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

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In 1979, I started working on the Massachusetts General Hospital IV team. My supervisor encouraged me to join the National Intravenous Therapy Association (NITA). She was a founder and past president, and strongly supported the team's participation as members. New to the IV therapy specialty practice at the time, involvement in NITA gave me an appreciation for the practice and offered the education I needed to provide safe patient care. In my practice, I placed short peripheral catheters (SPCs) only, applied Betadine ointment to the insertion site, and dressed it with gauze or a Band-Aid. In fact, the team did rounds on all patients with IVs and changed the dressings daily-without gloves! This was standard policy, since we couldn't visualize the site through the gauze.

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

The focus on infection prevention was certainly not the same as today. While we understood basic principles, our concentration on transmission of organisms wasn't a primary concern. We all had our "favorite" tourniquet, rubber tubing that was soft, malleable, labeled with our initials for easy identification; and used on all our patients! No single-use tourniquets were used. And when it broke, oh the chore of "breaking in a new one." Our belief at the time was that rotating SPCs every 48 to 72 hours would prevent catheter-related infections. However, based on today's research, SPCs aren't changed on a routine basis if no complications are evident, but replaced when clinically indicated. In fact, use of sterile gloves is being considered when inserting SPCs to support longer complication-free dwell times.


The evolution of the Standards began in 1979, with Venipuncture Hyperalimentation Standards and Standards of Practice for Home IV Therapy published in 1981 and 1984, respectively. The first updated and expanded edition of the Intravenous Nursing Standards of Practice was released in 1990. Now, after a title change to be inclusive of all clinicians providing infusion care, the 8th edition of the Infusion Therapy Standards of Practice will be released in 2021. The Standards are revered worldwide and have been translated in Spanish, Portuguese, and Chinese. To ensure its applicability globally, several members of the standards committee reside outside the United States. Review of the literature by all committee members isn't limited to US references and includes infusion-related research from international scholars.


My first NITA Annual Meeting took place in Boston in 1981. Like today, current clinical topics and recommendations to improve clinical practice were presented. Posters were often handwritten with markers or slightly embellished with adhesive letters. Exhibit halls were vast and full of industry leaders ready to unveil their next big product "rollout." The number of session offerings today have multiplied exponentially, complete with supplementary video content. Posters are now slickly produced, primarily in a digital format, and viewable virtually from anywhere in the world. Visiting the exhibit hall up close is still the perfect way to learn about new industry offerings, yet new products are quicker to market and booth displays have been dramatically enhanced to include more interactive demonstrations, hands-on learning activities, and live exhibitor theaters.


It's hard to imagine a time without the internet. Our website made its debut at the 1997 Annual Meeting in Salt Lake City. At the time, the site was a simple landing page. Today our site is fully interactive, engaging members and visitors to renew or sign up for memberships, communicate online, purchase educational materials, read our publications, and take advantage of the wide array of resources in the INS LEARNING CENTER.


On October 1, 1980, the US House of Representatives declared January 25th IV Nurse Day. This initiative was led by Senator Ed Markey (from my home state of Massachusetts). Markey, a US Congressman at the time, called the specialty "a vital branch of our nation's nursing profession." Celebrating IV Nurse Day gives us an opportunity to recognize the evolution of our specialty and the significant contributions that infusion nurses make in our patients' lives.


NITA has undergone 3 name changes. In 1988, the name was officially changed to the Intravenous Nurses Society, including "nurses" in the name to reflect who we were-a specialty nursing organization-and to give the public a better understanding of our purpose. As our knowledge base and scope of practice expanded and technology continued to advance, the latest name change, Infusion Nurses Society (INS), was approved by the members in 2001.


While our specialty looks very different than 40 years ago, there are still some things that remain the same. My introduction to the infusion specialty gave me the foundation to build my practice and share what I've learned-which I still do every day. The pace of change in health care is faster and member expectations are higher, but patients' rights to safe care remains forefront in my mind and that of my colleagues. I continue to be a steadfast advocate for evidenced-based research that improves patient outcomes and improves training methods and procedures for infusion nurses. And INS continues to be the leading organization of choice for the infusion nursing community worldwide.


Mary Alexander