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

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Good afternoon, and welcome to Phoenix and the 2008 INS Annual Meeting and Industrial Exhibition. I am pleased to deliver my report of the past year's activities and achievements. I am especially proud to be here to celebrate the 35th anniversary of the founding of our organization, which was first known as the National Intravenous Therapy Association.

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

As I was preparing this report, I was struck by how much INS has grown and changed over the years. In the 11 years that I have been CEO, INS has developed many new educational products, embraced new technology to enhance communications with our members, and offered new benefits without raising the membership fee.



2007 marked the fourth consecutive year of triple-digit increases in INS' membership. We finished the year with the membership rolls topping off at 5829. Since the beginning of 2004, our membership has increased by 750, or 15%. Better retention efforts and effective marketing plans through the use of broadcast e-mail programs, plus an increasing awareness of who we are and what we offer, have contributed to the positive membership numbers.


A strategic decision was made to hold the line on the cost of membership dues for the 11th consecutive year. Our ability to generate nondues revenue, while increasing the value of INS membership to our members, has enabled us to keep dues at the current $90 rate. Membership revenue increased by $23,000 in 2007, while expenses decreased by $10,000.


Equally as important as the actual increase in membership numbers and the financial impact this had for the organization is the increase in member participation. Our ability to attract hundreds of potential volunteers to serve on committees and task forces can be directly attributed to the influence we have on the specialty and the respect we have from clinicians practicing within the specialty.


Our local chapters and communities of infusion specialists continue to thrive in 2008. We currently have more than 150 chapter leaders representing 45 local chapters around the country. At last year's annual meeting, representatives from more than 20 chapters gathered for roundtable discussion sessions to talk about various chapter program ideas and successes. Our chapter leaders will meet again this week to collaborate on the future success of our local chapter program. Further details about the chapter sessions planned for this week can be found in your Convention Journal Program.



As some of you have seen at the INS Bookstore, our latest product, the Flushing Protocols set of 3 laminated cards, is now available. This valuable resource was created through the work of the INS Flushing Task Force to address the many issues associated with the process of flushing vascular access devices. The cards provide guidance on saline flushes, heparin locking, and drug incompatibilities. One of the cards incorporates a copy of the Flushing Standard found in the Infusion Nursing Standards of Practice.



Infusion education is one of INS' core business units. Year after year, we offer top-notch educational programs that address the latest issues in infusion therapy. The consistently high grades we receive from our attendees owe much to the work of the National Council on Education (NCOE).


The 2007 Fall National Academy of Infusion Therapy, held in Anaheim, California, was well attended. The special 1-day program, "PICC Tip X-Ray Verification and Stabilization," was fully funded by Bard Access Systems and Bard Medical. We are looking forward to the 2008 Fall National Academy to be held from November 14 to 16 in St Louis, Missouri. This year's National Academy will also be preceded by a special 1-day program sponsored by Bard Medical, "Healthcare-Associated Infections: New Regulations and Treatments."



As a way to broaden INS recognition as the global authority in infusion therapy, increase our visibility and scope of services, and create and expand business development opportunities, a separate business segment was created, Infusion Education Services (IES). IES focuses on building relationships with industry and third-party continuing education companies to provide educational opportunities for our members and the infusion nursing community. This business segment, started in the latter half of 2007, allowed INS to develop such diverse programs as webinars, the Counseling Points and Nursing Practice Management publications, and online CE programs, and will be responsible for increased revenue and program offerings in 2008.


The groundwork laid in 2007 will lead to a library of webinar offerings in 2008. In addition to the webinar funded by Novartis, "Excess Iron: Blood's Hidden Risk," and the first part of the Catheter Patency series, INS has commitments for an additional 3 webinars to be presented in 2008. The webinars will be sponsored by B. Braun Medical Inc and Baxter. All programs will be archived on INS' Web site and will be available for viewing at no charge to INS members. Also, INS has worked with Centocor and its third-party continuing medical education company to confirm a series of "dine-and-dialogue" programs that began in February and will continue through May 20, 2008.


In a consulting role, I've delivered infusion-related education programs with an emphasis on standards and the implications on clinical practice to nurses, other healthcare professionals, and pharmaceutical and device companies in the US, China, and Thailand.



The end of 2007 marked the conclusion of our celebration of the Journal of Infusion Nursing's 30th anniversary. We received lots of positive comments on the "new, updated" look of the Journal as well as our 2 new columns, "Speaking of Standards[horizontal ellipsis]," and "IV P.U.M.P.," which will continue to be featured in the Journal. We have also added a new tagline to the cover of the Journal: "The Art and Science of Infusion Nursing." Still more changes are in store for later this year. Our productive partnership with our publisher, Lippincott Williams & Wilkins, has contributed to the success of the Journal, as well as increased revenue from licensing, reprints, permissions, and advertisement sales.


The INS membership newsletter, Newsline, launched a new color design earlier this year. We hope the increased use of color photos and graphics will enhance your enjoyment of our primary membership communication medium.


Last year, INS initiated a new e-newsletter, the INS Connection, as a way to disseminate nursing news that is of interest to most of our members. The INS Connection uses our broadcast e-mail service, Magnet Mail, to send the newsletter to our membership very efficiently, at a very low cost.


By now you've had a chance to review our latest publication, INS Newsbrief. Sponsored by B. Braun Medical Inc, INS Newsbrief is an aggregator of infusion nursing news from hundreds of clinical publications around the world. This is yet another way that INS offers you the latest in infusion nursing news.


A major revision of the 2001 edition of Infusion Therapy in Clinical Practice is well under way and is projected to be published in 2009. This textbook continues to be an authoritative resource. The editors, Judy Hankins, Ann Corrigan, Lisa Gorski, and Roxanne Perucca, identified content experts as contributing authors and have been diligently working with them as they revise existing chapters or write new ones. New chapters include "Evidence-based Practice," "Clinician and Patient Safety," "Financial Considerations," and "Biologic Therapy." An important feature is a focus on evidence-based research and practice, with the goal of providing readers with a better understanding of what guides our clinical practice and patient interventions.



For the seventh consecutive year, INS sponsored a speaker at the National Student Nurses Association's (NSNA's) Midyear Conference. Director-at-Large Mary Zugcic represented INS on the specialty nurses panel. As always, the students were interested in the scope of practice and competencies aligned with infusion nurses.


INS has continued its partnership with the Hartford Institute for Geriatric Nursing. We are participating in the Specialty Nurses Impacting Aging initiative, the goal of which is to deepen the involvement of specialty nurse associations in improving nursing competencies in providing care to older adults. The work INS has done in this area was highlighted in the November/December 2007 supplement issue of Geriatric Nursing.


The American Society of Health-System Pharmacists will hold an "IV Safety Summit" in July, pulling together a group of key stakeholders, including INS, the Institute for Safe Medication Practices, the Joint Commission, the National Patient Safety Foundation, Brigham and Women's Hospital, and the US Pharmacopeia, to study the issue. Our incoming president, Cora Vizcarra, will represent INS at the summit and is also part of the planning committee.


Novartis Oncology selected INS to engage infusion nurses to help conduct a survey of patients who receive regular blood transfusions. The survey is designed to garner patient insights on their understanding of transfusion-related chronic iron overload. Results will be used to help create educational materials to help patients better understand this consequence of blood transfusions.


We continue to collaborate with the National Home Infusion Association on public policy issues. This year, INS signed on to a coalition letter urging Congress to pass legislation to add a meaningful home infusion therapy benefit to Medicare.


The Alliance for Plasma Therapies is a new organization committed to working for better access to intravenous immune globulin (IVIG) products. INS was invited to join the organization to represent infusion nurses and the role they play in providing care to IVIG patients. The Alliance has already begun working with lead officials of the federal Office of Health and Human Services, including those from the Centers for Medicare & Medicaid Services.


INS played a major role in revising the Centers for Disease Control and Prevention (CDC) Guidelines for the Prevention of Intravascular Catheter-Related Infections in 2002. The guidelines are being updated this year, and once again, INS has been invited to be part of the committee working on the revisions.


Last summer, I copresented a webcast on "Best Practices to Reduce Catheter-Related Bloodstream Infections," which was sponsored by Cardinal Health. Continuing nursing education credits were offered for the program.


The Institute for Safe Medication Practices (ISMP) regularly seeks comments from INS on articles related to infusion nursing. In turn, ISMP contributes a regular medication safety column for INS Newsline.


The Oncology Nursing Society sought out INS to review and comment on their oncology nurse practitioner competencies. Presidential Advisor Lynn Czaplewski reviewed them on behalf of INS; ultimately, the competencies were endorsed by INS.


INS is also pleased to announce that we have joined the American Nurses Association (ANA) as an organizational affiliate. In this capacity, organizational affiliates have voting seats in the ANA House of Delegates and the Congress of Nursing Practice and Economics.



We have 153 international members from 28 different countries outside of the US. At this meeting, we have representatives from Belgium, Canada, China, England, Italy, Japan, Costa Rica, and Thailand.


Last November I had the pleasure of traveling to Thailand and China as a guest of 3M to speak about infusion nursing to conferees in 6 cities. As this was my fifth trip to China, I noted that the interest in the infusion therapy specialty has grown exponentially since I first began my travels to Asia.


A new book, Nursing Without Borders, written by Sharon Weinstein and Ann Marie T. Brooks, was released in November. I contributed one of its chapters, "Global Standards and Certification," which recounted my experiences on a 2005 trip to Mexico for INS that resulted in a 10-week, 200-hour comprehensive infusion program for nurses.



As a member of the ANSR Alliance (Americans for Nursing Shortage Relief), INS was a signatory on testimony regarding the fiscal year 2009 appropriations for the Nursing Workforce Development Programs, submitted to the US House of Representatives Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Committee on Appropriations.


INS continued to represent infusion nurses on the Massachusetts Expert Panel on Healthcare-Associated Infections and was also a member of the Bloodstream Infection/Surgical Site Infection Task Force. In March, I testified before the Massachusetts Legislature's Joint Healthcare Finance Committee in support of a bill that would promote cost containment, transparency, and efficiency in the delivery of healthcare in Massachusetts.


We continue to work with 10 other nursing organizations within the National Quality Forum (NQF) to support nursing candidates for NQF Council positions and provide input on consensus standards.



If you have visited the INS Web site recently, you know that it has been redesigned and made more user-friendly. New features on the site allow members to update their profiles, access a special members-only space, and shop for INS products more quickly and easily. Previously presented webinars can be downloaded at the visitor's convenience, and archived versions of INS Newsline are available, and soon, archived issues of the Journal of Infusion Nursing will also be available to INS members online.



The Gardner Foundation continues to provide grants and scholarships to INS members wishing to pursue careers in infusion therapy and to promote infusion nursing research and educational programs. The number of submissions continues to increase from year to year, and this year the Foundation has begun to offer several new "Sharing Expertise" scholarships, sponsored by B. Braun. The "Sharing Expertise" scholarship awards winners $1000 to assist nurses in attaining their CRNI(R) credential.


In January, I attended the Nursing Organizations Alliance Foundations Meeting held at the Sigma Theta Tau International headquarters in Indianapolis. At this meeting, I had the opportunity to meet with individuals from other specialty nursing organization foundations to discuss and share best practices and lessons learned about fund-raising programs, planned giving, and philanthropic perspectives.



The Infusion Nurses Certification Corporation continues to receive positive comments on the computer-based testing (CBT) format for the CRNI(R) examination. In September 2007, for the second time, the CRNI(R) examination was given in the CBT format. A total of 422 candidates took this version of the examination, with an additional 8 foreign candidates taking a paper-and-pencil version of the test. The pass rate for nonforeign nurse candidates was 72.51%, compared to 73.11% in 2006. This year, the examination will be offered during 2 testing periods-March and September. The 2007 CRNI(R) recertification rate was 75%, compared to a 75% rate in 2005 and a 71.6% rate in 2006. This is consistent with the industry average of 70%-75%.


An important component of any certification program is a job analysis. This process ensures that the items on the examination reflect current nursing practice. In August, INCC created an 8-member job analysis task force, chaired by Crystal Miller. Over the past 7 months this group, in partnership with INCC's testing company, Applied Measurement Professionals (AMP), completed this process, which resulted in a revised detailed content outline and a new examination matrix. This information was passed on to the RN Examination Council which, during their March meeting, incorporated the new content into items that will be placed in the September 2008 examination.


The RN Examination Council plays a pivotal role in creating an objective, reliable, and valid examination. I want to recognize and thank Nancy Mortlock, whose term as the RN Council chair has expired, for her hard work and commitment. Also, thanks to Marvin Siegel for his participation as he will be leaving the Council to assume his new role as the INS secretary/treasurer. I'd like to welcome Kathy Puglise, the incoming chair, and Donna Gordon, member, as they assume their Council responsibilities.


The INCC Board of Directors continuously reviews the certification and recertification programs and discusses ways to enhance the existing offerings. At their annual meeting they approved 3 additional continuing education options that can be used to obtain recertification units: publishing an infusion-related manuscript in a peer-reviewed journal, publishing a chapter or editing an infusion-related book, and serving on the Journal of Infusion Nursing Editorial Review Board.


Our industry partners recognize the importance of specialty nursing certification and its impact on patient care. INCC is pleased to be working with Centocor on a CRNI(R) Certification Examination Scholarship program that offers 300 scholarships to nurses in the specialty areas of infusion, rheumatology, dermatology, and gastroenterology to take the CRNI(R) examination. The scholarships will include study aids and the cost of taking the examination.


INCC continues to play an active role in the American Board of Nursing Specialties (ABNS). Last July I completed my 2-year term as ABNS president and am now the nominations chair. Roxanne Perucca, INCC chair, is a member of the Awards and Recognition Committee, and Chris Hunt, INS/INCC executive vice president, will be on a panel at their Fall Assembly Meeting to discuss the topic of misrepresentation of credentials.


INCC has also updated its designs. The INCC newsletter, Chronicle, has added color and more graphics. The INCC Web site,, has a new look and incorporates many of the same technological advances and ease of navigation as the INS site.



INS continues to grow as we strive to meet our organizational mission and goals. I want to thank the INS Board of Directors for their commitment to excellence and passion for the specialty practice that continues to drive the Society forward as the global authority on infusion nursing. I also want to thank you, the members, for your dedication to your patients and our specialty practice. INS' continued success is a direct result of your active participation and our commonality of purpose.


We are well positioned for even more successes and growth in the months and years to come. INS has achieved much in just 35 years, and the future holds the promise of many new opportunities to advance the science of infusion therapy. We are eager to take on these challenges and prospects and look forward with enthusiasm to INS' next 35 years.