing of application forms – Poster Judgement at Congress

Practice Committee • New committee: – Mrs. Sandra Ouellette chairperson • Reviewing the Standards of practice, Monitoring Guidelines • Address Continuing education issues • Collect data about practice worldwide

Membership fees • 3 categories for membership based on World Bank classification of GPNI • Lower: 0, 75 CHF ( 0, 52 Euros) / active member of the country member association • Middle: 1, 25 CHF (0, 87 Euros)/active member of the country member association • Highest: 3 CHF (2 Euros)/active member of the country member association

Members categories • Upper Middle Income Countries: 1, 25 SFr (0, 87 Euros) per active member of organization Croatia, Gabon, Jamaica, Poland, Serbia • Low and Lower Middle Income countries: 0, 75 SFr (0, 52 Euros) per active member of organization Benin, Cambodia, Congo Democratic Republic, Ghana, Côte d’Ivoire, Indonesia, Morocco, Nigeria, Tunisia, Uganda

Members categories • High Income Countries: 3, 00 SFr ( 2 Euros) per active member of organization Austria, Belgium, Denmark, Finland, France, Germany, Hungary, Iceland, Italy, Luxembourg, Netherlands, Norway, Slovenia, Korea Rep, Spain, Sweden, Switzerland, Taiwan, United Kingdom and the United States of America

Education • Countries with 18 up to 24 months ( or more) of education: – Benin, Cambodia, Rep. Dem. of Congo, Denmark, France, , Gabon, Ghana, Hungary, Iceland, Indonesia, Ivory Coast, Jamaica, Luxemburg, Morocco, Netherlands, Nigeria, Norway, Poland, Sweden, Switzerland, USA • Countries with less than 18 months – Belgium, Finland, Taiwan, UK • Countries with combined training: – Austria, Germany • Countries with on site training: – Croatia, Italy, Serbia, Slovenia, Spain • Countries without formal nursing background: – Tunisia, partly Netherlands

Level of Education • Master’s: – USA – France in progress – Spain in progress • Post-bachelor: – Iceland – Norway ( in progress for Master’s) – Sweden – Taiwan in progress

National Data from country members • • Number of Nurse Anesthetists Number of members in association Number of Anesthesiologists Number of Anesthesia cases

Salaries per year ( Euros)

Salaries per month ( Euros)

Ratio Nurse Anesthetist / 100 000 Hbts Luxemburg Norway Sweden Denmark Iceland Finland Germany Switzerland Slovenia USA Netherlands France Taiwan Poland UK R. D. Congo Spain South Korea Ghana Cambodia 4. 84 1. 8 1. 2 0. 93 0. 72 0 19. 89 16. 31 14. 01 12. 87 12. 84 12. 54 11. 79 10. 43 9. 9 10 20 33. 15 32. 26 31. 73 30. 38 68. 7 43 Ratio 30 40 50 60 70 80

ratio of anesthesia cases not realized by anesthesiologists 100 RDCongo Spain USA cambodia Luxemburg France Netherlands Slovenia Switzerland Norway Finland 63 60 50 45 44 600/year 900/year 28 22 20 6 1. 8 0 20 40 60 80 100 120

IFNA Documentation • International Standards of Education for nurse anesthetists • International Standards of practice for nurse anesthetists • International Code of Ethics for nurse anesthetists • Monitoring guidelines • Guidelines for starting a nurse anesthesia program of education • Guidelines for a Master’s program • Accreditation for Nurse Anesthesia programs • Recommendations for creating a national organization

New Challenges • Work on the recognition of Nurse Anesthesia as Advanced Practice of nursing • Work on improvment of Nurse Anesthesia education at Master’s level • Implement the Accreditation program in order to facilitate the comparaison of nurse anesthesia programs and the recognition of equivalences • Improve the continuing education opportunities for our colleagues from less developped countries • Develop some research on nurse anesthesia internationally

1988 2010 We haven’t changed…

Thank you Merci Dank je wel Gracias Danke Kiitos