1. Alexander, Mary MA, RN, CRNI(R), CAE, FAAN

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Excerpts of the following report were delivered at the INS Annual Meeting and Industrial Exhibition in Fort Lauderdale, Florida, on May 17, 2010.

Mary Alexander, MA, ... - Click to enlarge in new windowMary Alexander, MA, RN, CRNI(R), CAE, FAAN

It is with much pleasure that I report on the extremely successful year enjoyed by INS in 2009. Our successes were spread across all facets of the organization and helped strengthen our leadership position within the infusion nursing specialty. This report will begin with Membership, which remains the focus of all we do.



The year 2009 marked the sixth consecutive year of triple-digit increases in INS' membership. INS realized the largest increase in over 15 years, with 266 more members than in the previous year. We finished the year with the membership rolls topping off at 6217, up from the 2008 membership number of 5951. Despite the economic challenges, the cost of membership dues remained constant at $90, making this the 13th consecutive year without an increase. Membership revenue increased by $20,000, compared to $6000 in 2008.


Aggressive recruitment and retention programs have contributed to the growth in INS membership. While increasing members' connection to INS, the Chapter Challenge also yielded over 100 memberships. The number of value-added programs continued to increase and enhance the member benefits package. For example, 4 webinars were offered at no charge to members, the "Membership-Exclusive" section on the Web site has been expanded, and the online functionality of publications (Journal of Infusion Nursing, Newsline, and Newsbrief) has been enhanced.


Equally as important as the actual increase in membership numbers and the financial impact this had for the organization is the increase in member participation. Our ability to attract potential volunteers to serve on committees and task forces can be directly attributed to the influence we have on the specialty and the respect we have from clinicians practicing within the specialty.



Education, one of INS' core business units, continues to provide necessary information to impact clinicians' practice and patient care. Year after year, we offer superior educational programs that address the latest issues and trends in infusion therapy. The consistently high grades we receive from our attendees are the direct result of the work of the National Council on Education (NCOE).


INS continues to have consistent, engaged audiences at our meetings, with more than 1000 attendees at the 2009 Annual Meeting and 500 attendees at the 2009 National Academy of Infusion Therapy (NAIT). Attendees at the Annual Meeting and the fall NAIT received CD-ROMs at no charge, courtesy of Roche and B Braun Medical, respectively. Not only does INS consistently offer quality education programs, but it also continuously strives to provide an enjoyable meeting experience for our attendees. The exhibit hall continues to expand in size, number of companies, and additions, such as the Exhibitor Theaters.


The One-Day Program prior to the 2009 Fall NAIT, "Developing an Infusion Alliance: A Benchmark for Success," was fully funded by B Braun Medical. We are looking forward to the 2010 One-Day Program and Fall NAIT to be held November 19-21 in Metro Washington, DC.


In addition to the quality programs offered at INS meetings, the enhancements to the Web site include a "Clinical Practice Questions" section and an online tool to submit questions to the INS Nursing Network. The creation of Educational Resource Bundles (Competencies Validation and Infusion Team Implementation) has helped increase sales of existing products. Online purchases of educational resources continue to grow.


Revision of the Infusion Nursing Standards of Practice commenced in 2009. A major enhancement to the current version will be ranking the evidence that supports the Standards. This project is fully funded by a grant from BD Medical. The projected publication date is the first quarter of 2011. At the same time, the Policies and Procedures for Infusion Nursing will also be updated and revised.



As a way to broaden recognition of INS as the global authority in infusion therapy, increase our visibility and scope of services, and create and expand business development opportunities, a separate business segment was created. Infusion Education Services focuses on building relationships with industry partners and third-party continuing education companies to provide educational opportunities for our members and the infusion community. This business segment allows INS to develop an array of programs such as webinars, publications, and online CE programs, and is responsible for additional nondues revenue streams and multiple offerings.


In 2009, 4 webinars, all sponsored and presented at no cost to members, were offered. The sponsors were the Hartford Foundation (Infusion Therapy in the Older Adult), Watson Labs (Iron Deficiency), Roche (REMS), and B Braun Medical (Infusion Alliance). In addition, several key nonmeeting sponsorships were secured that included funding for the INS Web site, INS Newsbrief, and several Gardner Foundation scholarships.


In 2009, CareFusion (formerly Cardinal Health) instituted their Appreciation Through Education Program (ATEP) to recognize and reward their loyal customers by giving them the ability to access professional educational resources such as those offered by INS, at no charge. Based on the total value of CareFusion product purchases made, a hospital was awarded credits to be used to purchase products and services from 4 different professional associations, of which INS was one. This program is a direct result of INS' high standing within the infusion community.



INS' flagship publication, the Journal of Infusion Nursing (JIN), continues to be the Number-1 member benefit, as confirmed through a recent member survey. Royalties earned were $115,000-down from a record high $139,000 in 2008. Revenue decreased most notably in advertising sales from $312,000 in 2008 to $220,000. The decrease in ad sales is consistent with industry norms as more and more companies are moving away from print advertising. Other revenues increased, such as electronic institutional subscriptions ($23,000); however, these increases were not enough to offset the ad sales shortfall.


In 2010, the popular column "Speaking of Standards..." was retired in anticipation of the revised Standards. As the JIN Editor, I would like to recognize Lisa Gorski, author of the column, for her contributions for the past 2 years.


The Journal also has enhanced features on its Web site. Now readers can search the entire Journal archives all the way back to the first issue from 1978 and print any article. It's easy to sort topics into saved collections and send an article to a colleague. The site will even help you set up Journal references as you are working on a research paper.


INS' authoritative reference, Infusion Nursing: An Evidence-Based Approach, made its debut at the 2009 INS Annual Meeting. It has been well received as seen by the 2009 book sales of more than 1300 copies.



The collaborations we have formed with industry, professional associations, and academia are responsible for much of our recent success. Our ability to work with each of these groups affords us the opportunity to increase our visibility and exposure and work toward meeting the needs of our ever-growing membership.


As we look to continue our work in identifying INS' research priorities that was started as a collaborative effort with Wayne State University College of Nursing, the article "Establishing Research Priorities for the Infusion Nurses Society," written by Mary Zugcic, MS, CNS-BC, CRNI(R); Jean Davis, PhD, RN; Lisa Gorski, MS, HHCNS-BC, CRNI(R), FAAN; and me, has just been published in the 2010 May/June issue of the Journal. INS will be building on this project to define further the priority areas of infusion nursing that need additional research.


INS continues its membership as an Organizational Affiliate (OA) of the American Nurses Association (ANA). In this capacity, OAs have voting seats in the ANA House of Delegates (HOD) and the Congress of Nursing Practice and Economics (CNPE). In June, Nancy Mortlock will be representing INS at the ANA HOD in Washington, DC. Due to a change in the ANA bylaws, INS will need to appoint a new CNPE representative. I want to thank Lisa Gorski for being INS' CNPE representative for the past 2 years. In order to recognize nursing's contribution to health care, last year the OAs agreed to dedicate organizational editorials on the value of nursing. These pieces were published around Nurses Week in May. In the 2010 May/June issue of JIN, my editorial "Nurses Join Forces to Build Power, Lead Change" addressed the value of infusion nurses. In our ongoing efforts to support infusion nursing research, INS is funding an ANF (American Nurses Foundation) Research Grant in the amount of $3500. The award winner, to be notified by August 31, 2010, must be conducting research related to the science and practice of infusion therapy and/or infusion nursing. Not only will the ANF grant give us visibility in the larger nursing community, it will also enable us to build our research capacity.


For the ninth consecutive year, INS sponsored a speaker on the Specialty Nurses Panel at the National Student Nurses Association's (NSNA's) Midyear Conference. In addition, INS is funding a $1000 scholarship for a student nurse through the Foundation of NSNA. Last month, INS Director-at-Large Ann Briggs presented the award to Neelam Sims, a nursing student at Linfield College, Portland, Oregon, at NSNA's Annual Convention in Orlando, Florida.


INS has continued its partnership with the Hartford Institute for Geriatric Nursing. Our proposal to participate in the "Specialty Nurses Impacting Aging" initiative through the development of a webinar highlighting infusion needs of the older adult was granted and conducted in September 2009.


We continue to collaborate with the National Home Infusion Association (NHIA) on public policy issues. In November, INS Secretary-Treasurer Marvin Siegel joined an NHIA-led provider delegation to discuss practice guidelines on the intravenous administration of monoclonal antibody agents by providers in the home and alternate-site settings to the New York Board of Nursing.


INS continues its work with the Alliance for Plasma Therapies, an organization committed to working for better access to intravenous immune globulin (IVIG) products. The Alliance is continuing its work to educate legislators and government agencies on the patient care issues related to access to IVIG.


Last July at the annual meeting of the International Academy of Nursing Editors (INANE), I was invited to participate on a panel that addressed the challenges and opportunities that editors find when soliciting research manuscripts for publication. From the perspective of a midsize membership organization, I spoke on "Publishing Research in the Journal of Infusion Nursing."


As the only specialty nursing organization invited to be on the committee to revise the 2002 version of the Centers for Disease Control and Prevention (CDC) Guidelines for the Prevention of Intravascular Catheter-Related Infections, INS was honored to provide valuable input and feedback. INS members were alerted when it was announced in the Federal Register that the comment period was open to the public. The revised draft has been submitted to the Healthcare Infection Control Practices Advisory Committee (HICPAC) for review and approval prior to its release for publication.



Through international activities, INS is broadening its recognition as the global authority in infusion therapy, increasing its visibility and scope of services, and creating business opportunities. Interest from our nurse colleagues in countries outside of the United States continues to grow. We have 275 international members from 38 countries and territories outside of the United States, an increase of more than 80 members from 10 additional countries. With interest in INS and infusion nursing by groups in foreign countries, the International Affiliate program was launched to formalize an official relationship between them and INS. INS UK and Ireland(R) and Thailand have obtained International Affiliate status, with New Zealand and Brazil, among others, also pursuing this opportunity.


This past year I delivered infusion-related education programs with an emphasis on standards and the implications they have for clinical practice to health care professionals in Mexico, Brazil, Colombia, and India. There is great interest in INS' Standards of Practice and Policies and Procedures for Infusion Nursing and how they can effectively be integrated into clinical practice. Other topics of interest for the foreign-educated nurses include medication delivery, patient safety, infusion nursing certification, and the implementation of infusion teams.



As a member of the Nursing Community and the ANSR Alliance (Americans for Nursing Shortage Relief), INS continues to support efforts to reauthorize the Title VIII Nursing Workforce Development Programs under the Public Health Service Act.


As a member of the National Quality Forum (NQF), we continue to work with other nursing organizations to support nursing candidates for NQF Council positions and provide input on consensus standards.


In January, I represented INS at the Anesthesia Patient Safety Foundation's Summit on "Medication Safety in the OR: Time for a New Paradigm." The goal of this meeting was to produce a consensus statement that defines the challenges and opportunities for improved practice.



The Gardner Foundation continues to enhance its program so that more scholarships and awards are distributed. Not only have the number of applications increased, but the quality of the submissions has also steadily improved. In 2009, the first INS Presidential Leadership Scholarship was awarded. The purpose of this scholarship is to honor the commitment and contributions of INS past presidents by recognizing exceptional leadership qualities among nurses within the infusion nursing specialty.


In order to increase the number and amount of donations to the Foundation, an online donation feature has been added to the INS Web site. Donors are now able to submit their contributions online. I want to acknowledge the industry sponsors that continue to provide financial support to the Foundation: they are B Braun Medical, BD Medical, and Smiths Medical.


In January, I attended the Nursing Organizations Alliance Foundations Meeting held at the Association of periOperative Registered Nurses (AORN) headquarters in Denver, Colorado. At this meeting, I had the opportunity to meet with individuals from other specialty nursing organization foundations to discuss and share best practices and lessons learned about fundraising programs, planned giving, and philanthropic perspectives.



INCC is pleased to be celebrating the 25th anniversary of the CRNI(R) credential. The first examination was administered in March 1985. This milestone is a tribute to the solid certification program that INCC has provided over the years. The CRNI(R) exam maintains its accreditation through the Accreditation Board for Specialty Nursing Certification (ABSNC).


While the March 2009 exam saw an increase of 11 candidates from 2008, the September administration realized a decrease of test takers by 70, attributed to the downward economy at the time. However, the registration for the 2010 March exam has exceeded budget estimates by 20%. The pass rate for 2009 candidates was 70%, compared to 71% in 2008. The 2009 recertification rate was 70%, compared to 73% in 2008. This rate is consistent with the industry average of 70% to 75%.


The JIN CE program continues to do well. It increases the recertification rate by giving CRNI(R)s a viable option for obtaining their recertification units. A popular strategy for gaining the necessary 40 recertification units is to attend the fall NAIT and One-Day Program (30) and complete the JIN CE (10). The 2009 fourth quarter royalties of $10,000 were one of the highest in the program's history.


INCC's financial position also remained strong despite an operating loss of $11,000. This loss was due to a changeover to an accrual method of accounting in 2009. Exam registrations of $38,000 that would previously have been recorded in 2009 were deferred to 2010. Investment income enjoyed the same positive results as INS with an increase of $38,000. Overall, INCC saw a $26,000 increase in net assets.


The INCC Board of Directors plays an important role as stewards of the organization. Their commitment to certification in general and infusion certification in particular is unsurpassed. As their terms of office will end at the board meeting in June, I want to thank Public Member Christine Armstrong and Director Bernice Bennett for the contributions they have made as members of the INCC Board. Their knowledge, expertise, and dedication to infusion nursing certification have enabled INCC to continue to provide a strong, reputable certification program.


An issue that INCC continues to address is the difference between a certification program and a certificate program. Oftentimes the terms certification and certificate are used interchangeably; however, there are distinct differences between them. It is important that exam candidates, certificants, and other health care professionals understand the separate programs and the implications they have with relation to public protection. Articles clarifying the differences have been published in Chronicle and Newsline; they are also available on the INCC Web site. INCC feels very strongly about this topic and will continue an awareness campaign to educate nurses and other health care professionals.


INCC continues to play an active role in the American Board of Nursing Specialties (ABNS). I completed my 2-year term as nominations chair and am on the Awards and Recognition Committee, while INS/INCC Executive Vice President Chris Hunt is serving on the Programs Committee.


In October 2009, ABNS and the Competency and Credentialing Institute (CCI) convened the Nursing Certification and Competency Summit in Baltimore. Its purpose was to create collectively a unified research agenda on nursing certification and continuing competency and to establish strategies for study. Three overarching research priorities were identified in the following categories: patient outcomes, continuing competence, and work environments. INCC will continue to participate as this work is being refined.


The INCC Web site,, has a new look with many of the same technological advances and ease of navigation as the INS site. Also, INCC has launched its own Facebook page and welcomes new fans.



I want to thank the INS Board of Directors for their commitment to excellence and their passion for the specialty practice that continues to drive the Society forward as the global authority on infusion nursing. I would also like to extend a special thanks to all our members. As INS continues its work on behalf of you, your patients, and the entire infusion community, we do so with the knowledge that our success is a direct result of your active participation and our commonality of purpose.


Your dedication to your patients and our specialty practice is unsurpassed, and for that we are extremely grateful. Thank you for all that you do to help set the standard for infusion care.