March/April 2022 INSider by InfusionNursesSociety

INSIDER

JANUARY/FEBRUARY 2021

T H E O F F I C I A L M E M B E R S H I P N E W S P U B L I C AT I O N O F I N F U S I O N N U R S E S S O C I E T Y

The Standards of Practice Committee Kicks Off a Three-Year Revision Cycle

Meet Two DEI Task Force Members

Learn About the INS 2022 Annual Meeting

MARCH/APRIL 2022

Read One Nurse’s Reflection Two Years Into the Pandemic VOLUME 5

INFUSION NURSES SOCIETY

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ISSUE 2

INS BOARD OF DIRECTORS 2022 PRESIDENT

Sue Weaver, PhD, RN, CRNI®, NEA-BC PRESIDENT-ELECT

Max Holder, MSN, RN, CRNI®, NE-BC

INSIDER

SECRETARY/TREASURER

Joan Couden, BSN, RN, CRNI®

T H E O F F I C I A L M E M B E R S H I P N E W S P U B L I C AT I O N OF INFUSION NURSES SOCIETY

PRESIDENTIAL ADVISOR

Angelia Sims, MSN, RN, CRNI®, OCN® INSider encourages the submission

DIRECTORS-AT LARGE

of articles, press releases, and other

Nancy Bowles, MHA, RN, OCN®, CRNI®, NEA-BE, CPC-A

materials for editorial consideration,

Angela Skelton, BSN, RN, CRNI®

which are subject to editing and/or

PUBLIC MEMBER

condensation. Such submissions do

John S. Garrett, MD, FACEP

not guarantee publication. If you are interested in contributing to INSider,

CHIEF EXECUTIVE OFFICER

please contact the INS Publications

Mary Alexander, MA, RN, CRNI®, CAE, FAAN

Department. Photos become the property of INSider; return requests must be in writing. INSider is an official bimonthly publication of the Infusion Nurses Society.

FUSION NURSES SOCIETY I N S S TA F F

Chief Executive Officer: Mary Alexander, MA, RN, CRNI®, CAE, FAAN Executive Vice President: Chris Hunt Director of Operations and Member Services: Maria Connors, CAE

Clinical Education & Publications Manager: Dawn Berndt, DNP, RN, CRNI® Marketing Manager: Whitney Wilkins Hall Editorial Production Coordinator: Rachel King Director of Clinical Education: Marlene Steinheiser, PhD, RN, CRNI

INFUSION NURSES SOCIETY

Senior Member Services & Conference Coordinator: Jill Cavanaugh Meetings Manager: Meghan Trupiano, CMP Certification Manager: Adrienne Segundo, IOM Certification Administrator: Bill Taylor Senior Certification & Member Services Associate: Maureen Fertitta Member Services Associate: Susan Richberg Bookkeeper: Cheryl Sylvia

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In this Issue President’s Message: Keep Calm and Research On by Susan H. Weaver, PhD, RN, CRNI®, NEA-BC

Cover Story: The Standards of Practice Committee Kicks Off a Three-Year Revision Cycle INS 2022 Annual Meeting Learn and Engage with Peers and Experts in Orlando, Florida!

If I Could Speak to My Early Pandemic Self, What Would I Say? by Craig Reinbold, RN, BSN, CEN

Poem: The Nurses Ebb and Flow by Kasia Nikhamina

CRNI® Connection: Are You Ready?

The INS DEI Task Force Shares Their Stories Danielle R. Jenkins, RN, BSN, CRNI®; Max Holder MSN, RN, CRNI®, NE-BC

Leadership Award Winner Margaret Hempstead, BSN, RN, CRNI®, VA-BC, EMT-B

Virtual Symposium: Infusion Therapy Related Complications

Member Spotlights: Our members share their experiences with the infusion community

INSide Scoop: A closer look at what’s going on within INS

Welcome New INS Members: Domestic and International

P R E S I D E N T ’ S

M E S S A G E

KEEP CALM AND

RESEARCH ON the PhD in nursing program at Rutgers, the Since “ReSEARCH Your Passion” is my State University of New Jersey. Although it was presidential theme, I want to share my journey into nursing research as well as briefly discuss a challenge juggling school with work and quality improvement, evidence-based practice, family responsibilities, if you’d like to pursue and research. Since nursing school, I have research, I would highly recommend obtaining been fascinated by nursing research and your PhD. Now, in my role as a nurse scientist, thought maybe someday I would be involved I conduct and disseminate research on the with it. Although I continued my education, nursing workforce because I am passionate obtaining a BSN and MSN, and progressed in about supporting the work of nurses. my career from surgical and ICU staff nurse Before discussing nursing research, let’s define to ICU assistant nurse manager and educator Susan H. Weaver quality improvement, evidence-based practice, and eventually evening nursing supervisor, PhD, RN, CRNI®, NEA-BC and research. Quality improvement (QI) is the I dismissed the thought of research and more process of evaluating health care workflow and school due to family responsibilities. Yet in my processes to see whether they meet specified standards role as educator and supervisor, I eagerly participated in or outcomes of care and to identify whether they can be the journal club discussions at my hospital. When reading improved. Plan, do, check, act (PDCA) are the typical steps the articles to be discussed, I became increasingly tired of of a QI project. Evidence-based practice (EBP), as defined just understanding the beginning and end of the articles by Bernadette Melynk, is a problem-solving approach that and not understanding the methodology and the results. integrates the most relevant and best research along with So, when my youngest son entered high school, I entered one’s own clinical expertise and patient preference and

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values. In EBP, the PICOT (population, intervention, comparison, outcome, time) format is typically used for developing an appropriate and clear question and really helps in searching the literature. Research is the systematic inquiry to validate and refine new knowledge and to generate new knowledge. Quantitative and qualitative are the two primary methods of research. Both methods utilize a systematic approach; however, quantitative collects information that allows precise measurement and describes and tests relationships and examines cause-and-effect interactions among variables while qualitative collects information as described by people and gives meaning to the information. Although I have conducted quantitative research, with most of my studies, I utilize qualitative designs such as focused ethnography and phenomenology. In 2015, I interviewed 30 administrative or house supervisors from throughout the United States to explore the supervisors’ perspectives of their managerial practices used to enhance safety and held seven focus groups with night shift staff nurses to identify the administrative supervisors’ role in nurse and patient safety. My findings revealed supervisors do whatever is necessary to achieve nurse and patient safety: building trust with the staff, doing rounds, educating, and providing support to the front-line team. In my most recent qualitative study, using a phenomenological method, I and other nurse scientists at my organization are exploring and describing the lived experience of nurses caring for patients during the COVID-19 pandemic. I enjoy qualitative research because it is interesting conducting interviews and focus groups and hearing participants’ stories. Presenting the results from qualitative research is also rewarding because you share quotes from the participants. For instance, in the nationwide study, administrative supervisors explained they support nurses with clinical tasks such as inserting intravenous catheters and accessing implanted ports. A supervisor explained that since many new nurses work the evening and night shifts and have “never started an IV or placed an NG tube,” she often takes advantage of teaching moments by “bringing the new ones with me so they can watch.” Another supervisor stated, “I may start an IV if there is a difficult IV start.” A qualitative study on patients with difficult venous access was recently published in the Journal of Infusion Nursing. To understand the experience of adult patients who had difficult venous access with short peripheral intravenous catheter (PIVC) insertion, Plohal interviewed ten patients. Four themes emerged and were supported with quotes from participants. For the theme skills and techniques of

the clinician, participants inquired, “Why can’t I start with the best nurse first” or “They know I have bad veins, why do they keep trying?” For the theme lack of communication, participants described that clinicians told them “It’s not going to hurt”; however, they also felt the insertion was “the worst part of being in the hospital.” The quotes help to illustrate and provide a better understanding of the themes. The results from this qualitative study allow us to better understand and improve patients’ experience with insertion of short PIVCs. At INS 2022, there will be presentations based on quality improvement, evidence-based practice, and research. Attending these presentations will provide a better understanding of QI, EBP, and research and may spark your spirit of inquiry for a project. Remember the best projects are generated by you—infusion nurses! So, until then keep calm and research on!

References Hedges C. Pulling it all together: QI, EBP, and research. Nurs Manag. 2009;40(4):10-12. doi:10.1097/01.NUMA.0000349683.16542.e4 Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice step by step: The seven steps of evidence-based practice. Am J Nurs. 2010;110(1):51-53. doi:10.1097/01.NAJ.0000366056.06605.d2 Plohal A. A qualitative study of adult hospitalized patients with difficult venous access experiencing short peripheral catheter insertion in a hospital setting. J Infus Nurs. 2021;44(1):26-33. doi:10.1097/NAN.0000000000000408 Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 10th ed. Wolters Kluwer Health; 2017. Rebar CR, Gersch CJ. Understanding Nursing Research: Using Research in Evidence-Based Practice. 4th ed. Wolters Kluwer; 2015. Weaver SH. Exploring the administrative supervisor role and its perceived impact on nurse and patient safety. Order No. 10307922. Rutgers The State University of New Jersey, Newark; 2016. Weaver SH, Lindgren TG, Cadmus E, Flynn L, Thomas-Hawkins C. Report from the night shift: How administrative supervisors achieve nurse and patient safety. Nurs Adm Q. 2017;41(4):328-336. doi:10.1097/NAQ.0000000000000252

March/April 2022

The Standards of Practice Committee Kicks Off a Three-Year Revision Cycle The Standards of Practice Committee was able to meet in person in the INS office in Norwood on January 25 (IV Nurse Day) and January 26 to launch the revision of the Infusion Therapy Standards of Practice. For more than 40 years, INS has developed and published the Infusion Therapy Standards of Practice. As the professional specialty nursing association that represents infusion and vascular access nurses, INS is responsible for regularly reviewing and revising the Standards that guide the specialty. Since 2006, the Standards has been revised every 5 years. In her January/February 2022 Journal of Infusion Nursing editorial, Mary Alexander wrote, “As infusion- and vascular access-related research continues to be published at a rapid pace, it makes sense to update the Standards on a more frequent basis than every 5 years.” As 5

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the specialty continues to change, it is incumbent on INS to ensure that these changes are reflected in the Standards as quickly as possible. As a result, INS will be revising the Standards every 3 years, with the next edition scheduled to be published during the first quarter of 2024. Studies have shown that frequent updates are necessary. For example, in “Current Best Practices and Standards for Development of Trustworthy CPGs: Part II, Traversing the Process,” Shekelle and colleagues applied six situational criteria to assessment of need for updating 17 clinical guidelines published by the Agency for Healthcare Research and Quality. The six criteria being as follows: 1) Changes in evidence on the existing benefits and harms of interventions; 2) Changes in outcomes considered important; 3) Changes in available interventions;

4) Changes in evidence that current practice is optimal; 5) Changes in values placed on outcomes; and 6) Changes in resources available for health care. They found 7 of the clinical guidelines were so out of date that a major update was required; 6 guidelines required a minor update; 3 guidelines remained valid; and 1 guideline’s update needs were inconclusive. The authors concluded that, as a general rule, guidelines should be reevaluated no less frequently than every 3 years. INS has seated a Standards of Practice Committee consisting of twelve highly knowledgeable clinicians with a wide range of expertise within the infusion specialty. At the in-person meeting in January, these committee members learned the technical programs necessary to the revision process as well as discussed and assigned research assignments. Amy Nadell, a health sciences librarian, trained the committee members in EndNote, a reference management tool. Dawn Berndt, DNP, RN, CRNI®, presented an overview of Ovid Synthesis Clinical Evidence Manager for critically appraising the literature as well as provided tutorials in utilizing SharePoint for document revision and version control. The committee will gather articles in Endnote, coalesce and appraise their research in Ovid Synthesis, and revise the Standards in SharePoint. Each committee member is the primary point person on a group of standards and a secondary support person to an additional set of standards. The next year will be an intense time of research, discussion, and revision before the committee submits the revised Standards for public comment in spring of 2023.

INS 2024 Standards of Practice Committee Chair:

Barb Nickel

APRN-CNS, CRNI®, CCRN

Co-Chair:

Lisa Gorski

MS, RN, HHCNS-BC, CRNI®, FAAN

Peter Carr

PhD, MMedSc, BSc, RN

Simon Clare MRes, BA, RGN

Rachael Crickman

DNP, ARNP-CNS, AOCNS, OCN, RN

Michelle DeVries MPH, CIC, VA-BC

Samantha Keogh PhD, RN, BSc(Hons)

Tricia Kleidon MNSc, BSc, RN

Amy Kyes

MSN, RN, CRNI®, CVRN-BC, APRN, AGCNS-BC

Britt Meyer Throughout 2022, committee members will be sharing their Standards research process in videos within each edition of the INSider. Check back in our May/June issue for the first installment! As INS continues to “Set the Standard for Infusion Care,“ we remain focused on how best to deliver patientcentered infusion care, strive for consistency in practice, enhance competency, and provide a guide for clinical decision-making around the globe.

PhD, RN, CRNI®, VA-BC, NE-BC

Jennie Ong PharmD

Mary Jo Sarver

MSN, ARNP, AOCN, CRNI®, LNC, VA-BC

March/April 2022

INS 2022 Annual Meeting Learn and Engage with Peers and Experts at the Rosen Shingle Creek Resort in Orlando, Florida!

Preconference Workshop Are you interested in a small group, hands-on learning before the INS 2022 Annual Meeting begins? Check out the INS 2022 preconference workshop where you will have the opportunity to work with clinical experts on the following skills: ultrasound assessment, ultrasound needling, vascular access care and management, device selection, device salvage, and intraosseous access and use. At the conclusion of this workshop, you will be able to articulate best practices for determining infusion access choice (vascular or IO), for insertion, for care and management, and for device salvage. Space is limited, so apply soon. We hope to see you there!

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Conference Sessions This year’s Annual Meeting will start on Saturday with our president’s welcome followed by an engaging session titled “Rebuilding Strong Health Care Teams: Connecting as a Pathway Forward.” We are all too familiar with how the COVID-19 pandemic has impacted our already struggling teams and systems in health care. In this session, we will discuss our present-day realities and the importance of connection as a pathway through the chaos. Another highlight on Saturday will be a session presented by our Diversity, Equity, and Inclusion (DEI) Task Force titled “Do You Know Who I Am? Can You See Me?” This session promises open dialogue and case examples from a panel of 3 DEI Task Force members. There will be education for all skill levels and interests during each day of the Annual Meeting. Topics include pediatric parenteral nutrition, fluid balance in older adults, pediatric vascular access complications, CLABSI prevention strategies, how to bring your invention to market, biosimilars, monoclonal antibodies, vascular access device technology, and much more. A session on Aseptic Non Touch Technique (ANTT), a new clinical standard in the INS 2021 Infusion Therapy Standards of Practice will provide attendees the opportunity to learn how to implement ANTT into small teams and large organizations. Originators Stephen Rowley and Simon Clare will join us in the exhibit hall following the session to work closely with attendees on the principles of ANTT. All INS sessions will be based on quality improvement, evidence-based practice, and research.

Can’t make it to Orlando? There will be an opportunity to attend the INS 2022 Virtual Conference, which packages 15 educational sessions for a total of up to 30 recertification units (RUs) to support your individual practice or your infusion team’s efforts in reaching the next-level in infusion practice. Learn, among other topics: • why vascular access device (VAD) planning must be intentional and goal-oriented • how ultrasound-guided peripheral intravascular catheter (PIVC) insertion improves clinician insertion skills and patient satisfaction • how skilled assessment throughout all aspects of intravenous therapy promotes vessel preservation and prevents patient harm • why tracking peripheral intravenous catheter infections is imperative • how to demonstrate your role or your infusion team’s impact on cost-effective delivery of infusion therapy • new sepsis guidelines Register for this option here.

We will conclude our Annual Meeting on Tuesday with a session lead by INS 2021 Standards of Practice chair and INS 2024 Standards of Practice cochair, Lisa Gorski, and INS 2024 Standards of Practice committee member, Michelle DeVries, titled “Implementing the INS Standards of Practice.” The speakers will share data about the Standards with the greatest and lowest levels of adoption, and those not adopted, and how to publish new evidence and quality improvement projects. Intrigued by the INS Standards? Come to this concluding session to learn more. March/April 2022

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If I Could Speak to My Early Pandemic Self, What Would I Say? by Craig Reinbold, BSN, RN, CEN My earliest memory of the pandemic is from January 2020. My wife and I were walking our kids to school, a day like any other, except China had just quarantined 11 million people in Wuhan. It’s only a matter of time, I said, but I didn’t really believe it. It was just something to say. Knock on wood. Like putting the defibrillator outside a patient’s door when they’re in SVT. Warding off evil spirits. Then, in February, our first COVID patient came through our emergency department. He may not have even had COVID, but he’d just returned from a business trip to China and he had a cough. We put him in a negative pressure room. We donned all the PPE. We tested him and sent him home with instructions to quarantine. After he left, our environmental services staff refused to clean the room. They refused to go in. Their manager came down and offered to help, but he had a beard and wasn’t fitted for an N95.

to be reused indefinitely. One of our docs got sick, then another. Then nurse after nurse. Our department was cleaved in two. Hot zone, cold zone. Our EMS bay became a COVID overflow. Our hospital filled up. We boarded patients. I spent shift after shift draped in a plastic showercurtain gown, my snot-filled mask melded to my face, my face shield like a dirty window between the world and me. Like that, 2020 came and went. In a lot of ways 2021 was even more difficult, and now, 2022... Even so, this latest round feels different. The other day I was chatting with that doc who bought the handgun. We reminisced, and we laughed some, which is easy enough to do now. We’re not running scared the same way. That gun he bought, he keeps it in a lockbox, hasn’t touched it since those early days. Doesn’t feel the need to. It’s just there, a talisman, warding off evil spirits.

At that time we didn’t know how the virus spread, didn’t know the transmission rate, or the mortality rate. We didn’t know anything. All we had were stories. Stories of people dying in China. People dying in Seattle. People dying. I had recently read Richard Preston’s Crisis in the Red Zone, a chronicle of the 2013–2014 Ebola outbreak, and the Sierra Leone hospital at its epicenter. Two of the hospital’s doctors became infected and died, along with 37 nurses. And there we were, February 2020, with so much unknown, so much uncertainty. I kept thinking about that number, 37—37 nurses, from a single, small hospital.

The end is still nowhere in sight, but at least we know how that first chapter turned out.

Of course our EVS crew didn’t want to go in the room. Who could blame them?

If only I could say the same for everyone.

I put all the gear back on and cleaned the room myself. I put on some upbeat tunes—Toots and the Maytals is my go-to on late nights in ER—and spent 20 minutes bleaching every surface I could reach. If I could have held my breath that long I would have. Then it was March and suddenly the country was hoarding toilet paper. One of our docs bought a handgun. One of our nurses was stockpiling ammunition. Another bought 25 pounds of pintos and talked about setting up camp in the woods. We were told our PPE was running out and were given one N95 per day. Then we were given one N95

Looking back, if I could, I would tell my 2020 self that I’d be fine. My family, our close friends, we’ll survive. We’re tired, and anxious, and frustrated, but we’re still here. For now at least, we’re okay. Looking back that is what I would tell myself: we will survive. We will survive.

Craig Reinbold, BSN, RN, CEN, came to nursing after ten years of working as a teacher and writer. He received an MFA in nonfiction from the University of Arizona, and his writing has appeared in many journals and magazines, most recently AGNI, Ruminate, and Essay Daily, where he also coedited the anthology How We Speak to One Another: An Essay Daily Reader (Coffee House Press). He works in the emergency department at Aurora West Allis Medical Center, in southeastern Wisconsin, and was named the hospital’s 2021 Nurse of the Year.

March/April 2022

The Nurses Ebb and Flow by Kasia Nikhamina The nurses ebb and flow, wax and wane. Day shift gives way to night shift gives way to day to night to day— Caroline Rebecca Jin Navi—when they start repeating, can your mom go home then?—Eric Georgiana Clara Emily— they press their IDs against the reader, push open the locker room door with their hips. Do they say door the way waiters with full trays rounding a corner say corner? You don’t know. You cannot hear through the glass, over the white noise of the HVAC, the mesmerizing puff and pull of the ventilator that is breathing for your mother now— Sometimes a nurse is about to go into the locker room, when she spots a friend approaching from the other end of the ICU, and maybe the friend is saying something as she approaches, and she is listening, smiling through her mask, green hip midswing against the door— Past her green legs, I see a narrow bench. All kinds of boots and sneakers, a pair of hot pink crocs. Water bottles covered in stickers. Brown paper bags—is it still lunch, if you eat it at night? The nurses wear fleeces over their uniforms. NYU logos embroidered in purple over their hearts. They pull on purple latex gloves without wincing.

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“Talk to your mother,” they say, “as if she can hear you. Because she can hear you.” You open your mouth, but no words come— As a teenager, you talked so much at home. You sought to fill the room so there would be no time for questions. “Nadajesz jak Radio Wolna Europe,” your mother would say, “you broadcast like Radio Free Europe.” Did she fall for it, your ruse, or was she relieved, content to skirt the secrets, yours and hers? But when you wanted something, needed something—you were Ariel. Your voice trapped in a seashell of fear. Emily Clara Eric Rebecca—your mother liked it when they wrote their name on the whiteboard in her room—Jin Navi Caroline Georgiana—when they changed the date—December 26, 2021. January 17, 2022. February 1, 2022.— Now she is asleep. Not asleep—sedated. But it feels as if she’s sleeping, and it feels strange to sit with her while she sleeps, stranger still to talk to her. To project your voice over the HVAC, over the puffs, the pulls of the ventilator— blue tube, white tube—over the space-agey sounds of the IVs—INFUSION COMPLETE. Someone—which sister?—has drawn a heart on the white board, next to your mother’s name. A blue heart, because there is only one marker and it is blue — In sixth grade, Mr. Allen said once you learned a word, you’d see it everywhere. Every Monday, you were supposed to find that week’s spelling words in the newspaper. All twenty. Clip them, Scotch-tape them into your notebook. Every Monday, your mother sat with you at the kitchen table, poring over the Sunday Newsday. Not reading— searching. The spelling list between you. The faces of Tony Danza and Liam Neeson missing from the Arts section. Your cheeks and fingers ashen, where newsprint had mixed with tears. Why did she help you with this? Was it because she could not help you with the other thing? “Remember when I drove you crazy, smudging all the light switches with my newsprint fingers, and then I started turning the lights on and off with my nose?” She sleeps and you sit and the nurses come and go and the machine breathes and in your mother's lungs— you hope—the alveoli begin to gossip, trading oxygen for carbon dioxide.

Find more of Kasia Nikhamina’s work at https://tinyletter.com/kasianikhamina.

March/April 2022

Are You Ready? With everything going on in the world, are you ready to do what you need to do to either obtain or retain your CRNI®? Let’s look at those of you preparing for the March 2022 exam. Currently, we have 235 RNs from 7 countries who have registered.

Let’s review some study materials at your disposal to prepare you for the exam. • CRNI® Academy: The academy combines information from four CRNI® study resources (Core Curriculum for Infusion Nursing, Infusion Therapy Standards of Practice, Infusion Nursing: An Evidence-Based Approach, and Policies and Procedures for Infusion Therapy) into one comprehensive, online study tool. • CRNI® Study Information: This page on the ins1.org website is the hub of study materials for CRNI® exam—your go-to page for resources. It has links to the CRNI® Exam Handbook as well as links to the Detailed Content Outline. INCC encourages all applicants to complete a self-assessment with the outline to identify their strengths and weaknesses. Other resources are available on the CRNI® Study Information page. Please use the entire page to your advantage. And please remember the registration deadline for the March exam is March 15.

If this year is your time to recertify, let’s review what you need. First, you need to visit the CRNI® Recertifications Page at ins1.org. Here you’ll find the eligibility requirements. To recertify your CRNI® credential, you must meet the following requirements: • Hold a current, active, and unrestricted RN license. • Have a minimum of 1,000 hours of experience in infusion therapy as an RN within the last three years; direct bedside experience is not required. Nursing experience may be in the areas of nursing education, administration, research, or clinical practice within the infusion specialty.

Once those requirements are met, there are 2 ways to recertify. • Recertification by Exam: To recertify by exam, a CRNI® must pass the CRNI® exam during the final year of certification (year three). Applications will become available in the last year of the CRNI®’s certification cycle under their CRNI® Certification Profile online. 13

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• Recertify by Continuing Education (CE): CRNI®s choosing to recertify by continuing education require a total of 40 RUs during their 3-year cycle, of which at least 30 RUs must be from an INS meeting (live or online). To view all of your recertification options, click here. The options shaded in green fall under the INS meeting category. To recertify by CE, you must submit three items in the final year of your certification cycle: 1. A recertification by CEU application 2. Payment for your recertification fee 3. 40 recertification units (RUs) On the RU options page, there’s an RU Options Chart, which shows how to earning the 40 RUs needed to complete your recertification. Let’s say you need all 40 RUs this year. You’re not alone; we understand that life gets in the way. Register and attend INS 2022, the INS Annual Meeting. If you attend all the sessions, you’ll earn all 40 RUs. Can’t make it to Orlando? INS 2022 Virtual Conference will have 15 select sessions from the conference virtually and on-demand. For CRNI®s, this adds up to 30 RUs. Register here for this option. The deadlines to recertify are as follows: • March recertifications are due no later than March 31. • September recertifications are due no later than September 30. • January recertifications are due no later than December 31.

Once you’ve accumulated the required RUs, submit your application for recertification. Go to ins1.org and: 1. Access your profile. 2. Apply from your profile page. • Click the Certification–Certification Management tab to access your CRNI® Certification Profile. • At the bottom of the page, select Click to Register to recertify by CEU. Please note: Your recertification fee is due at time of application.

We hope these tips are helpful for you. We truly appreciate your support of the CRNI® program. Here’s to a great 2022.

March/April 2022

The INS DEI Task Force Shares Their Stories In order to begin to fulfill the DEI Task Force mission of listening to the diverse voices within the infusion nursing community and looking for opportunities to address bias and intolerance in health care, the DEI Task Force members are searching for venues to share their stories. Recently, Julio Santiago was featured on the blog Minority Nurse. You can read his story here. Additionally, every INSider over the next several months will feature a couple members from the DEI Task Force. Danielle R. Jenkins and Max Holder share their stories in these inaugural videos.

Danielle R. Jenkins, BSN, RN, CRNI

Danielle R. Jenkins is a registered nurse practicing in nursing administration and health care operations for over twenty years. She is currently the director of practice management for Paragon Healthcare. As an entrepreneur and inspirer, she has a passion for encouraging others in the health care field to always remember their power of influence. Danielle holds a AS in nursing from Delgado Community College, a BS in nursing from the University of Texas-Arlington, and is currently enrolled at Capella University working toward an MBA in health care. Danielle has published numerous articles sharing her knowledge on issues that impact nursing and has received numerous awards in leadership. She serves on multiple committees in the capacity of diversity, equity, and inclusion, and enjoys serving her community through outreach programs. One of her quotes she uses to inspire is: “Never let the fear of striking out keep you from taking chances: life is meant to be lived.”

Max Holder, MSN, RN, CRNI

, NE-BC

Max Holder has 29 years of nursing experience in emergency nursing, corporate compliance, and infusion therapy/vascular access. He is the nurse manager of the Vascular Access Team and Acute Care Hemodialysis Unit at Baylor Scott and White Health (BSWH) University Medical Center in Dallas, Texas, a 900-bed quaternary teaching hospital; and serves as a clinical expert for the BSWH CLABSI Eradication Program and as the chairman of the BSWH Vascular Access System Council. Max served two terms as director-at-large on the Infusion Nurses Society board of directors from 2014 to 2019 and is the 2022 president. He received the Baylor University Medical Center Clinical Nurse Excellence Award in 2019, and was named a Dallas/Ft. Worth Great 100 Nurse in 2020. Max works as an expert witness in cases related to infusion therapy and vascular access. He has been involved in nursing continuing education throughout his career and continues to publish and present on vascular access and infusion therapy topics and advocate for the implementation of evidence-based best practices.

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INS Convenes a Diversity, Equity, and Inclusion Task Force INS affirms our belief that all people deserve to be treated with dignity and respect. Further, we acknowledge and embrace our obligation to advance equal and effective care for all people. Inclusiveness is one of INS’ core values. We are committed to listening to the diverse voices within the infusion nursing community and we look for opportunities to address bias and intolerance in health care. To ensure that INS is supporting and promoting diversity and inclusion within the infusion community, we have established a standing Diversity, Equity, and Inclusion (DEI) Task Force. Our goal is to plan and execute meaningful actions.

INS DEI Task Force Members:

Crystal Miller, co-chair Felicia Schaps, co-chair Jeanette Adams Ludy Aquino-Lasam Marcela Beatty Tracy Davis

The DEI Task Force has identified what Diversity, Equity, and Inclusion means to INS. Diversity:

Melanie Eld Jennifer Helal Max Holder

Embracing and accepting our differences, respecting all people without prejudice, and practicing health care with reverence for each unique individual.

Danielle Jenkins

Equity:

Larry Sisei

Doing what is fair and just to achieve the best outcome for all people.

Jannifer Stovall

Inclusion: Ensuring that our organization honors the thoughts, ideas and perspectives of each person.

Yvonnie Love Julio Santiago

Debra Toney Sue Weaver

March/April 2022

View these webinars and more on-demand: www.learningcenter.ins1.org/webinars Infectious Complications in People Who Inject Drugs

Protecting Clinicians from Hazardous Drug Exposures

Being Provaccine in a World of Vaccine Hesitancy

Listen to these podcasts and more on-demand: www.learningcenter.ins1.org/podcasts Two Infusion Nurses Describe their Practice, Challenges and Rewards

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Gel-Free Ultrasound-Guided Peripheral Vascular Access Device Insertion

Tissue Adhesive–A New Approach to Vascular Access Device Securement

The 2022 INS Leadership Award:

Margaret Hempstead The Leadership Award is presented to an infusion nurse in a management position or higher who provides leadership, guidance, dedicated service, and a vision of success to his or her organization and who exemplifies the traits of a leader. Margaret Hempstead, BSN, RN, CRNI®, VA-BC, EMT-B is the winner of this year’s Leadership Award. She was nominated by her employee Patricia Seifert BSN, RN. Margaret Hempstead has enjoyed a 43-year nursing career at Mount Sinai South Nassau Hospital, a Magnet-recognized hospital in Oceanside, New York. She serves as a nurse manager of a department of 20 infusion/vascular therapy nurses and holds both the CRNI® and VA-BC credentials. Margaret is a staunch follower of the Infusion Nursing Standards of Practice: she is well-versed in them and lives by them in her daily practice. She also instills the importance of following the Standards with not only her own staff members, but all clinical providers throughout the hospital. She is often called upon as a resource by her staff, nurse educators, and administration. As a leader, Margaret will never ask her staff to perform a task she herself is not willing to perform. Despite the multitude of responsibilities she holds as a manager, Margaret is often seen at the bedside performing vascular access procedures, especially when the unit is shortstaffed. A strong supporter of continuing education, she is frequently observed watching webinars or reading articles in order to keep current. Most importantly, Margaret advocates for patient safety and comfort. It is not uncommon for her to give her business card to patients to assure them that she is available if needed. We offer our congratulations to Margaret and thank her for her commitment to her patients, colleagues, and the infusion specialty!

March/April 2022

Virtual Symposium: Infusion Therapy Related Complications This Infusion Nurses Society virtual symposium will address the following 5 challenging aspects involved in the delivery of infusion therapy. Managing Infusion Reactions

All infusion reactions involve the immune system; however, some (anaphylactic) are allergic in nature whereas others (anaphylactoid) are not true allergic reactions. Although reactions can be allergic or nonallergic, the clinical manifestations are the same and require prompt, accurate assessment and management to avoid severe adverse events, including fatality. Content in this session addresses the nurses' role in patient risk assessment, institution of prophylactic measures, administration monitoring, severity grading, management, and follow-up care.

Preserving Skin Integrity

For some patients, maintaining skin integrity is challenging. Many patients receiving infusion therapy have multiple comorbidities, including renal impairment, nutritional deficiencies, hematologic disorders, or cancer. These conditions can impair the skin surrounding the vascular access device (VAD) insertion site which is vulnerable to being injured or damaged during VAD insertion, care, and dressing changes. Medical adhesive-related skin injuries (MARSI) can occur when the superficial layers of the skin are removed by VAD dressing medical adhesives, causing skin trauma. MARSI impairs the patient’s skin integrity and increases the risk for infection. In this session, attendees will learn about selecting the appropriate VAD dressing for each patient, techniques for dressing application, and interventions to prevent MARSI.

Infiltration and Extravasation: Prevention, Assessment, and Interventions

The inadvertent administration of a solution, nonvesicant (infiltration) or vesicant (extravasation), into surrounding tissue can cause significant patient harm. Despite adherence to policies and procedures for VAD insertion and care and management during infusion therapy, an infiltration or extravasation may occur. In this session, educational content addresses prevention, assessment, and interventions for infiltration and extravasation.

Implanted Port Complications and Management

Implanted vascular access ports are vascular access devices that are surgically placed in the body to facilitate long-term infusion therapy. Implanted ports differ in construct, size, and application and can be subject to technical difficulties which may lead to patient complications. In this session, learn more about implanted vascular access ports, use and management, complications—such as occlusions, malposition, infection, infiltration, and extravasation—and ways to intervene.

Competency Validation for Patient Safety

Competency is a required level of effective performance in the work environment defined by adherence to professional standards, including knowledge, skills, abilities, and judgment based on established science. Due to its invasive, high-risk nature, the clinician with responsibility for VAD insertion, safe delivery of infusion therapy, and VAD management must demonstrate competency with each of these skills as well as with the comprehensive role of infusion nursing. The length of clinical experience and passive recurrent performance are not surrogates for clinical knowledge and procedural competence for experienced clinicians. So how can initial and ongoing competency be validated? In this session, attendees will learn about managing competency assessment and validation in 2 phases: initial competency and ongoing competency.

At the completion of this symposium, attendees will earn 5 contact hours and 10 RUs. 19

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Supported Through an Educational Grant by

INS Member

Spotlight

INS is honored to share our members’ stories with the infusion nursing community. Each nursing journey is unique and we can learn so much from each other. We will continue to share stories from our members who care for patients in a variety of care settings. We are proud of you all and commend you for your hard work, passion, and dedication to patient care.

Maria Sassoui

What led you into the nursing profession? I believe people were made to be well, not to suffer with disease, disability, and death. What made you decide to specialize in infusion therapy? I believe it is the quickest and least invasive way to improve health, especially in crisis situations. How has INS Membership benefited you in your journey? INS has many avenues available to allow one to achieve their goals. Has there been a mentor, colleague, or INS member who has helped along the way? I read articles that are inspiring and encouraging to help me stay positive and focused on improving my infusion skills.

Deborah Sousa-Van Veen

MSed, BSN, RN, OCN, CRNI®

What led you into the nursing profession? Back in high school, in 1968, I was very good in art and physical education. Biology interested me but I had no desire to learn English and math. There was a need for nurses, and The Manpower Act gave us a weekly stipend for going to school. I had been working since age 15 washing dishes in a local nursing home. I loved meeting the residents and saw how they enjoyed talking to relieve boredom, and sometimes delved into something nostalgic with me. The nurses asked me if I would like to train as a nurse’s aide, and I did. When I went on to apply to the LPN program in Southern Massachusetts, the nurse recruiter, Mrs. Renner, saw my poor grades and did not want to admit me. But she saw a sincerity in me, I guess, when I told her “I wanted to work with people, not paper.” Mrs. Renner had on a beautiful white cap and black velvet ribbon of an RN and took a chance on me. I graduated and did well on my boards. She was so proud of me, and she saw I loved nursing, the skills and the science, and had found my passion. From there I did a lot with that LPN, then went on to the RN, and BSN, and masters and certifications in each specialty. I became a nurse 1971. It will be 50 years this November, and I still love sharing with new nurses, teaching them how to insert IVs or pathophysiology, just all of it. Sharing the enjoyment of what I do. What made you decide to specialize in infusion therapy? I was a hospice nurse and had a lot of patients with ports and PICCs and pumps of different types, and there was an opening in the infusion department. I had taken phlebotomy classes as an LPN and learned that not only did I enjoy it but I was the go-to for tough sticks in our surgical office; I was good at it. How has INS Membership benefited you in your journey? I read the journals, even every advertisement. I enjoy the research articles and the data presented. I like how things have evolved. Often I think back to my early years at Malden Hospital. So much was new then: an antecubital incision and cut down or peripheral IV seemed about it before all of our lines came out. I like seeing the drugs discussed and topics of interest for thought.

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Has there been a mentor, colleague, or other INS member who has helped along the way? I have been pretty much a self-motivator—but having each hospital or place I have worked give me tuition assistance was of great value to me. I never had to take out loans or large debit. I am grateful. Do you have stories from your practice that you would like to share with the infusion community? The hospice memories/stories are endless of the people who were in their end stages of life. Their spirituality and peace amazed me. Often I would see someone’s eyes get bright as if to follow something or someone just as they would pass. Their trust in you as a nurse, their gratitude of your good care and calming presence, and their invitation of you into their home to walk them through that journey was all incredible. It is as I told Mrs. Renner years ago: I take care of people, not paper. At any given day it could be us in their chair.

Danielle R Jenkins

BSN, RN, CRNI®

What led you into the nursing profession? My mother-in-law was one of my biggest influences to pursue nursing, and nurse Gina, my OB nurse when I delivered my first child, is my second biggest influence. These nurses were both confident and compassionate about nursing and delivered outstanding nursing care. My mother-in-law also taught me the business of health care. At the time, she owned and operated multiple home health agencies, and she allowed me to work in her company to learn the ends and out of home health and to understand the impact of health care regulations, clinical excellence, and the importance of making sure what you say and the care you deliver is well-documented. She taught me how to navigate and take control of difficult conversations. Watching her over the years lit a fire inside of me to pursue nursing and to progress to nursing administration and later to be a home health owner and consultant. What made you decide to specialize in infusion therapy? I began my career as a nurse tech during my senior year of nursing school on the oncology ward. I loved the autonomy of infusion nursing. I was mentored by a nurse named Valerie Langford who taught me how to run an infusion suite and give excellent patient care. She taught me the importance of infection control, double-check protocols, and so much more. When I left oncology and went into home health, I encountered a patient with a mediport. No one on staff was familiar with the care involved with a mediport so I stepped up to care for the patient. It was at that moment that I realized infusion therapy was not common knowledge and that I could make a career of it. I love the autonomy of infusion nursing, the one-on-one care, and taking care of patients from the start to finish of their disease process. It’s been 20 years and I’m still in love with infusion nursing. I love sharing my passion with many new nurses to expose them to this side of nursing. How has INS Membership benefited you in your journey? The membership has kept me abreast of changes in the industry and has helped me to craft policy and procedures to govern infusion nursing programs. Has there been a mentor, colleague, or INS member who has helped along the way? Yes, my mentors were Valerie Langford who exposed me to infusion suites and Cynthia Sumrall who exposed me to the business side of home infusion nursing from a pharmacy perspective. Do you have stories from your practice that you would like to share with the infusion community? One of my most memorable stories is when I had to teach an elderly patient how to self-infuse a drug using a pump in the home setting. This patient gave me the most contorted look of disbelief and said, “I am not a nurse.” Once I worked through that difficult moment and empowered the patient and caregiver, that patient took hold of the process and began self-administering her infusion meds. When I went back the next week for a follow-up visit, she had family members visiting, and she said, “Nurse Danielle, I taught all of them how to run that infusion. I’m a pro now.” This story still warms my heart, and taught me to always listen to a patient’s concerns as well as to empower the patient. Empowering patients not only helps the patient, but transcends to empower others.

March/April 2022

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Candace Gandy

M E M B E R

S P O T L I G H T

MSN, RN

What led you into the nursing profession? I chose nursing as a second career. I realized I wanted to be in a profession that ministered to people’s emotional, spiritual, and physical needs. What made you decide to specialize in infusion therapy? IV therapy is a specialized area. I first got into infusion therapy when I took a position to open an IV pharmacy for the acute care hospital that I was working for. In my later years, as a nursing instructor, I have realized that infusion therapy is not consistently experienced by all students. I wanted to make sure that the infusion standards are taught to my clinical students. I also want to make sure the students understand infusion therapy and devices. I want to instill a passion for infusion therapy and safety in all my students. How has INS Membership benefited you in your journey? I am able to keep up with the latest infusion therapy standards. My students are able to obtain articles and resources for assignments that allow them to develop nursing policies. Has there been a mentor, colleague, or INS member who has helped along the way? Many people from INS and friends that I have met at conferences have helped me along the way. The magazine and educational resources assist in new knowledge when a mentor is not available. Do you have stories from your practice that you would like to share with the infusion community? Yes, many on how experienced infusion nurses can mentor students and new nurses.

Delia Patlani Moreno

MSc, RN

What led you into the nursing profession? Admiration for caring for people in a critical and important moment and contributing with care to strengthen the return of people’s health. What made you decide to specialize in infusion therapy? Infusion therapy is the mainstay of intravenous treatment. We can save lives at all times, and even reduce many adverse events. In Mexico there were great contributions from our national leaders, Mtra. Almazán Catillo, Dr. Juanita Jimenez, and Mtra Teresa Rosas Resendiz, where thousands of opportunities were dedicated to improve people’s health. I love the opportunity to transmit knowledge to new generations of health care professionals, to improve intravenous therapy processes, and to contribute to improving the health of each patient and reduce the probability of adverse events. How has INS Membership benefited you in your journey? My dialogues and my decisions are scientifically based. Since I became a member, I have had the opportunity to strengthen my knowledge, to share advances with my colleagues focused on strengthening patient care, and to make decisions with scientific and updated evidence, in addition to learning the great contributions of evidence from other countries. I have certainly learned a lot.

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INSide Scoop Our recurring feature, INSide Scoop, serves to keep you informed on things happening within INS as well as upcoming events, items of interest, new educational deliverables, certification news, and other current information. Here we communicate directly with our membership as well as with the larger infusion nursing community to keep you informed on topics—in real time.

Meetings INS 2022 Virtual Conference Not able to make it to Orlando for INS 2022? No worries. We have a virtual option for you! This option gives the learner the ability to attend 15 select sessions virtually and on-demand. For CRNI®s, this adds up to 30 recertification units (RUs)—a great alternative for those who are not able to attend the in-person event! The virtual option will include the 5-hour veINS Focus Track on Monday, June 6, plus 10 additional 1-hour sessions on Sunday, June 5. For more information on this option or to register, please visit the INS LEARNING CENTER. We hope to see you either in-person or virtually in Orlando!

Publications In January, the Journal of Infusion Nursing Editorial Board met for the first time. The members are Lynn G. Brown, MS, MA, BSN, RN, CRNI®, FACHE; Gail P. Dammert, MBA, MSN, RN, OCN; Angie Malone, DNP, APRN, ACNS-BC, OCN, AOCNS, NE-BC; and Theresa Wicklin Gillespie, PhD, MA, FAAN. Randi Davis, Senior Publisher at Wolters Kluwer; Dawn Berndt, DNP, RN, CRNI, Clinical Education and Publications Manager at INS; Mary Alexander, MA, RN, CRNI®, CAE, FAAN, Chief Executive Officer at INS and Editor of JIN; and Rachel King, Editorial Production Coordinator, at INS also joined the meeting. The members introduced themselves and their areas of specialties, suggested people who might write articles and topics for articles, and brainstormed potential themed issues. After many years of planning, we’re excited that the editorial board has come to fruition. We look forward to working with the members in the years ahead!

March/April 2022

Welcome New Members! NEW DOMESTIC MEMBERS

Erica Adame Dawn Albury Gaitor Bernhardine Ammons Michelle Aristhomene Mata Nicole Bailey Debra Balise Charlene Basler Kaitlin Bauder Maria Beth Alyssa Blandford Ian Bordelon Melissa Brent Candice Brown Cindi Brown Shelby Brown Kate Burnett Ali Burns Charity Cabreros Erica Cannatella Nancy Cannon Alessandra Carbonaro Kristie Carroll Karla Chandler Janet Chen Michele Ciaburri Shannon Clark Melissa Clifford Genieveve Cline Christine Cook

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Krystal Cool

Becky Hudgins

Maribeth Coolbrith

Mira Jensen

Jennifer Curley

Yuki Kawai

Rebekah Cypher

Jackie Keehne-Miron

Julie Davidson

Diane Kerr

Cheryl Davis

Samantha Keylich

Alice Dawson

Sylvia Kimbi

Nora Diaz

Taylor Kintz

Jean DiGiorgio

Josh Kohrs

Rebecca Donnelly

Megan LaJoie

Lori Dougherty

Mary Lange

Kimberly Dufficy

Jeanette Lawson

Deirdre Durbin

Kimberly Leach

Sean Edde

Seth Lemons

Cameron Edds

Raul Leyte-Vidal

Patrick Emrick

Bernice Lolio

Theresa Fanasch

Irene Luciano

Rachel Fishback

Jamie Major

Christie Fitzgerald-Dunlap

Belen Manybanseng

Kailyn Flosi

Karen Martin

Bolanle Folarin

Meredith Maurey

Lori Fornwalt

Michael McClenon

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Kimberly McNabney

Monica Gogosanu

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Frida Gonzalez

Kathleen Mendetta

Christa Gould

Janice Mitchell

Jason Greene

Katherine Montfort

Elaine Griffin

Amanda Morales

Alexandra Heckathorn

Nellys Morejon

Rachel Henderson

Pamela Moseley

Maria Elena Hermosillo

Jordan Mott

INFUSION NURSES SOCIETY N E W I N T E R N AT I O N A L M E M B E R S

Caroline Murphy

Mike Stern

Andrea Mutzabaugh

Sheridan Stokes

Monica Myers

Marilyn Strain

Mohammad Al-kharabsheh – Jordan

Michelle Neverida

Sierra Stulb

DaEun Cho – South Korea

Amanda Nucifora-Stonaha

Allison Tant

Julie Onebamoi

Frederick Tempesta

Rose Otero

Sheryl Tianero

Ladrea Parker

Carlo Tinio

Dahee Lee – South Korea

Kimberly Parkinson

Mark Anthony Torres

KwonSun Lee – South Korea

Karen Pederson

Joyce L. Turner

Michelle Pelage

Candis Valentine

Taylor Phelps

Phillip Vasquez

Drochelle Pierce

Corina Veazey

Maria Luiza Silva Pereira – Brazil

Julie Pinquiere

Jennifer Webb

Eun Seo Seo – South Korea

Brenda Pulsifer

Novia Webster

Jon Rasmussen

Amy Werre

Chantelle Read

Theresa Wicklin Gillespie

Noella Rebello

Anna Wilson

Jessica Rebolledo

Natalie Wilson

Teresa Redmond

Natascha Wolter

Cristina Rivera

Christina Yen

Colleen Romer

Jen Zaremba

Brad Rudge

Lindsey Zeoli

Ruth Dunleavey – United Kingdom Ahamd Ibdah – Jordan

Soonhyun Lee – South Korea Jan Little – New Zealand

Hyein Song – South Korea YiFeng Wu – Canada Season Yu – China

Brooke Saxby Neil Schwaiger DeAndrea Scott Alice Sisco Tawnya Slafka Renee Smith Keri Spillman Ashley Stankiewicz

March/April 2022