1. Alexander, Mary MA, RN, CRNI(R), CAE, FAAN
  2. INS Chief Executive Officer Editor, Journal of Infusion Nursing

Article Content

I can't help but think about the impact COVID-19 has had on our lives, personally and professionally. At the time of this writing, we have received numerous directives to self-quarantine or stay-in-place, work remotely at home or another site, practice social distancing measures, and procure and properly utilize personal protective equipment (PPE). Health care professionals have been required to react with nimble precision and revise practice under extraordinary conditions. This unprecedented disruption and loss of life is hard to comprehend, and sorrow plagues the hearts of all.

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

In the acute care settings, our health care professionals are on the frontlines caring for gravely ill patients with COVID-19, while concerned for their own safety and that of their loved ones. And at times overlooked, we cannot forget others who support the health care team, such as those in the health care technology and environmental and nutrition services, who without their support, would make it difficult for our providers to do their jobs. If safety is assured, patients are being discharged to home rather than going to a rehabilitation or alternative site for recovery, in an effort to minimize the risk of exposure to COVID-19. Our home health care professionals are vital for care coordination so that patients receive the services and medications they need, and the guidance to learn how to self-administer their therapies.


With issues related to shortages, such as PPE, pumps, or medications, minimizing risk of exposure, and providing safe patient care, clinicians are faced with modifying practice for adherence to INS' Infusion Therapy Standards of Practice. We understand that clinicians are hesitant to divulge what is actually happening at the point of care, at times not aligning with the Standards. We recognize the challenges many are facing when trying to conserve supplies and reduce the frequency of exposure to clinicians who go into patients' rooms to manage their infusions. For example, to limit the number of times the clinician enters the room of a patient with COVID-19, long extension sets are being attached to infusion pumps so that they can be placed outside the room. This short-term solution has potential safety risks that need to be evaluated, such as the potential for infection when IV tubing is on the floor; multiple connections to extend sets can become disconnected, resulting in medication loss and chance of infection, and inaccurate or incomplete infusions when medications remain in the extended tubing after a secondary infusion is complete, to name a few. While these practices are not ideal and not recommended, if organizations must resort to them during this crisis, clinicians must evaluate the risks versus the benefits of the actions. INS will continue to provide support and develop resources, so you will be ready when quarantines are lifted, and the curve of patients with COVID-19 flattens.


Use of infusion pumps is ubiquitous; however, in times of limited supply, methods of administration can be changed without negatively impacting patient care. For example, gravity administration or subcutaneous infusions may be suitable. With familiarity and reliance on smart pump technology, practice changes may require some refresher education.


Making future plans is fraught with uncertainty. INS is working to redevelop our face-to-face Annual Meeting into a virtual program this September. We are also offering the Fundamentals of Infusion Therapy (FIT) at a reduced rate for the schools of nursing and individual students who have had to finish their education online. Along with every purchase of the FIT program, INS is contributing free student membership that provides access to the INS LEARNING CENTER, which has mapped suggestions to other learning assets.


Practicing safe health care can be trying on a good day. Organizations need to determine the best alternative practices to ensure safe care for the patient and protection for the caregiver. We must also remember to take care of our physical and emotional health. In alignment with the Centers for Disease Control and Prevention, INS is continually updating our COVID-19 resource page on our website ( to address these needs and more.


While it has been difficult to feel "connected" at a time when we are physically unable to participate in face-to-face gatherings, we endeavor to remain joined with you and united in purpose. As we learn to navigate through unparalleled changes in health care, we hold fast to what will not change and will stay true to our mission. On behalf of the INS Board of Directors and staff, I extend our gratitude and support for your tireless work and dedication, from hospitals to home care. We have full confidence that you will do what is best for your patients to ensure they receive the safe care they deserve. As a community, we'll get through this. Know that INS is here to support you now and throughout the days ahead. Take time to take care of yourself while you care for others.


Be well and stay safe,


Mary Alexander