1. Alexander, Mary BS, CRNI

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FIGURE We are coming to the end of 2000 and can safely say that we survived the transition to a new millennium. Now that we know that Y2K bugs cannot harm us, we may reflect on what this year has brought and what other kinds of "bugs" actually do need to be worked out of our system-our healthcare system. There is a public health crisis due to nursing staff shortage. The competency of generalist nurses to perform infusion procedures varies greatly and is difficult to standardize. Greater patient acuity, smaller nursing staffs, fewer IV teams, and less time to devote to perfecting venipuncture techniques take their toll on patient satisfaction and overall treatment outcomes. If we are to continue to provide high-quality infusion care, the challenges and changes in healthcare that are affecting our practice must be countered with innovative solutions and confidence in our competency.

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By positioning the infusion nurse as a key player in healthcare, we can bring attention to the significant positive impact that a specialist's expertise can make on a facility. Infusion nurses know that infusion therapy is a process, not just a procedure. Some facilities are already reinstating IV teams, with the realization that infusion nurses provide a level of care that is cost-effective from both a financial and a clinical viewpoint. Infusion nurse specialists reduce the rate of complications through prevention, early detection, and appropriate intervention. They reduce costs through the efficient use of supplies (fewer needlesticks and restarts) and prevention of complications that require further treatment and decrease patient satisfaction. Infusion nurses improve overall infusion practice at a facility by sharing their knowledge and expertise. And they improve the level of patient care through appropriate device selection and advanced skills.


INS' focus is currently on guiding the transition from "intravenous nursing" to "infusion nursing" to more accurately reflect what we do. Our practice is no longer limited to intravenous delivery of therapy. The clinical focus of nurses called upon to administer infusion treatments includes epidural, subcutaneous, intraspinal, and intraosseous routes. These treatments are not restricted to one or two care settings, but are performed in acute care, homecare, long-term care, skilled nursing facilities, ambulatory infusion centers, and physicians' offices. Infusion therapy is part of many different kinds of treatment for various pathologies. Generalist nurses insert and care for peripheral catheters; oncology nurses are involved in the administration of antineoplastic therapy. Emergency department clinicians must quickly obtain venous access to administer life-saving fluids or medications. The expertise of IV teams is crucial, but so is the infusion-related competency of emergency and critical care staff, advanced nurse practitioners, and student nurses emerging into the workplace.


Knowledge of infusion therapy cannot be restricted to any one practice setting or set of practitioners. Infusion nurse specialists can greatly improve the quality and cost-effectiveness of care, but with greater visibility they also can become organizational resources and educators of their colleagues. The need for change begins with nursing school curricula, which currently does not require instruction in infusion therapy. Let us all go to the source and make a difference where we practice, whether by advocating for infusion education at our schools, or urging our managers and administrators to establish organizational infusion therapy protocols. Together we can create a new vision for healthcare, in 2001 and beyond.