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  • The 5 Why's of Injectable Medication Shortages

    Contains 3 Component(s), 1 credit offered Recorded On: 03/28/2018

    At the end of the presentation, attendees will be able to identify the impact of injectable medication shortages on patient care and learn strategies for best practices.

    Medication shortages, especially injectable drugs, cause significant risks to patients from both safety and clinical treatment aspects. Clinicians are faced with daily drug shortages in practice settings that necessitate restrictions, rationing, and sometimes rapid changes in therapies. This webinar will explain why drug shortages occur, identify the key stakeholders in drug shortage management, describe the current drug shortages, and offer predictions on how long current injectable medication shortages may last. Dr. Pasko will also discuss the impact to patient care as a result of these shortages and provide strategies for best practices.

    Learning Outcome:

    At the end of the presentation, attendees will be able to identify the impact of injectable medication shortages on patient care and learn strategies for best practices.

    Deborah A. Pasko, PharmD, MHA, BPharm

    Director Medication and Safety ASHP

    Deborah Pasko, PharmD, MHA, BPharm, is the director of medication safety and quality at the American Society of Health-System Pharmacists. She earned a BPharm from Ohio Northern University, an MHA from Walden University and a PharmD from Idaho State University. She has training and experience in a number of pharmacy practices, including pediatrics, critical care, medication safety, and process improvement. In 2009, she transitioned to hospital administration at the University of Michigan, where she chaired the Pediatric Medication Safety committee and advised the adult committee until2014. She has led pediatric and adult initiatives focused on adverse drug events (ADE) and health care-acquired infection prevention, in addition to serving as lead pharmacist for safety technology implementations, including smart infusion devices and Epic EHR. Dr. Pasko’s professional interests include intravenous and oral liquid standardization, all pillars of the national ADE action plan, antimicrobial resistance and stewardship, opioid stewardship, safety technology solutions, drug shortages and population health initiatives.

    CRNI® RUs: This session has been approved for 1 CRNI® recertification unit 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 28, 2021

  • Episode 21: March 21, 2018 - Central Vascular Access Device Malposition

    Contains 1 Component(s)

    CVAD malposition refers to the suboptimal location of the tip of the catheter. Signs and symptoms range from the sound of “gurgling” in a patient’s ear to pneumo- or hemothorax. Malposition can lead to other complications including infiltration or extravasation. In this final episode of the series, it’s all about location, location, location.

    CVAD malposition refers to the suboptimal location of the tip of the catheter. Signs and symptoms range from the sound of “gurgling” in a patient’s ear to pneumo- or hemothorax. Malposition can lead to other complications including infiltration or extravasation. In this final episode of the series, it’s all about location, location, location.

    Crystal Miller, MA, BSN, CRNI®, NE-BC

    Nurse Manager

    Crystal Miller, MA, BSN, CRNI®, NE-BC is the nurse manager of the IV Therapy Department in the Outpatient Infusion and Mandell Multiple Sclerosis Centers at St. Francis Hospital and Medical Center in Hartford, Connecticut. She has more than 30 years’ experience in infusion nursing. Crystal served as president of the Infusion Nurses Society from 1998 to 1999 and chaired the Infusion Nurses Certification Corporation from 2011 to 2013. 

    Guest:
    Crystal Miller, MA, BSN, RN, CRNI®
    Nurse Manager, St. Frances Hospital and Medical Center, Hartford, CT

    Knowing how to treat infusion therapy-related complications means recognizing the signs and symptoms. Identifying the problem as early as possible will significantly impact positive patient outcomes. Treating the sequelae of unrecognized complications can be costly, result in poor outcomes, and decrease patient satisfaction.

    CVAD malposition refers to the suboptimal location of the tip of the catheter. Signs and symptoms range from the sound of “gurgling” in a patient’s ear to pneumo- or hemothorax. Malposition can lead to other complications including infiltration or extravasation. In this final episode of the series, it’s all about location, location, location.

  • Episode 20: March 7, 2018 - Air and Catheter Embolisms

    Contains 1 Component(s)

    Our series continues with a look at two complications that while, infrequent, can have devastating consequences. Signs and symptoms can be nonspecific, but early recognition and prompt intervention are crucial to decrease the chances of harm to the patient.

    Our series continues with a look at two complications that while, infrequent, can have devastating consequences. Signs and symptoms can be nonspecific, but early recognition and prompt intervention are crucial to decrease the chances of harm to the patient. 

    Mark Hunter, BSN, RN, CRNI®, VA-BC

    Medical Affairs Manager

    Mark R. Hunter, BSN, RN, CRNI®, VA-BC, is a medical affairs manager at BD, where he focuses on medical device development, risk management, patient safety, and regulatory agency communications. He began his corporate nursing career at Baxter in 2007, where he helped drive the launch of multiple new products. A registered nurse for 27 years, Mark specialized in the fields of critical care and infusion nursing before joining industry. An active INS member, Mark has contributed to the development of INS’ Infusion Nursing Standards of Practice (2011), sessions for its annual meeting, and the CRNI® certification exam. Mark is also an editorial reviewer for the Journal of Infusion Nursing. 

    Guest:
    Mark Hunter, BSN, RN, CRNI®, VA-BC
    Medical Affairs Manager, BD

    Knowing how to treat infusion therapy-related complications means recognizing the signs and symptoms. Identifying the problem as early as possible will significantly impact positive patient outcomes. Treating the sequelae of unrecognized complications can be costly, result in poor outcomes, and decrease patient satisfaction.

    Our series continues with a look at two complications that while, infrequent, can have devastating consequences. Signs and symptoms can be nonspecific, but early recognition and prompt intervention are crucial to decrease the chances of harm to the patient. 

    References:
    Alexander M, Corrigan A, Gorski L, Phillips L.  
    Core Curriculum for Infusion Nursing. 4th ed. Wolters Kluwer Lippincott Williams & Wilkins. 2014

    Brenda L Natal, MD, MPH; Chief Editor: Erik D Schraga, MD. Venous Air Embolism Dec 2017 https://emedicine.medscape.com...
     
    Robert Wilkins, Martin Unverdorben. Accidental intravenous infusion of air, JIN 2012 pg 404-408. DOI: 10.1097/NAN.0b013e31827079fe 

    Complications of Peripheral Venous Access Devices: Prevention, Detection, and Recovery Strategies Crit Care Nurse April 1, 2017 37:e1-e14 
    http://ccn.aacnjournals.org/co...

    Something’s Missing: Peripheral Intravenous Catheter Fracture
    doi: 10.3122/jabfm.2013.06.130097 J Am Board Fam Med November-December 2013 vol. 26 no. 6 805-806
    http://www.jabfm.org/content/2...

    Fibel, Kenton H., et al. “Pressurized Intravenous Fluid Administration in the Professional Football Player.” Clinical Journal of Sport Medicine, vol. 25, no. 4, 2015, doi:10.1097/jsm.0000000000000150.

    Macklin, D. (1999). What’s physics got to do with it. a review of the physical prinicples of fluid administration. Journal of Vascular Access Devices, 7-11.

  • Episode 19: February 28, 2018 - Advocating Empowerment: A Conversation With INS 2018 Keynote Speaker Elizabeth Smart

    Contains 1 Component(s)

    Like many moms, her typical day starts with a personal wake-up call from her toddler daughter, tending to her infant son, taking a quick run with her dogs, then tackling the day’s to-do list. Elizabeth Smart is a typical mom with an inconceivable story. Abducted at knife point from her home in 2002 at age 14, then raped, drugged, and abused for 9 months, the story of Elizabeth Smart’s ordeal gripped the nation. Now an advocate for survivors of sexual assault and other types of abuse, Elizabeth talks about recovering from her traumatic experience and how empowerment is a key component to victims’ survival.

    Like many moms, her typical day starts with a personal wake-up call from her toddler daughter, tending to her infant son, taking a quick run with her dogs, then tackling the day’s to-do list. Elizabeth Smart is a typical mom with an inconceivable story. Abducted at knife point from her home in 2002 at age 14, then raped, drugged, and abused for 9 months, the story of Elizabeth Smart’s ordeal gripped the nation. Now an advocate for survivors of sexual assault and other types of abuse, Elizabeth talks about recovering from her traumatic experience and how empowerment is a key component to victims’ survival.

    Interviewer: Leslie Nikou, INS Associate Managing Editor

    Guest: Elizabeth Smart
               Author/Speaker/Survivor
               INS 2018 Keynote Speaker 

    Like many moms, her typical day starts with a personal wake-up call from her toddler daughter, tending to her infant son, taking a quick run with her dogs, then tackling the day’s to-do list. Elizabeth Smart is a typical mom with an inconceivable story. Abducted at knife point from her home in 2002 at age 14, then raped, drugged, and abused for 9 months, the story of Elizabeth Smart’s ordeal gripped the nation. Now an advocate for survivors of sexual assault and other types of abuse, Elizabeth talks about recovering from her traumatic experience and how empowerment is a key component to victims’ survival.

    Information and resources:
    www.elizabethsmart.com

  • Episode 18: February 21, 2018 - Vascular Access Device Occlusion

    Contains 1 Component(s)

    Occlusions can affect any vascular access device at any point during the course of treatment. We’ll identify various occlusions and what can be done to manage this potentially significant complication in both peripheral and central VADs.

    Occlusions can affect any vascular access device at any point during the course of treatment. We’ll identify various occlusions and what can be done to manage this potentially significant complication in both peripheral and central VADs.

    Guest:
    Maria Santini BSN, RN, VA-BC

    Knowing how to treat infusion therapy-related complications means recognizing the signs and symptoms. Identifying the problem as early as possible will significantly impact positive patient outcomes. Treating the sequelae of unrecognized complications can be costly, result in poor outcomes, and decrease patient satisfaction.

    Occlusions can affect any vascular access device at any point during the course of treatment. We’ll identify various occlusions and what can be done to manage this potentially significant complication in both peripheral and central VADs.

  • Using a Model of Empowerment to Create a Culture of Civility in the Practice of Infusion Nursing

    Contains 3 Component(s), 1 credit offered Recorded On: 02/20/2018

    Incivility in health care presents a significant threat to our health care system and especially to safe patient care. A hostile environment has the potential to damage collaboration among members of the health care team. Nurses are central to the infusion team and are in a position to take the lead in changing this destructive phenomenon. This presentation will review the intersection of incivility and disempowerment. It will illuminate overt and subtle behaviors that create hostile and unhealthy interactions in health care teams, which present a compelling danger to patients. The presentation will impart practical strategies to change the environment to establish a culture of civility within the infusion team. The educational strategies presented are organized by an empowerment framework developed by Worrell et al (1996) and are supported with evidence from experts in the areas of civility and empowerment. The empowerment framework includes communication, collegiality, autonomy, and accountability.

    Incivility in health care presents a significant threat to our health care system and especially to safe patient care. A hostile environment has the potential to damage collaboration among members of the health care team. Nurses are central to the infusion team and are in a position to take the lead in changing this destructive phenomenon.  This presentation will review the intersection of incivility and disempowerment.  It will illuminate overt and subtle behaviors that create hostile and unhealthy interactions in health care teams, which present a compelling danger to patients.  The presentation will impart practical strategies to change the environment to establish a culture of civility within the infusion team.  The educational strategies presented are organized by an empowerment framework developed by Worrell et al (1996) and are supported with evidence from experts in the areas of civility and empowerment.  The empowerment framework includes communication, collegiality, autonomy, and accountability.  

    Linda Shanta, PhD, MSN, RN, ANEF

    Linda L. Shanta, PhD, MSN, BS, ANEF, is a clinical associate professor and the director of the Nurse Educator Track in the College of Nursing and Professional Disciplines at the University of North Dakota in Grand Forks. Her passion for life-long learning in her field led her to study a variety of disciplines, most recently on topics of empowerment, emotional intelligence, and civility. She has held an array of leadership positions in nursing practice, education, and regulation. Dr. Shanta is currently chair of the National League for Nursing’s Education Accreditation Policy Committee. A prolific writer and speaker, she is also the recipient of numerous awards. 

    CRNI® RUs: This session has been approved for 1 CRNI® recertification unit 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: February 20, 2021

  • Episode 17: February 7, 2018 - Infusion-related Infection

    Contains 1 Component(s)

    From insertion site infections to catheter-related blood stream infections, every patient receiving infusion therapy is at risk of this potentially serious complication. Despite ongoing prevention and awareness campaigns, infections still happen. Are you putting your patients at risk?

    From insertion site infections to catheter-related blood stream infections, every patient receiving infusion therapy is at risk of this potentially serious complication. Despite ongoing prevention and awareness campaigns, infections still happen. Are you putting your patients at risk? 

    Guest:
    Lynda Cook, MSN, RN, CRNI®
    Vascular Access Consultant

    Knowing how to treat infusion therapy-related complications means recognizing the signs and symptoms. Identifying the problem as early as possible will significantly impact positive patient outcomes. Treating the sequelae of unrecognized complications can be costly, result in poor outcomes, and decrease patient satisfaction.

    From insertion site infections to catheter-related blood stream infections, every patient receiving infusion therapy is at risk of this potentially serious complication. Despite ongoing prevention and awareness campaigns, infections still happen. Are you putting your patients at risk? 

    Links to helpful information and resources:
    Nursing Infection Control and Education (NICE) Network:  A joint venture of the ANA, the CDC and 20 nursing organizations, including INS. The goal of the NICE Network is to improve adherence to infection prevention and control practices.
    http://www.nursingworld.org/In...

    CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections (2011)
    https://www.cdc.gov/infectionc...

    Association for Professionals in Infection Control and Epidemiology (APIC)
    https://apic.org/

  • Episode 16: January 24, 2018 - Phlebitis: Mechanical, Chemical, Bacterial, Oh My!

    Contains 1 Component(s)

    Infusion therapy-related phlebitis is the most common, and preventable, complication of infusion therapy. Phlebitis prevention begins with critically assessing and evaluating the therapy ordered and the patient’s vascular status. Strict adherence to established insertion policies and procedures as well as frequent assessment can greatly reduce the occurrence of this complication.

    Infusion therapy-related phlebitis is the most common, and preventable, complication of infusion therapy. Phlebitis prevention begins with critically assessing and evaluating the therapy ordered and the patient’s vascular status. Strict adherence to established insertion policies and procedures as well as frequent assessment can greatly reduce the occurrence of this complication.

    Guest:
    Irma Sivieria, MS, BSN, CRNI®, VA-BC
    Vascular Access Clinical Coordinator
    South Shore Hospital, Weymouth, MA

    Knowing how to treat infusion therapy-related complications means recognizing the signs and symptoms. Identifying the problem as early as possible will significantly impact positive patient outcomes. Treating the sequelae of unrecognized complications can be costly, result in poor outcomes, and decrease patient satisfaction.

    Infusion therapy-related phlebitis is the most common, and preventable, complication of infusion therapy. Phlebitis prevention begins with critically assessing and evaluating the therapy ordered and the patient’s vascular status. Strict adherence to established insertion policies and procedures as well as frequent assessment can greatly reduce the occurrence of this complication.

    Resources:

    2016 Infusion Therapy Standards of Practice

    Policies and Procedures for Infusion Therapy, 5th Edition

    INS Phlebitis Scale

    GradeClinical Criteria
    0No symptoms
    1Erythema at access site with or without pain
    2Pain at access site with erythema and/or edema
    3-Pain at access site with erythema
    -Streak formation
    -Palpable venous cord
    4-Pain at access site with erythema
    -Streak formation
    -Palpable venous cord > 1 inch in length
    -Purlulent drainage
  • Frequency of Assessment of the Short Peripheral Catheter

    Contains 3 Component(s), 1 credit offered Recorded On: 01/17/2018

    Short peripheral catheters (SPCs) are the most commonly used invasive device among hospitalized patients, yet nurses often underestimate the risk and the potential for serious consequences associated with peripheral access. Critically important to reducing the risks associated with SPCs are appropriate device and site selection, impeccable insertion technique, and regular and careful assessment for signs/symptoms with prompt catheter removal if present. INS established recommendations for the frequency of SPC assessment as presented in a 2012 position paper and incorporated these recommendations in the 2016 Infusion Therapy Standards of Practice. This presentation will explore and describe assessment recommendations in relation to current evidence.

    Short peripheral catheters (SPCs) are the most commonly used invasive device among hospitalized patients, yet nurses often underestimate the risk and the potential for serious consequences associated with peripheral access. Critically important to reducing the risks associated with SPCs are appropriate device and site selection, impeccable insertion technique, and regular and careful assessment for signs/symptoms with prompt catheter removal if present. INS established recommendations for the frequency of SPC assessment as presented in a 2012 position paper and incorporated these recommendations in the 2016 Infusion Therapy Standards of Practice. This presentation will explore and describe assessment recommendations in relation to current evidence.

    Lisa Gorski, MS, HHCNS, CRNI®, FAAN

    Lisa Gorski has worked as a Clinical Nurse Specialist (CNS) at Wheaton Franciscan Home Health & Hospice in Milwaukee, Wisconsin for more than 30 years. She received her bachelor’s and master’s degrees from the University of Wisconsin-Milwaukee College of Nursing. She is the author of Fast Facts for Nurses About Home Infusion Therapy, the upcoming 7th edition of Manual of IV Therapeutics, and more than 50 journal articles related to infusion therapy. She was also an editor for INS’ 2010 textbook, Infusion Nursing: An Evidence-Based Approach and is currently working on an updated edition scheduled for 2018 release. Lisa was named CRNI® of the year by INS in 2003 and CNS of the year by the National Association of Clinical Nurse Specialists in 2011. In 2006, she was inducted as a Fellow into the American Academy of Nursing. Lisa served as INS President from 2007-2008 and was chair of the 2011 and 2016 INS Standards of Practice committees. She currently lectures throughout the U.S. and abroad on infusion therapy-related topics, standards development, and home health care. 

    CRNI® RUs: This session has been approved for 1 CRNI® recertification unit 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, 2021

  • Episode 15: January 10, 2018- Infiltration & Extravasation: similar start, very different results

    Contains 1 Component(s)

    For all intents and purposes, infiltration and extravasation could be the same thing, except for one major difference. Listen in to the first episode of the series to find out why early identification of infiltration and extravasation is key to the prevention of potentially devastating complications.

    For all intents and purposes, infiltration and extravasation could be the same thing, except for one major difference. Listen in to the first episode of the series to find out why early identification of infiltration and extravasation is key to the prevention of potentially devastating complications.

    Guest:
    Britt Meyer Ph.D., RN, CRNI®, VA-BC, NE-BC
    Nurse Manager Operations- Vascular Access Team 
    Duke University Medical Center

    Knowing how to treat infusion therapy-related complications means recognizing the signs and symptoms. Identifying the problem as early as possible will significantly impact positive patient outcomes. Treating the sequelae of unrecognized complications can be costly, result in poor outcomes, and decrease patient satisfaction.

    For all intents and purposes, infiltration and extravasation could be the same thing, except for one major difference. Listen in to the first episode of the series to find out why early identification of infiltration and extravasation is key to the prevention of potentially devastating complications.

    Information and resources:
    Journal of Infusion Nursing Volume 40 Number 1. January/February 2017
    “Development of an Evidence-Based List of Noncytotoxic Vesicant Medications and Solutions”
    Infusion Nurses Society Vesicant Task Force

    Download your copy of “Noncytotoxic Vesicant Medications and Solutions” from the INS LEARNING CENTER. Log in at the INS website: www.ins1.org