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Good afternoon, and welcome to Reno and the 2006 INS Annual Meeting. As CEO of INS, I am pleased to have the opportunity to deliver my report on the activities and accomplishments of our organization. 2005 was another successful year for INS. While increasing growth, involvement, and exposure of the organization, we made sure our work was in alignment with our strategic initiatives. We are committed to adding value to INS membership, enhancing our attendees' meeting experiences, collaborating with our industry partners, and ensuring efficiency in our operations.

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


In 2005, INS' membership increased by 200 members, bringing the total membership to 5,472. Year-to-date, INS membership is approximately 5,580 members, with an increase of 101 members. Corporate membership programs with BD and Medex continue to support the membership roles. Direct mail campaigns, personal correspondence from INS department managers, dual-year memberships, and our targeted marketing efforts of INS' programs, products, and services have contributed to the positive membership numbers.


As Michelle Berreth mentioned in the financial report, this is the ninth consecutive year without a membership dues increase. We continue to seek sources of non-dues revenue so that we can keep INS membership affordable.


Currently there are 43 active chapters, and INS receives frequent inquiries about new chapter formation. INS is improving communication between the chapters and the national office by monthly e-newsletters to chapter officers, increased correspondence between members and national staff, and further technological advancements that allow chapters to post upcoming meeting and seminar information on our Web site for increased visibility to not only our current members but also prospective members who find us on the Web. We are encouraged by an engaged membership on both the local and national levels.



We have learned from the Allegiance for Associations membership survey that our members remain active because we have been able to develop programs, products, and services that meet their infusion nursing needs.


During the past year, our distinguished committee of clinical experts and reviewers completed the revision of the Infusion Nursing Standards of Practice. The 2006 edition, a supplement to the Journal of Infusion Nursing, reflects the advances in technology and nursing practice that have occurred since the 2000 edition was published. The Standards, based on current clinical research and evidence-based practice, aid the clinician in delivering safe, quality patient care. INS extends appreciation to BD Medical-Medical Surgical Systems for its generous support of the revision of the 2006 Infusion Nursing Standards of Practice through an educational grant. As a result of this funding, all members as of January 2006 received a complimentary copy of the Standards along with their January/February issue of the Journal of Infusion Nursing.


The companion piece to the Standards, the Policies and Procedures for Infusion Nursing, was also revised this past year to reflect the Standards changes. It includes an expanded section on Neonates and Pediatrics, as well as new policies and procedures for infusion delivery practice.


We are pleased to announce that sales of both the Standards and Policies and Procedures to members and nonmembers have been overwhelming. Also, versions of both publications are now available for handheld personal digital assistants, or PDAs, for ease of use at the bedside.


And, to help you keep up-to-date on infusion practice, we are also revising two other education products: the Clinical Competency Validation Program, which is now available on CD-ROM, and the PICC Education Module, which should be available later this year. We will be looking at the program platforms and methods of delivery that will best suit our members' needs, including licensing agreements for multiple users.


INS continues to partner with Nursing Knowledge International, a subsidiary of Sigma Theta Tau International, a nonprofit global organization that markets and distributes nursing knowledge. As we look to reach a wider nursing audience, the products that Nursing Knowledge International sells on behalf of INS include the Infusion Nursing Standards of Practice, Policies and Procedures for Infusion Nursing, and the CD-ROM Fundamentals of Infusion Therapy. In an effort to increase our market presence within the healthcare community, INS is also in discussions with a distributor of medical and nursing education products.



Key to our mission and one of our core businesses is providing quality education programs. We continue to offer programs that address cutting-edge infusion therapy information, and the meeting evaluations consistently receive high grades from our attendees. The 2005 Fall National Academy of Infusion Therapy, held in Atlanta, GA, was well attended. Thanks to the generous support of ZLB Behring, a one-day special program, titled "Caring for the Patient Requiring Immunoglobulin and Blood Component Replacement Therapy," preceded the National Academy. Articles written by the presenters of the one-day program have just been published as a supplement to your May/June issue of the Journal of Infusion Nursing.


We are looking forward to the 2006 Fall National Academy, which has been rescheduled for November 18-19 in Metro Washington, DC, due to the devastation in New Orleans from Hurricane Katrina. This year's National Academy will also be preceded by a special one-day program sponsored by Bristol-Myers Squibb, titled "Autoimmune Diseases of the Connective Tissues."


INS is proud to be a provider of continuing nursing education through the American Nurses Credentialing Center (ANCC). As an ANCC-accredited provider, INS has demonstrated that our programs and processes meet stringent requirements that enhance the lifelong learning opportunities nurses rely on to increase their knowledge and maintain their competence. Our provider status is granted until 2010.



The Journal of Infusion Nursing, INS' flagship publication, continues to be one of the most popular member benefits. In the last year, we published two issues offering CE tests, including one Special Focus issue on "Advances in Infusion Care." The March/April issue featured an article written by Ann Lamondy, "Hyperemesis Gravidarum and the Role of the Infusion Nurse." Ann had participated in the writing mentorship program and was mentored by Christine Pierce, whom we thank for her guidance.


As editor of the JIN, I encourage you to think about submitting a manuscript for possible publication. The diversity of our membership (including practice settings, types of patients, conditions, and diseases we treat, use of technology) provides the potential for multiple issues to be addressed. In order to substantiate existing or change current clinical practices, published research is needed to support a particular position. Your manuscript will be reviewed by your colleagues on the Editorial Review Board, to whom we also owe our gratitude. Our publications staff can help guide you through the publishing process. And soon, the process will be easier than ever when we inaugurate a new online manuscript tracking system, which should be up and running in the next few weeks.


Another value-added benefit for members is INS' newsletter, Newsline. It provides shorter-length clinical articles and covers issues and activities related to the infusion nursing specialty. Readers look forward to the featured columns such as "Frequently Asked Questions," "IV P.U.M.P (Politically Useful Messages for Practicing Nurses)," and "IV Drug Safety," written by MacArthur Foundation "Genius Grant" award winner Michael Cohen. This year we added a column, "Back to Basics," that addresses fundamental practices of infusion therapy. I also invite you to submit to Newsline clinical articles and chapter information to share with the membership.



As other healthcare organizations seek input from INS, it gives us the opportunity to disseminate standards-based infusion information. INS was an external reviewer for the Community Health Accreditation Program (CHAP) Infusion Therapy Nursing Standards, and we also reviewed an infusion guideline for the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). INS continues to support the National Home Infusion Association in its initiative against the Medicare Part D drug benefit as it challenges this Medicare policy. Also, INS will sponsor a speaker at the 2006 Annual Consumer/Clinician Conference of the Oley Foundation to be held this summer in Salt Lake City, Utah.


For the third consecutive year, INS presented a preconference workshop, "IV Therapy Boot Camp: Advancing Your Knowledge and Skills in Infusion Therapy," at the Nursing2006 Symposium. The program was presented by infusion experts Lynn Hadaway, Roxanne Perucca, and Debbie Benvenuto. This well-received program prompted lots of interest at the INS exhibit booth, in the Infusion Nursing Standards of Practice, Policies and Procedures for Infusion Nursing, and the CRNI(R) certification exam.


This past December a grant proposal for $100,000 was approved by Biogen/Idec to develop a CD-ROM education program on the administration of monoclonal antibodies. Work on the development of this product will commence this summer. In its efforts to ensure that medications are infused properly and safely, Biogen/Idec also made a bulk purchase of the CD-ROM Fundamentals of Infusion Therapy to be distributed to their field clinicians. INS is also in discussions with several other pharmaceutical companies interested in developing infusion-related programs and resources that will produce enduring materials.


As a result of being "Googled," INS received a call last summer from Genaera, a pharmaceutical company that is conducting research on a medication used to treat wet macular degeneration. Initial findings showed that the drug is effective against this condition, but the researchers noticed complications associated with the vascular access devices being used on the elderly patient subjects. Realizing they needed infusion-related expertise, I was invited to present the fundamentals of basic venipuncture, one to the US research team in Las Vegas, Nevada, and the second to the international team in Prague, Czech Republic. After learning of our resources, they made a bulk purchase of the Policies and Procedures for Infusion Nursing of the Older Adult.



Last summer I returned to Mexico as a guest of PiSA Pharmaceuticals, a manufacturer of infusion-related products and solutions, to deliver lectures to Mexican physicians and nurses on applying standards and guidelines to clinical practice. They continue to seek information on Standards, infection control measures, and other infusion-related issues.


Due to the increased interest by our foreign colleagues for INS publications to be translated in other languages, in particular the Standards and Policies and Procedures, we are in active discussions with Lippincott Williams & Wilkins, INS' publisher, about the process. The languages of primary interest are Japanese, Chinese, Spanish, and Portuguese. Despite language barriers, the fundamentals of infusion care are transferable, regardless of the country in which one is practicing. In fact, right now I'd like to welcome attendees from Canada, France, South Korea, Mexico, the United Kingdom, and China. Thank you for traveling all this way. I'm sure the trip will be worthwhile.



As part of the larger healthcare community, INS continues to remain engaged with other organizations that are addressing issues of critical importance for the nursing profession. We are one of 50 national nursing organizations that belong to the ANSR Alliance (Americans for Nursing Shortage Relief), a collective that is identifying and creating strategies to address the nursing shortage. As a signatory, INS endorsed letters and testimony addressing funding for the Nursing Workforce Development Programs under Title VIII of the Public Health Service Act at the Health Resources and Services Administration (HRSA) in fiscal year 2007. The critical issues highlighted in the submissions include the impact of the nursing shortage on patient care and homeland security, the growing shortage of nurses, and the desperate need for nurse faculty.


The Centers for Medicare and Medicaid Services (CMS), together with research from the Agency for Healthcare Research and Quality (AHRQ), is close to implementing nationally the Hospital Consumer Assessment of Health Providers and Systems Survey (HCAHPS) to allow consumers public access to information on patients' hospital satisfaction. The standardized survey instrument represents the first nationwide opportunity for consumers to use a standard measurement approach in comparing hospitals.


The survey tool has been refined to a total of 27 questions that are designed to gain perspective of a patient's hospital experience, relative to coordination of care and management of treatments. However, there are no questions on the patient's perspective on infusion therapy services-a universal experience of hospitalized patients. INS submitted testimony to Mark McClellan, MD, administrator of CMS, strongly recommending that an opportunity to survey patient perspectives on the quality of their hospital-based infusion therapy not be missed, by adding 2 IV-related questions.


In a related matter, INS also submitted testimony to Rep. Joseph Barton, chair of the House Committee on Energy and Commerce, in response to a statement given by the American Hospital Association on public reporting of hospital-acquired infection rates. Once again, we urged that public reporting of infusion-related infections be included in any patient satisfaction survey.


The National Quality Forum (NQF) is involved in a project to develop a comprehensive set of national consensus standards for the public reporting of healthcare-associated infections data in the United States. One of the 6 areas that will be addressed is intravascular catheters and bloodstream infections. INS has been in discussions with NQF and offered to be a resource as it moves forward with this project.



INS has increased its use of an effective e-mail messaging system (MagnetMail) in the past year. We know you need the most up-to-date infusion news in order to give your patients the best care possible and that you look to INS as a key resource to keep you well versed in the latest infusion advances. The MagnetMails we send provide brief information about new INS educational products and services, upcoming meetings, and the latest infusion products from INS sponsors. We have also started to conduct membership surveys in order to learn what is important to you. Feedback from MagnetMail tells us that this service has increased INS' exposure and generated interest for participation in INS activities and on INS committees.


The INS Web site ( also continues to expand. We are making the site more interactive for members and potential sponsors in order to make it easier to register for a meeting, apply for a Gardner Foundation scholarship, or purchase exhibit booth space for an upcoming national meeting. It's also easy to purchase our educational products at the online INS Store with just a few clicks.


The online Career Center continues to post job vacancies in the infusion nursing field. The anonymous resume function allows employers to browse the resumes of potential hires while maintaining the privacy of the job-seeker. I encourage you to take a look at the online Career Center and the rest of the INS Web site in the Exhibit Hall or stop by the Cyber Cafe (sponsored by Genentech), where free Web access is available. Available nursing positions will also be posted in the INS booth.



The Gardner Foundation continues to support our members through its scholarship and awards program. In addition to individual and corporate donations and profits from sale of the IV Nurse Day products, the Foundation seeks creative ways to increase its endowment. After the Gardner Foundation reception on Monday evening, we will be holding a slots tournament in the casino, and a raffle will be held on Wednesday during the Industrial Exhibition. All proceeds from the tournament and raffle will be donated to the Foundation. All members are encouraged to take advantage of the Foundation awards and scholarships that are available.



The Infusion Nurses Certification Corporation is pleased to announce that the 2006 CRNI(R) exam will be administered as a computer-based test (CBT). The transition from a paper-and-pencil exam to CBT will make it easier than ever to take the test, and you don't even need computer skills to do so. CBT will provide instant scoring, a flexible testing schedule, and additional test locations.


The CRNI(R) exam will be offered in over 140 assessment centers, Monday through Friday, during the month of September. Candidates will be tested on 150 items within the 4-hour seat time of the exam. I encourage you to pursue the CRNI(R) credential by taking the exam; your employer, your patients, and you will benefit from certification.


With increased marketing, employer support, and ANCC's Magnet Recognition Program, the number of nurses who sit for the CRNI(R) exam continues to grow. The number of candidates who sat for the 2005 exam exceeded the 2004 exam numbers by 13%. In 2005, 433 nurses took the CRNI(R) exam, and 300 passed. Of the new passers, 96% were newly certified, and 4% renewed their credential. The 2005 recertification rate was 75%, which is consistent with the industry average of 70% to 75%.


At their March meeting, the RN Examination Council, chaired by Nancy Mortlock, in collaboration with INCC's psychometric company, Applied Measurement Professionals (AMP), approved the 2006 exam, and diligently worked on other exam-related activities. I would like to recognize Inez Nichols, whose term has expired, for her hard work and commitment while on the Council, and welcome Kenn Jones and Susan Markel-Poole as new members.


Knowing the importance of preparing for the exam, INCC continues to provide resources to assist the candidates in this process. The series, "Preparing for the CRNI(R) Exam," is being revised and will be produced on CDs and DVDs. Check the INCC section of the INS Web site for news about the publication date of these study aids.


INCC continues to work with the American Board of Nursing Specialties (ABNS) to achieve accreditation of the CRNI(R) exam. ABNS is an organization composed of 27 specialty nursing certification organizations, and exists to promote the value of specialty nursing certification to all stakeholders. To achieve accreditation, INCC must meet the stringent criteria for the 19 ABNS standards. INCC's application for accreditation is currently under review.


As part of a joint research effort among ABNS member organizations, INCC participated in the Value of Certification Survey project. In response to identified priority research areas, ABNS chose to undertake a study that would validate nurses' perceptions, values, and behaviors related to certification. In particular, the study sought to address perceptions of managers on the value of certification; challenges and barriers to certification; benefits and rewards to nurses for being certified; and the impact of certification on nurse retention. Over 11,000 responses were obtained from certified nurses, noncertified nurses, and nurse managers. ABNS is in the final phases of the project-analyzing the data and writing a manuscript for publication. In addition, I want to thank all of you who took part in the survey. This study is an important step in furthering our understanding of nursing certification and the implications for healthcare organizations, nursing certification boards, and certified and noncertified nurses.


INCC continues to play an active role in ABNS. As of July 1, I will have completed the first year of my 2-year term as ABNS president. Brenda Dugger, INCC chair, is a member of the ABNS Awards and Recognition Committee. In November at the National Organization for Competency Assurance (NOCA) Annual Conference, Hugh Webster, INCC's and ABNS' legal counsel, and I presented "Conducting an Organizational Audit."


Over the past year I've attended several meetings as a representative for both ABNS and INCC. Along with Bonnie Niebuhr, ABNS CEO, we met with Stephen Miller, MD, president and CEO of the American Board of Medical Specialties (ABMS). The purpose of our meeting was to explore opportunities for collaboration and partnership, and to seek endorsement of ABNS' "Position Statement on the Value of Nursing Certification." ABNS will continue to pursue the possibility of developing a working relationship with ABMS.


As a supporting organization, ABNS was invited to attend the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) symposium, "Transforming Health Professional Education." The Institute of Medicine (IOM) has recommended that all healthcare professionals be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics. The program addressed the broad changes in the academic, training, and practice settings that are necessary to drive adoption of the IOM-recommended core competencies across four disciplines: health administrators, nurses, physicians, and pharmacists.


I have also attended several meetings of the Advance Practice Nursing (APN) Consensus Work Group. The purpose of this group is to provide a set of uniform expectations that can be used by educators, credentialers, and employers to ensure access to high-quality, effective advanced practice nurses. Discussion and debate continues on defining the criteria for the 4 advance practice nurse roles.



Finally, I would like to say thank you to the INS Board of Directors. Despite their busy personal and professional lives, they have remained committed and passionate about the work of INS. To you, our members, thank you for your participation in INS, for the feedback you offer, and for your continued dedication to your specialty practice. I hope you take advantage of the many educational and networking opportunities available this week.


Aristotle said, "We are what we repeatedly do. Excellence, then, is not an act but a habit." Striving for excellence is a habit INS does not intend to break.