1. Perdue, Maxine B. RN, BSN, MHA, MBA, CRNI(R), CNAA

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What a great opportunity-to celebrate 30 years of excellence with the Infusion Nurses Society (INS). I remember well when Judy (Terry) Hankins was installed as president of the National Intravenous Therapy Association (NITA) in May 1978. It was the first time I left my hometown in North Carolina, flew across the country, and experienced a full week packed with excellent programs, all related to infusion therapy. The experience was so overwhelming and enriching that I made a vow to become the very best IV nurse possible and to devote my career to the specialty practice of infusion therapy. With each year and attendance at INS Annual Meetings, I became more passionate about the specialty practice and became involved first as an INS chapter president and then with the Infusion Nurses Certification Corporation.

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

In 1992, I was installed as president of INS, and my enthusiasm for infusion therapy grew as I traveled and met with nurses across the United States and in Japan and Korea. The passion for our specialty was tremendous and embellished my theme, "The Hallmarks of Infusion Therapy: Caring, Competency, and Certification." These simple words continue to be our hallmarks. They remain powerful words that sum up what we are all about-as nurses and as a professional society.


Caring is the principal reason why most of us became nurses and why we choose to practice infusion therapy based on standards of practice derived from research. We all share a common bond for the delivery of infusion patient care, whether as an infusion therapy nurse or as a generalist practicing infusion therapy, whether in a hospital, home, or alternative care setting. We have raised the bar while moving our specialty forward, gaining knowledge through research and developing standards based on evidence-based practice. We know that excellence is achieved in the delivery of patient infusion care through our specialty. We have placed the patient at the center of all that we do and maintained our focus on providing only quality infusion patient care. Over the past 30 years, INS has paved the way for excellence through the Journal of Infusion Nursing, the Infusion Nursing Standards of Practice, Infusion Therapy in Clinical Practice, Core Curriculum for Infusion Nursing, Policies and Procedures for Infusion Nursing, Fundamentals of Infusion Therapy, and numerous educational programs-all current, innovative, and visionary. Each translates to our deep sense of caring for our patients and the specialty practice of infusion therapy.


Equally important to caring for our patients is the need to care for ourselves. Healthcare today is very different from the way it was 30 years ago. Reimbursement has gone though an evolution beyond our comprehension 30 years ago, and Centers for Medicare and Medicaid Services (CMS) regulations change quarterly, making it increasingly difficult to implement the required changes. Change is constant and somewhat frightening as it turns our daily operations upside down. Yet change brings numerous opportunities for nurses to demonstrate their skills and expertise. We can rise to the occasion only if we have committed to caring for our personal and professional growth. We will not see opportunities or envision the future unless we maintain our physical, psychological, and spiritual selves. Nurses frequently experience frustration and a sense of hopelessness. We may feel compelled to leave the profession that we once cared so much about, but when we take care of ourselves, we flourish and our creative juices flow.


Webster defines competency as sufficient needs for one's existence, ability, skill, fitness, and in law, legal qualification, power, or jurisdiction. My word for competency is excellence. Excellence is not perfection; it is stellar performance. It is keeping current and complying with evidence-based practice standards. It is not accepting the status quo, rather, being visionary and innovative and a catalyst for research. It is sharing information with others by writing articles for the Journal of Infusion Nursing and speaking at INS meetings. Each day is an opportunity to step outside the box and look at how we practice infusion therapy and to focus on each aspect of what we do as a chance to improve infusion care.


Our specialty has come a long way in setting the standards, and while the phrase evidence-based practice has only recently been applied to healthcare, INS has had evidence-based standards since the publication of the first edition of Infusion Nursing Standards of Practice. We cannot rest on our laurels, however. We must continue to raise the bar and see the opportunities available to us. We need to evaluate our practice, perform research, and make improvements in our own organization so that we become the curators of evidence-based practice and the movers and shakers at the governmental level, where our voices can be heard across the United States. We need to document our research and keep the articles flowing through our tool for sharing infusion practices, the Journal of Infusion Nursing. Evidence-based practice comes to fruition through sharing of evidence, and there is no better way to do so than through the Journal of Infusion Nursing.


As we care for ourselves and exhibit competency in our practice, we must recognize the correlation with certification. The nurse who seeks certification, putting aside fear, procrastination, and excuses to prepare for and take the certification exam, cares for herself, her patient, and her profession. The nurse who passes the exam and wears the CRNI(R) credential proudly reflects competency in clinical performance and practice at the highest level. Numerous articles have been written about the benefits of certification and the great impact on patient care. The Joint Commission (formerly JCAHO), private insurers, and the federal government are all taking a close look at certification. Certification has become a critical component for hospitals obtaining and maintaining Magnet status. Hospitals and alternative care settings have realized the effect on quality and the financial savings incurred from having a certified nurse provide infusion patient care.


The CRNI(R) credential is a validation of competency in our specialty. This specialty practice actually had its roots in my home, when a small number of nurses came together in Raleigh, North Carolina to discuss how they could provide education in IV therapy. They dreamed of an organization that could change IV patient care. They wanted to educate nurses about the correct way to perform a venipuncture, infection control principles relative to IV therapy, and the development of universal guidelines (as they were termed at that time). They were appalled at the number of needles used to perform a venipuncture and that prepping procedures were either inconsistent or not used at all. (Remember the IV butterfly needle that had only a piece of tape for a dressing?) There were no guidelines; standards were unheard of, and evidence-based practice was a term that did not exist. That first group, who named themselves the National Intravenous Therapy Association, paved the way for excellence. Their work has given us more than 30 years of excellence, and the "Hallmarks of Infusion Therapy: Caring, Competency, and Certification" are as relevant to our practice today as they were in 1992, when I first presented my theme to the membership. Hold these hallmarks dear and close to your heart as you continue to move forward. Excellence is only achieved through commitment-to yourself to do your best and to promote excellence in others.


Thank you for the opportunity to share my thoughts. I remain very passionate regarding the specialty practice of infusion therapy and the daily operation of my IV team. Remember: Care for yourself and validate your competency through certification!!