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

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During INS' most recent Annual Convention, I heard comments by attendees who felt that many of the educational programs were geared toward infusion nurses in hospital-based settings. They wondered why our educational programs did not address topics specific to alternative settings such as the home and long-term care facilities. Many of INS' education sessions can be applied to all practice settings, including home care and alternative sites. The subjects we choose are relevant for all infusion nurses, whether or not the phrase "home care" or "long-term care" is included in the session title. We all have a professional interest in topics that help us provide the best possible infusion care for our patients.

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

Health care delivery in general is becoming increasingly more complex. The Patient Protection and Affordable Care Act includes components that will change the way all of us provide care, and as organizations apply the recommendations of the Institute of Medicine/Robert Wood Johnson Foundation report, The Future of Nursing, our roles as nurses will change significantly.1,2 Infusion nurses practicing in alternative settings are delivering more complex therapies. Because of the increasing responsibilities, these infusion nurses, like infusion nurses in an acute care setting, must be familiar with the latest technologies and infusion techniques, as well as broader health care issues. Even if a particular therapy or technique is not performed in the alternative setting just now, it's quite likely that in the future that therapy or technique will be required to be delivered in that environment.


Just look at how home care has changed over the years. Home infusion care grew as an industry first in 1965, when the newly introduced Medicare program included a home care benefit, then exploded in the 1980s, when changes in reimbursement resulted in patients being discharged earlier from hospitals and needing continued care at home.3 Many nurse entrepreneurs took advantage of the opportunity and opened their own home infusion agencies.


New associations cropped up in the wake of the surge in home care, such as the Visiting Nurse Associations of America, the National Association of Home Care, and the National Home Infusion Association.3 These organizations still provide leadership and support for home care nurses. INS, however, remains the global authority in infusion nursing across all practice settings.


Home infusion nurses do have some concerns different from infusion nurses in other settings. Patient education generally takes more time with the home care patient. There may be safety issues (eg, unsafe neighborhood, aggressive pets), complicated case management, or family resistance to assisting with care. But for the most part, all infusion nurses have the same challenges, including preventing catheter-related bloodstream infections; selecting and maintaining the appropriate vascular access device; resolving complications; ensuring proper dosing; and advocating for your patients.


To be better prepared to manage these duties in your practice, I urge all of you to become well acquainted with the Infusion Nursing Standards of Practice. The Standards of Practice is written to be applicable in all patient settings and address all patient populations. Each standard and practice criterion is written to guide decision making for infusion nurses in all settings and to help develop patient-centered plans of care based on the best evidence available. Home care agencies and long-term care facilities should have copies of the Standards, as well as its companion piece, Policies and Procedures for Infusion Nursing, readily available to their infusion nurses.


As models for health care delivery continue to evolve to meet our patients' needs, we must be prepared to deliver that care safely and efficiently. INS' education programs must be inclusive and relevant, so that all infusion nurses regardless of their practice setting are adding to their knowledge base. While we customize care for each individual patient, be assured INS' comprehensive education programs will suit all infusion nurses.




1. Marrelli T. 2010 is the International Year of the Nurse-healthcare reform may make that recognition ongoing and permanent, from a home healthcare policy perspective! Home Healthc Nurse. 2010;28(7):391-394. [Context Link]


2. National Institute of Medicine. The future of nursing: leading change, advancing health. Published October 2010. Accessed June 22, 2011. [Context Link]


3. Alexander M, Corrigan A, Gorski L, Hankins J, Perucca R, eds. Infusion Nursing: An Evidence-Based Approach. St Louis, MO: Saunders/Elsevier; 2010:120-126. [Context Link]

Claire L. Watson 1927-2011


Claire L. Watson, president of the National Intravenous Therapy Association (NITA-forerunner to INS) from 1977 to 1978, passed away in July of this year.


Claire received her RN diploma from Boston's Deaconess School of Nursing in 1949. She worked for many years in local hospital settings and later relocated to Pennsylvania, California, and North Carolina before retiring to her native Massachusetts.


We are grateful for Claire's vision and contributions to the organization as one of INS' first leaders. Two significant achievements that have endured the test of time occurred during her tenure: the introduction of the journal, NITA, and the creation of NCOE (known then as the National Committee on Education). She was an outstanding leader, mentor, nurse, and friend who will be missed.


Claire is survived by two children and two grandchildren.


-Mary Alexander