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  • Contains 3 Component(s), Includes Credits Includes a Live Web Event on 10/16/2024 at 1:00 PM (EDT)

    Pain management is a priority for health care workers. In recent years, the potential of unwanted side effects from systemic pain medications has been highlighted. Health care practitioners are exploring and using topical anesthetics as an alternative for pain relief in minor procedures. Vapocoolants are topical anesthetics that contain no medication and provide transient anesthesia through evaporation-induced skin cooling, which reduces pain. This comprehensive overview will explore the broad vapocoolant category, describe clinical study results when using skin refrigerants for needle procedures, and review the 2024 INS Standards of Practice regarding vapocoolants.

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    Pain management is a priority for health care workers. In recent years, the potential of unwanted side effects from systemic pain medications has been highlighted. Health care practitioners are exploring and using topical anesthetics as an alternative for pain relief in minor procedures. Vapocoolants are topical anesthetics that contain no medication and provide transient anesthesia through evaporation-induced skin cooling, which reduces pain. This comprehensive overview will explore the broad vapocoolant category, describe clinical study results when using skin refrigerants for needle procedures, and review the 2024 INS Standards of Practice regarding vapocoolants. 

    Learning Objectives: At the conclusion of this session, learners will be able to: 
    • Define vapocoolants and their mechanism of action
    • Describe clinical studies concerning vapocoolant use in needle procedures
    • Discuss the 2024 INS Standards of Practice concerning Vapocoolants

    Nancy Moureau, PhD, RN, CRNI®, CPUI™, VA-BC

    Nancy Moureau, PhD, RN, CRNI®, CPUI™, VA-BC, has been the owner of PICC Excellence, Inc., an education service provider for infusion therapy and vascular access device insertion and care for more than 30 years. Dr. Moureau's clinical experience spans pediatric, neonatal, ICU PICC/IV Team, and home infusion patient care. As the CEO of PICC Excellence, her current responsibilities include education development, research, speaking worldwide, legal case review, manufacturer consulting, and clinical practice with insertion and supervision of peripheral and central vascular access. PICC Excellence has developed more than 80 online educational courses and pathways to promote insertion competency and the application of evidence-based practices. PICC Certification™ CPUI™, Certified PICC Ultrasound Inserter, and now Neonatal PICC CNPI credentialing programs were established to validate education, knowledge, and competency for PICC inserters. As Co-Chair of the 2015 WOCOVA CVC Taskforce, Nancy facilitated the completion and publication of an evidence-based publication on minimal CVC training requirements. Nancy is an author of over 100 publications, a recipient of the Reader’s Choice Award for publications, and the Herbst Award for lifetime contributions to the specialty of vascular access. Nancy most recently released a systematic approach for the UGPIV Mastery Learning process, an ultrasound-guided peripheral insertion training toolbox, that has received the very first Seal of Approval from INS. Nancy welcomes your questions through her email, nancy@piccexcellence.com or through the PICC Excellence website, www.piccexcellence.com.

    CRNI® RUs: This session has been approved for 2 CRNI® recertification units and meets the non INS Meeting criteria.

    Contact Hours: This session has been approved for 1 contact hour

    Expiration date for receipt of contact hours: October 16, 2027

    To receive contact hours for this educational activity, you are required to attend the entire educational activity and complete the evaluation.

    The Infusion Nurses Society is approved as a provider of continuing nursing education by the California Board of Registered Nursing, provider #CEP14209. The certificate must be retained by the attendee for a period of 4 years.

  • Contains 3 Component(s), Includes Credits Recorded On: 09/18/2024

    The treatment of an extravasation, the inadvertent delivery of a vesicant into the tissue around a vascular access device (VAD), is a source of patient harm that is under-recognized, under-reported, and thus likely ineffectively treated. Unfortunately, recommendations for extravasation treatment (primarily reliant on case reports) can be difficult to leverage into clear clinical guidelines, increasing the risk of inadequate or delayed post-extravasation monitoring and treatment. This presentation will review vesicant properties and their mechanisms of tissue injury, peripheral vs central VAD extravasation risks with related prevention measures, and recommended extravasation treatment strategies and resources using a case study approach.

    The treatment of an extravasation, the inadvertent delivery of a vesicant into the tissue around a vascular access device (VAD), is a source of patient harm that is under-recognized, under-reported, and thus likely ineffectively treated. Unfortunately, recommendations for extravasation treatment (primarily reliant on case reports) can be difficult to leverage into clear clinical guidelines, increasing the risk of inadequate or delayed post-extravasation monitoring and treatment. This presentation will review vesicant properties and their mechanisms of tissue injury, peripheral vs central VAD extravasation risks with related prevention measures, and recommended extravasation treatment strategies and resources using a case study approach.

    Objectives:

    • Describe the properties of the major vesicant categories that may precipitate tissue injury
    • Relate the relative extravasation risks of peripheral vs central VADS to extravasation prevention strategies
    • Describe current recommendations for treatment of selected vesicant extravasations, using a case study approach

    Barb Nickel, APRN-CNS, CCRN, CRNI®

    Barb Nickel, APRN-CNS, CCRN, CRNI®, is a Clinical Nurse Specialist, specializing in critical care and vascular access.  Her role includes staff development, quality improvement, and clinical consultation. She has presented nationally and published on infusion therapy. She was chair of the 2024 INS Standards of Practice Committee and is chair of the newly forming 2027 Standards of Practice Committee.

    CRNI® RUs: This session has been approved for 2 CRNI® recertification units and meets the non INS Meeting criteria.

    Contact Hours: This session has been approved for 1 contact hour

    Expiration date for receipt of contact hours: September 18, 2027

    To receive contact hours for this educational activity, you are required to attend the entire educational activity and complete the evaluation.

    The Infusion Nurses Society is approved as a provider of continuing nursing education by the California Board of Registered Nursing, provider #CEP14209. The certificate must be retained by the attendee for a period of 4 years.

  • Contains 3 Component(s), Includes Credits Recorded On: 08/21/2024

    The need for alternate sites of care for oncology patients is growing with the expansion of the biologic drug portfolio. Insurance companies are shifting patients from hospital sites of service to independent providers, and the home and ambulatory clinic settings are now an attractive option for patients seeking more convenient sites for their infusions. In this session, we will outline the framework necessary to design an oncology infusion program, the policies and procedures necessary, and components of training needed to meet the challenges that serving this population of patients brings.

    The need for alternate sites of care for oncology patients is growing with the expansion of the biologic drug portfolio. Insurance companies are shifting patients from hospital sites of service to independent providers, and the home and ambulatory clinic settings are now an attractive option for patients seeking more convenient sites for their infusions. In this session, we will outline the framework necessary to design an oncology infusion program, the policies and procedures necessary, and components of training needed to meet the challenges that serving this population of patients brings.

    Learning Objectives: At the conclusion of this session, learners will be able to: 
    • list the critical components necessary to provide safe infusion care for the oncology population
    • discuss the process used to determine medications’ appropriateness in the alternate infusion setting
    • describe key points for a training program to be used for nurses in the expansion of their skillset to include oncology
    • define effective communication methods and patterns to support the administration of oncology therapies in a setting outside of hospital outpatient facilities or physician office. 

    Pamela Jones McIntyre, MSN, RN, CRNI®, IgCN, OCN, VA-BC

    Pamela Jones McIntyre, MSN, RN, CRNI®, IgCN, OCN, VA-BC, has over 4 decades of comprehensive nursing experience. She is considered a subject matter expert in infusion therapy, with extensive experience operating ambulatory infusion clinics for specialty and oncology therapies, and 24 years of experience as an operator and Vice President of Clinical Services for home infusion. Recent projects have focused on expanding oncology biologic therapies to alternate sites of infusion, which Ms. McIntyre is determined to see accomplished safely and in the best interest of the patients and providers. She provides consulting services to health care organizations for infusion nursing program development and newly established ambulatory infusion centers through her LLC, Expert Infusion Nurse Consulting.

    CRNI® RUs: This session has been approved for 2 CRNI® recertification units and meets the non INS Meeting criteria.

    Contact Hours: This session has been approved for 1 contact hour

    Expiration date for receipt of contact hours: August 21, 2027

    To receive contact hours for this educational activity, you are required to attend the entire educational activity and complete the evaluation.

    The Infusion Nurses Society is approved as a provider of continuing nursing education by the California Board of Registered Nursing, provider #CEP14209. The certificate must be retained by the attendee for a period of 4 years.

  • Contains 3 Component(s), Includes Credits Recorded On: 06/11/2024

    Over 2 billion intravascular devices are inserted globally each year, and determining optimal maintenance protocols is challenging. Literature cites late complications of central venous access devices (CVAD) range from 7.2% to 32.1%. Implanted vascular access devices (IVADs) are quoted to have lower risk than other CVADs but are not risk-free. Despite risk, patients often retain their devices for extended periods. In this session, we will review the basics of care and management of IVADs and let evidence-based practice guide the way to minimizing potential complications.

    Over 2 billion intravascular devices are inserted globally each year, and determining optimal maintenance protocols is challenging. Literature cites late complications of central venous access devices (CVAD) range from 7.2% to 32.1%. Implanted vascular access devices (IVADs) are quoted to have lower risk than other CVADs but are not risk-free. Despite risk, patients often retain their devices for extended periods. In this session, we will review the basics of care and management of IVADs and let evidence-based practice guide the way to minimizing potential complications.  

    Learning Objectives: At the conclusion of this session, learners will be able to: 
    • Identify best practices when accessing IVADs, including pre-assessment, skin preparation, needle access, and positioning. 
    • Discuss dressing changes and options available when patients have skin variables making dry and intact dressings difficult to achieve. 
    • Review how tubing changes vary dependent on the infusate.
    • Compare variances in flushing frequency and options related locking solutions.

    Mary Jo Sarver, MN, ARNP, AOCN, CRNI®, VA-BC, LNC

    CEO

    Sarver Better Living

    Mary Jo Sarver, MN, ARNP, AOCN, CRNI®, VA-BC, LNC, has more than 37 years of experience in infusion therapy and oncology/hematology care. Her role focuses on continuity of care and seamless transitions for patients within and outside the acute care setting. She collaborates and acts as a consultant locally and on a system level for Providence, guiding staff development, competency assessment, and process improvement to improve outcomes in multiple areas of clinical practice and new graduate transition to practice. She attends cancer care conferences, rounds in the clinics and hospital, and actively consults and sees patients and families for treatment and care planning. She has published, conducted research, and spoken on multiple topics within the United States. For decades, passion has prompted her to participate both locally on the Puget Sound Infusion Nurses Society (PSINS), Puget Sound Oncology Nursing Society (PSONS), and American Cancer Society (ACS) boards and to nationally assume various roles through the Infusion Nurses Society (INS) and Oncology Nursing Society) (ONS). She is CEO of Sarver Better Living Products LLC, a family-run company.

    CRNI® RUs: This session has been approved for 2 CRNI® recertification units and meets the non INS Meeting criteria.

    Contact Hours: This session has been approved for 1 contact hour

    Expiration date for receipt of contact hours: June 11, 2027

    To receive contact hours for this educational activity, you are required to attend the entire educational activity and complete the evaluation.

    The Infusion Nurses Society is approved as a provider of continuing nursing education by the California Board of Registered Nursing, provider #CEP14209. The certificate must be retained by the attendee for a period of 4 years.

  • Contains 19 Product(s)

    INS 2024 Virtual Conference will provide a great alternative for those who are not able to attend the in-person event. Participants will have the ability to attend 18 select sessions virtually and on-demand. This option also enables CRNI®s to earn up to 36 recertification units (RUs). The virtual conference will include some of the sessions in the Vascular Access Device (VAD) Track devoted to an important aspect of infusion therapy, vascular access devices as well as sessions included in the Alternative Care Setting Track dedicated to the care of patients outside of acute care settings.

    INS 2024 Virtual Conference will provide a great alternative for those who are not able to attend the in-person event. Participants will have the ability to attend 18 select sessions virtually and on-demand. This option also enables CRNI®s to earn up to 36 recertification units (RUs). The virtual conference will include some of the sessions in the Vascular Access Device (VAD) Track devoted to an important aspect of infusion therapy, vascular access devices as well as sessions included in the Alternative Care Setting Track dedicated to the care of patients outside of acute care settings.

  • Contains 3 Component(s), Includes Credits Recorded On: 05/08/2024

    Controlled substances diversion (CSD) is a risk for any organization that prescribes, stores, dispenses, or administers controlled substances. CSD can lead to patient safety issues, including inadequate patient pain relief, harm to the nurse, and a significant liability risk to the organization. The American Nurses Association estimates that 6% to 8% of nurses have a substance abuse problem that impacts their practice. Some contributing factors to the issue of CSD include the global pandemic, nurses with easy access to medications, and lack of intravenous product standardization. A multidisciplinary approach to reduce the risk of CSD should include drug diversion prevention, diversion program standards and policies, and monitoring and reporting procedures. Strategies to promote diversion prevention include dose sizes that eliminate waste and use of pre-filled syringes in ready-to-administer (RTA) form. RTA medications are recommended by The Joint Commission, the Institute for Safe Medication Practices (ISMP), the American Society of Health-System Pharmacists (ASHP), and the Anesthesia Patient Safety Foundation (APSF). In this session, we will discuss the issue of CSD, contributing factors, prevention methods, and monitoring and reporting programs.

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    Controlled substances diversion (CSD) is a risk for any organization that prescribes, stores, dispenses, or administers controlled substances. CSD can lead to patient safety issues, including inadequate patient pain relief, harm to the nurse, and a significant liability risk to the organization. The American Nurses Association estimates that 6% to 8% of nurses have a substance abuse problem that impacts their practice. Some contributing factors to the issue of CSD include the global pandemic, nurses with easy access to medications, and lack of intravenous product standardization. A multidisciplinary approach to reduce the risk of CSD should include drug diversion prevention, diversion program standards and policies, and monitoring and reporting procedures. Strategies to promote diversion prevention include dose sizes that eliminate waste and use of pre-filled syringes in ready-to-administer (RTA) form. RTA medications are recommended by The Joint Commission, the Institute for Safe Medication Practices (ISMP), the American Society of Health-System Pharmacists (ASHP), and the Anesthesia Patient Safety Foundation (APSF). In this session, we will discuss the issue of CSD, contributing factors, prevention methods, and monitoring and reporting programs. 

    Learning Objectives: At the conclusion of this session, the learner will be able to:
    • Discuss the prevalence and contributing factors to CSD.
    • Describe the impact of CSD upon patients, clinicians, and the organization.
    • Identify strategies to promote diversion prevention, including RTA medications and dose sizes.
    • Discuss CSD prevention policies, standards, monitoring and reporting programs.

    Evan Frasure, PharmD, BCPS

    Evan S. Frasure III, PharmD, BCPS, is the Director for Controlled Substance Diversion Prevention for Duke University Health System, where he oversees the diversion prevention efforts across Duke Health. Dr. Frasure graduated from pharmacy school at Idaho State University in 2007 and completed a PGY1 residency at Carolinas Medical Center – NorthEast in Concord, NC. He has held various positions during his time at Duke, including continuity of care, administration, and business services oversight. He started in his current role in March 2017. In this role, he has implemented staff education modules, a diversion oversight committee, and updated policies & procedures and an analytics software program. Many of these changes have been the result of learning from Drug Enforcement Administration (DEA) settlements.

    CRNI® RUs: This session has been approved for 2 CRNI® recertification units and meets the non INS Meeting criteria.

    Contact Hours: This session has been approved for 1 contact hour

    Expiration date for receipt of contact hours: May 8, 2027

    To receive contact hours for this educational activity, you are required to attend the entire educational activity and complete the evaluation.

    The Infusion Nurses Society is approved as a provider of continuing nursing education by the California Board of Registered Nursing, provider #CEP14209. The certificate must be retained by the attendee for a period of 4 years.

  • Contains 3 Component(s), Includes Credits Recorded On: 04/10/2024

    Despite being one of the most common invasive medical devices, peripheral intravenous catheters (PIVC) fail at unacceptably high rates, with around 50% to 75% failing before treatment is complete. The development of nursing professionals’ expertise is essential in reducing failures and complications associated with PIVC use. Proper training is necessary to acquire professional expertise in strategies that ensure an accurate performance and minimize the risks inherent to the procedure. Even though PIVC insertions are a prevalent, technically complex, and invasive procedure, most health care practitioners receive little substantive PIVC education, training, or opportunities to practice skills to become competent. In addition, PIVC training can vary between professionals and curriculums. In some countries, technical professionals without higher education, such as licensed practical nurses (LPN), are part of the nursing team and are licensed to perform PIVC insertions. In this session, we will discuss an innovative instructional simulation strategy for PIVC insertion training used with LPNs to improve performance and reduce complications associated with the procedure.

    Despite being one of the most common invasive medical devices, peripheral intravenous catheters (PIVC) fail at unacceptably high rates, with around 50% to 75% failing before treatment is complete. The development of nursing professionals’ expertise is essential in reducing failures and complications associated with PIVC use. Proper training is necessary to acquire professional expertise in strategies that ensure an accurate performance and minimize the risks inherent to the procedure. Even though PIVC insertions are a prevalent, technically complex, and invasive procedure, most health care practitioners receive little substantive PIVC education, training, or opportunities to practice skills to become competent. In addition, PIVC training can vary between professionals and curriculums. In some countries, technical professionals without higher education, such as licensed practical nurses (LPN), are part of the nursing team and are licensed to perform PIVC insertions. In this session, we will discuss an innovative instructional simulation strategy for PIVC insertion training used with LPNs to improve performance and reduce complications associated with the procedure.

    Learning Objectives: At the conclusion of this session, learners will be able to:
    1. Describe clinicians’ PIVC insertion performance from the perspective of patient safety.
    2. Present an innovative instructional simulation strategy for PIVC insertion training.
    3. Discuss how innovative educational simulation strategies for training PIVC insertion among health care professionals can improve performance and reduce complications associated with the procedure.

    Juliana Faria Campos, PhD, RN

    Dr. Juliana Faria Campos is an intensive care specialist, an associate professor at the Department of Fundamental Nursing at Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro (EEAN/UFRJ), and a permanent professor of the master's and doctoral programs in nursing at EEAN/UFRJ. She is a research leader of the Research Group Technologies and Conceptions for the Systematization of Nursing Care (TECCONSAE), a coordinator of the Laboratory of Skills and Clinical Simulation at UFRJ, and a reviewer of scientific journals. She holds a PhD in nursing, and has experience in intensive care nursing and health training, working mainly on clinical simulation, simulated training, and deliberate practice in rapid cycles.

    CRNI® RUs: This session has been approved for 2 CRNI® recertification units and meets the non INS Meeting criteria.

    Contact Hours: This session has been approved for 1 contact hour

    Expiration date for receipt of contact hours: April 10, 2027

    To receive contact hours for this educational activity, you are required to attend the entire educational activity and complete the evaluation.

    The Infusion Nurses Society is approved as a provider of continuing nursing education by the California Board of Registered Nursing, provider #CEP14209. The certificate must be retained by the attendee for a period of 4 years.

  • Contains 3 Component(s), Includes Credits Recorded On: 03/06/2024

    Did you know that the properties of Infusion therapy play a crucial role in determining the most appropriate vascular access device for patients? They are critical factors to consider and can have a significant impact on patient care and outcomes. By understanding the importance of these properties, we can ensure that our patients receive the best possible treatment. During this session, we will explore this topic further to ensure we provide the best care for our patients.

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    Did you know that the properties of Infusion therapy play a crucial role in determining the most appropriate vascular access device for patients? They are critical factors to consider and can have a significant impact on patient care and outcomes. By understanding the importance of these properties, we can ensure that our patients receive the best possible treatment. During this session, we will explore this topic further to ensure we provide the best care for our patients.

    Learning Objectives: At the conclusion of this session, learners will be able to:

    • Define up-to-date clinical standards of pharmacokinetics of vascular infusions, medications, and treatment as relates to patient safety and vessel preservation.
    • Identify evidence-based practices for potential complications of peripheral and central vascular access devices.
    • Discuss clinical indications, evaluations, and rationales for evidence-based practice regarding vessel preservation complexities.
    • Discuss clinical indicators related to evidence-based practice for vascular access devices and their complications in various patient populations.

    Carla Dillard, MSN, RN, VA-BC

    Carla is the current chief nursing officer for Dynamic Access. She is responsible for overseeing the clinical and regulatory compliance of the organization. Carla has been with Dynamic since 2005 and has held various leadership roles in the development of clinical, operational, and educational components of the organization. Before joining Dynamic, Carla worked as a registered nurse in acute care emergency and intensive care units. She established an educational company in 2013 to address deficiencies in clinical bedside care. Motivated by her passion for education, Carla remains dedicated to bridging these gaps.

    Katie Nesbitt, PharmD, BCPS

    Katie Nesbitt, PharmD, BCPS, received her Doctorate in Pharmacy from Philadelphia College of Pharmacy and completed a PGY1 general pharmacy residency at Tower Health Network in Reading, Pennsylvania.  After working at Tower Health Network for 5 years, she transitioned into a clinical pharmacy specialist role focused in cardiology and anticoagulation at Lehigh Valley Health Network. She currently serves as a clinical pharmacy consultant for RxToolKit.  Dr. Nesbitt is a board-certified pharmacotherapy specialist. Utilizing her current roles and experiences, she is able to pursue her passion for educating in areas including critical care pharmacotherapy and cardiology-related medication topics.

    CRNI® RUs: This session has been approved for 2 CRNI® recertification units and meets the non INS Meeting criteria.

    Contact Hours: This session has been approved for 1 contact hour

    Expiration date for receipt of contact hours: March 6, 2027

    To receive contact hours for this educational activity, you are required to attend the entire educational activity and complete the evaluation.

    The Infusion Nurses Society is approved as a provider of continuing nursing education by the California Board of Registered Nursing, provider #CEP14209. The certificate must be retained by the attendee for a period of 4 years.

  • Contains 6 Product(s)

    Join us for a deep dive into the all-new 2024 INS Standards of Practice. This 2-day symposium will provide a comprehensive overview of the revisions introduced in the 9th edition. At the conclusion of the meeting, you will be able to claim 5 contact hours and 10 CRNI® recertification units.

    Join us for a deep dive into the all-new 2024 INS Standards of Practice. This 2-day symposium will provide a comprehensive overview of the revisions introduced in the 9th edition. At the conclusion of the meeting, you will be able to claim 5 contact hours and 10 CRNI® recertification units.

  • Contains 3 Component(s), Includes Credits Recorded On: 01/17/2024

    Smart infusion pumps have been around for over 20 years and represent one of the most valuable pieces of health care technology in place to promote patient safety. By allowing significant control over how intravenous medications are administered, errors can be prevented prior to them reaching the patient. A good catch is when smart infusion pump programming triggers an alert for a value that is considered unsafe and temporarily stops additional forward programming of the smart infusion pump. In this session, we will review examples of good catches, discuss how health care systems can quantify cost savings from severe harms averted, and explain how to champion smart pumps as a key tool to safely administer intravenous medications.

    Smart infusion pumps have been around for over 20 years and represent one of the most valuable pieces of health care technology in place to promote patient safety.  By allowing significant control over how intravenous medications are administered, errors can be prevented prior to them reaching the patient. A good catch is when smart infusion pump programming triggers an alert for a value that is considered unsafe and temporarily stops additional forward programming of the smart infusion pump. In this session, we will review examples of good catches, discuss how health care systems can quantify cost savings from severe harms averted, and explain how to champion smart pumps as a key tool to safely administer intravenous medications.

    Learning Objectives: At the conclusion of this session, learners will be able to: 

    1.     Discuss literature on the use of smart infusion pumps and Dose Error Reduction Software (DERS).

    2.     Define a good catch.

    3.     Describe how good catch data can be used to promote the use of smart infusion pumps to improve patient safety.

    Joanne Hatfield, PharmD, BCPS

    Joanne Hatfield, PharmD, BCPS, is the director of clinical solutions at Bainbridge Health, where she leads the analysis and interpretation of network data in order to provide actionable insights to improve medication safety. Dr. Hatfield also coordinates and provides educational activities for the National Infusion Collaborative, the largest collective of infusion practitioners across the United States. She previously served as clinical manager and cochair of the Pharmacy and Therapeutics Committee at University Health-Truman Medical Centers, where she was responsible for complete formulary oversight and clinical operations. Dr. Hatfield is board certified in pharmacotherapy and completed the ASHP Foundation Traineeship in Pain and Palliative Care.

    CRNI® RUs: This session has been approved for 2 CRNI® recertification units and meets the non INS Meeting criteria.

    Contact Hours: This session has been approved for 1 contact hour

    Expiration date for receipt of contact hours: January 17, 2027

    To receive contact hours for this educational activity, you are required to attend the entire educational activity and complete the evaluation.

    The Infusion Nurses Society is approved as a provider of continuing nursing education by the California Board of Registered Nursing, provider #CEP14209. The certificate must be retained by the attendee for a period of 4 years.