1. Alexander, Mary CRNI INS Chief Executive Officer Editor

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The 1999 INS Annual Meeting and Industrial Exhibition marks the end of Crystal Miller's presidency and the beginning of Beth Fabian's leadership term. The transition between INS Board of Directors officers allows time for reflection and planning. This week we begin the new INS year, so to all INS members and friends, I offer my best wishes for a happy "new year." As we end another INS year of nursing excellence and leadership, we can look forward to continued advancement and success.


After reviewing the Society's 1998 accomplishments, I thought it appropriate to present to the INS membership and Board of Directors a comprehensive appraisal of the year's progress and my view of what lies ahead. In every way, we moved the Society forward in 1998-membership recruitment and retention, human resources, community exposure, global visibility, strategic initiatives, organizational revenues, information systems, industrial partnerships, certification, publications, education-all of these areas have progressed because of our renewed confidence in ourselves and each other. INS is on a fast track, and I am confident that it is the right track.


Last year INS embarked on an aggressive marketing campaign to raise awareness of membership benefits. Through Newsline articles, journal advertising, INS Website promotion, and improved telephone and written correspondence, INS continues to spotlight the benefits that make INS unique among specialty nursing organizations. Exclusive access to the National IV Nursing Network, Gardner Foundation scholarship and grant funds, and discounts that make continuing education and CRNI certification more accessible are among the many benefits that set INS apart from other professional organizations. In the coming year, all INS National Office departments will consider additional programs and services that may complement the "menu" of benefits already in place. The goal of our membership marketing efforts is to make INS membership even more enticing to prospective members and renewing or rejoining members alike.


In the shifting healthcare environment, retaining membership numbers is just as challenging as attracting new members. In response, INS developed a membership strategy with a two-pronged focus: campaigning for new members while simultaneously striving to improve the membership retention rate. The initial phases of the plan included the "Reach for the Stars" member-to-member campaign, appeals to nursing students and faculty, and surveys sent to former members whose memberships had lapsed. Our efforts to attract new members and encourage existing members to stay with us have seen early success. Membership retention rates are on the rise and attrition is decreasing, thanks in part to the Membership Services Department's diligent telephone reminders of expiration dates, follow-up calls, and correspondence to assure that members' needs are addressed.


Throughout the next year our "membership project" will continue, and we will work toward increases in both new members and member retention. Our goal this year is to attract members from different segments of the healthcare world. Long-term care settings, nursing schools, and homecare are among the targets of upcoming membership marketing efforts. With a call for increased member participation on committees, interactive events such as the INS Town Meeting, and improved opportunities for involvement at all levels of the Society, we will encourage current INS members to stay with us. The committee structure has been expanded, new chapters are forming, and we are working hard to embrace nurses in all facets of the healthcare industry.


INS membership demographics provide insight about the intravenous therapy community. Our ongoing membership surveys so far have elicited responses from about one-third of the 6074 active INS members. Active members comprise 97% of the entire INS membership; Associate members are 1.6% of the Society's membership base, and Charter, Honorary, and Industry members combined make up the remainder.


It is appropriate to extrapolate the number of responses we have received to gain a view of the specialty's composition and direction. A few statistics speak for themselves: 42% of respondents practice in homecare and home IV pharmacy; 38% practice in the hospital setting. Thirty-four percent of respondents reported salaries in the $40,000-$50,000 range; the next highest percentage was 24% in the $50,000-$60,000 range. Thirty-one percent of our members are associate's degree-prepared, 35% have earned bachelor's degrees, and 7% have master's degrees. Approximately half of our members have the CRNI credential. These demographics enable us to provide products and services that fit our membership. Because a large proportion of our membership shifted from traditional practice settings to alternate sites, INS created three alternate site committees and planned a one-day educational program for alternate site practitioners. Because statistics told us that our members were interested in advancing their professional education, we added one-day programs and more advanced sessions to our educational offerings. Our ongoing data collection and commitment to serving our members will help us to tailor INS membership benefits and services to meet the changing needs of our varied constituents.


The Society's visibility in the healthcare community has improved dramatically, with additional exposure planned for the remainder of 1999 and beyond. We are working hard to push INS into the forefront of the IV specialty and the broader sphere of specialty nursing. We want this organization to be the IV nurse specialist's first thought, not an afterthought, when questions or professional development needs arise. Advertising and public relations have been expanded to include nationally recognized journals with far-reaching circulation rates. The advertising plan will continue in the next year, reminding readers of pharmacy, nursing, state nursing association publications, and other audiences of the value of INS membership and educational meetings.


Participation with other healthcare and nursing organizations also increases INS visibility and is evidence of our growing presence as a respected, highly participatory entity in the healthcare field. As an act of partnership with other specialty organizations, INS has responded to requests to review position papers and commented on other organizations' Standards of Practice. In another example of our commitment to organizational collaboration, INS has submitted a proposal to present an educational session at the 2000 American Nurses Association Biennial Convention. The presentation, "Quality Initiatives: Applications to Clinical Infusion Practices," is designed to promote discussion of the IV nurse specialist's role in the wider healthcare environment. The two-hour session also will identify methods for developing and validating clinical competency of those who deliver IV therapy.


Assuming a global presence is an INS priority. Our official agreements and partnerships with our colleagues in Australia, New Zealand, and Canada have resulted in a broader perspective of IV therapy's position in the global healthcare community. Our counterparts in Japan and England have demonstrated interest in helping INS to stretch its boundaries on an international scale. The positive results of such collaboration are obvious: extending the INS family to include IV nurse specialists in other nations will lead to better patient care and growth of the specialty. Sharing information will strengthen our arsenal of IV-related resources for our members' career development and professional education. We can promote awareness of the specialty and make a case for universal use of the Intravenous Nursing Standards of Practice. Another benefit of an expanded international network is the potential for growth of the INS membership base. Welcoming international members will enrich our global view and teach us to be sensitive to our colleagues' and patients' cultural differences and the economics of healthcare around the world.


The line of INS publications available by subscription and for retail sale is another vehicle for sharing the INS mission and goals with the healthcare community. The Journal of Intravenous Nursing maintains its position as a premier IV therapy clinical journal. The addition of Special Focus Issues in 1998 tailored the Journal to meet the information needs of specific segments of the INS membership population. Pediatrics and professional development were highlighted in the first Special Focus Issues. Collaboration between the INS Publications and Education Departments led to stronger clinical content. The number of manuscript submissions is on the upswing, as is the percentage of manuscripts accepted for publication. These increases are attributable to more focused follow-up with meeting speakers, on whose manuscripts the Journal depends, and the Publications Department's commitment to making publication an accessible goal for first-time or other inexperienced writers.


The Journal is gearing up to offer continuing education credit and recertification units, the next phase in the exciting evolution of our flagship specialty publication. The Marketing, Education, and Publications Departments are working with publisher Lippincott Williams & Wilkins to develop a suitable strategy for offering these professional development opportunities to Journal readers. We look forward to joining the ranks of other professional publications to facilitate members' fulfillment of continuing education requirements.


Newsline is on the move with the continuation of the "CyberNurse" column for readers interested in incorporating computer communication into clinical practice, information for nurse entrepreneurs, and the addition of an Alternate Site Committee column in 1999. Readers can look to Newsline for the latest on developments in the specialty and details on INS programs and services. Beth Fabian's Presidential Column made its debut in the May/June 1999 issue and will continue throughout her presidency.


The Publications Department is shepherding through production a wide range of resources for INS members and other healthcare professionals. The Core Curriculum ofIntravenous Nursing is approaching publication, with an anticipated midsummer release. This textbook will serve as a comprehensive study aid for those preparing for the INCC certification examination and for our colleagues who develop IV therapy educational programs. Intravenous Nursing Standards of Practice will be revised during the next 2 years to address the changing face of the specialty. A peripherally inserted central catheter (PICC) education module is in production to serve as a "train the trainers" program for IV nurse specialists. To complement the PICC program, INS also is developing a basic IV therapy educational program and a Policies and Procedures Manual for use in all practice settings. Each of these products is intended to address needs identified by members who wish to provide outstanding IV care and educate colleagues to improve their practice skills.


To encourage research and publication of data related to the IV nurse specialist's place in healthcare, the INS Research Department has initiated a study that compares the roles of the IV nurse specialist and the generalist nurse. INS plans to share data derived from this study to support the INS beliefs that IV nurse specialists are more cost-efficient than are their generalist counterparts and that patient outcomes are positively affected when certified specialists are involved in care.


The INS membership has responded to our call for increased member involvement in the Society's life. Election returns were encouraging, with 26% of members voting in the 1998 Board of Directors election. It is my sincere hope that the number will continue to increase as we establish new vehicles for member participation and feedback and welcome new members who are committed to strengthening this professional organization. To reach the outer limits of what the Society can become, the entire membership must stand behind the INS Board of Directors, committees, and National Office staff.


One factor contributing to the Society's progress of the past year is the improved stability of National Office human resources issues. In the past, consistency of service suffered from a high rate of employee turnover. I am pleased to report that the turnover rate has decreased sharply, and all departments have mapped out cooperative work plans and schedules. Each National Office staff person is committed to supporting the INS mission and goals, whether by following up on members' inquiries with care and efficiency or by planning and promoting INS educational events.


The staff works closely with the Board of Directors, committees, and INS Local Chapters to build on the progress that has been made. They are sensitive to economic and informational needs-the goal of every Marketing, Education, Publications, or Meetings Department project is to provide the best possible product with consideration to cost and timeliness. National Office staff members are creative, innovative, and cost-conscious; they invite feedback through evaluations and surveys and put members' responses into action.


On the financial front, naturally our goal is to maximize revenue and control expenses. We seek favorable returns on our investments as a means of careful stewardship of resources. A system of internal controls and constant attention to budgets and organizational goals holds us in good stead for the future. INS is realistic in developing its annual budget, always keeping in mind the organization's financial priority: control costs for members as best we can without compromising the quality of INS products and services. The 1998 INS Annual Report in this issue of the Journal features a full financial statement.


Information systems is an area of multiplying importance as we approach the year 2000. The National Office computer network, including the INS Website and the improved membership database, will be safe from harm should Y2K issues encroach on the Society. Our entire computer system is under review, and every effort will be made to ensure that the change of century will not create interruptions in delivery of our programs and services.


As we look to the future of healthcare, the specialty, and the future of the Society itself, it is critical to develop strategies that will safeguard the fruits of our labor. A Fall 1999 timeline has been established to initiate development of an INS Strategic Plan that will carry us into the new century. Our future relies on a plan that defines members' needs and anticipates organizational growth. INS also plans to develop an Industry Advisory Council in an effort to continue to improve communication between INS and its industry friends. INS Industrial Exhibitors will be invited to participate in the Council's opportunities for sharing expertise and industry experience.


The future of the Gardner Foundation looks just as promising. The fledgling fundraising project created in memory of a departed colleague has become a self-supporting nonprofit foundation that promotes nursing excellence and advancement of the specialty. Grants and scholarships awarded annually by the Gardner Foundation take INS members closer to their educational and professional goals. The new Gardner Foundation Board of Directors offers guidance and structure for the Foundation's continued growth. The INS Marketing Department works closely with Gardner Foundation leaders to share the Foundation's mission with all INS members and industry friends. Research studies, advanced degrees, and participation in INS meetings are made more accessible to INS members thanks to the Foundation. The Gardner Foundation Capital Campaign, now in its second year, and significant industry support led to the expansion of the awards program this year; additional scholarship and grant opportunities will become available as funds permit.


The INS relationship with the Intravenous Nursing Certification Corporation (INCC) continues to be mutually beneficial. Both organizations recognize the importance of advancing separate missions while working in tandem to promote excellence in the IV specialty. This year both organizations signed an agreement to formalize the Society's provision of association management services to INCC. Enhancement of communication between the two corporations continues to be a priority, so representatives of the respective organizations' boards of directors now participate in each other's board meetings.


The INCC Board of Directors is committed to its responsibilities and has developed a forward-thinking attitude in its consideration of the issues crucial to the corporation's continued success. Assuring that a valid test is administered and paying close attention to all nine core content areas of the specialty means that the CRNI and CLNI credentials will hold their value far into the next century. The LPN certification program, which offered the CLNI credential, was put on hold indefinitely because a lack of interest among prospective examination takers had a serious impact on the program's viability. CLNIs who earned the credential before the program was discontinued are able to recertify through continuing education to maintain their credentials.


Other actions of the INCC Board of Directors in the last year include the announcement that INCC will participate in the Nursing Credentialing Research Coalition. This group, organized by the American Nurses Credentialing Center, has hired a full-time scholar who has initiated data collection that will further research on the impact, role, and benefits of nursing specialty certification. INCC believes that this effort to pool information and resources with other nursing certification entities will produce meaningful and credible data to support the value of the CRNI and CLNI credentials. The goal of INCC's participation in the Coalition is to increase opportunities for INCC-certified nurses in all practice settings.


To give you a view of how INCC's mission is put into action, I can offer some telling demographics. In most categories, including educational background and practice setting, 1998 INCC certification statistics correlate with the overall INS membership demographics. Ninety percent of those who took the examination in 1998 were female. Fifty-one percent practiced in the home IV setting. Although INCC certification criteria do not require a bachelor's degree in nursing, 36% of exam takers hold the degree. Forty-six percent were between the ages of 40 and 49 years, and 79% were taking the examination for the first time. Sixty-two percent of first-time takers and 50% of the "repeat takers" passed the examination.


INCC has made great strides in the past year, and all evidence leads us to believe that the progress will continue. The Board of Directors has embraced its goal of increasing corporate involvement in INCC ventures. Through sponsorship of continuing education programs such as the Item Writers Workshop and publications like INCC Chronicle, INCC's corporate partners have made tremendous contributions to the organization.


I am pleased to have had this chance to share our accomplishments and goals with you. Thank you for your commitment to the Intravenous Nurses Society. I am reminded every day of the value of this organization to our specialty and to our patients-all it takes is one call to the National Office for a membership kit, one question asked through the INS Website, or one vote of confidence from a corporate sponsor. Intravenous nurse specialists believe in what we do. Patients see the results of our information and resources. The IV industry supports us. Other specialty nursing organizations collaborate with us. Journal and Newsline readers look to us for information, and National IV Nursing Network callers look to us for answers. The tireless work of INS members and friends has created a Society of which we all may be proud.


I look forward to another year of high achievements, and I am grateful to each of you for your contributions to our success.