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Noncytotoxic Vesicant Medications and Solutions
INS established a vesicant task force with the goal of developing an evidence-based list of noncytotoxic vesicant medications/solutions. Outside of oncology practice, there is not a list of noncytotoxic vesicants as established by a ­professional­ organization. ­INS ­identified ­the ­need ­to ­­address ­this ­gap ­based on ­the­ following­ ­premise:­the­ first­ step ­in­ preventing ­extravasation ­is ­the ­identification ­and ­recognition ­of ­vesicant­ drugs and solutions. The scope of work was limited to creating an evidence-based list of noncytotoxic vesicant medications/solutions and developing an extravasation checklist that outlines risk reduction strategies including early recognition of signs and symptoms of extravasation.
Infusion Therapy Standards of Practice 2016 to 2021 Crosswalk
This document highlights the notable revisions of the 2016 Infusion Therapy Standards of Practice to the current 2021 Infusion Therapy Standards of Practice. Clinicians are strongly encouraged to review the entire publication to help ensure infusion practices follow the most current evidenced-based data.
Improving Vascular Access and Care with Near Infrared (NIR) Technology
Peripheral venous access is an essential part of modern in-patient medical care that is poorly managed and has a high rate of failure. Patients and clinicians are frustrated because they wish it could be done better. Old fashioned concepts and inadequate attention to developing best practices has led to the creation of an epidemic of difficult vascular access patients. Our knowledge and experience are growing and with the help of vein visualization technology, we are at a turning point to help reduce the number of venipuncture attempts and better preserve veins. Near Infrared (NIR) technology is well suited to help us implement these best practices. It provides a rapid means to assess a patient’s venous options, identifies potential venous targets, and helps optimize catheter position. It has also been proven to reduce venipuncture attempts, improve first attempt success and prolong dwell times. It thus helps improve efficiency and reduce overall costs both materially and nursing time. NIR can also reduce the need for central venous access by providing more venous options, thus reducing the risk of CLABSI. NIR is an incredibly important tool for our approach to modern venous access best practice.
The Role of the Registered Nurse in the Insertion of Nontunneled Central Vascular Access Devices
As the result of requests from several state boards of nursing, INS convened a task force to determine if insertion of central vascular access devices by appropriately trained registered nurses (RNs) should be recommended. The task force consisted of RNs and advanced practice registered nurses with infusion therapy experience in various practice settings. The results are presented in the following INS position paper. [Approved September 2017]
Managing Infusion Hypersensitivity Reactions with Intravenous Antihistamines
​Management of hypersensitivity infusion reactions (IRs) with H1-antihistamine premedication and/or treatment is recommended for several biologics and chemotherapies used in infusion centers. The sole second-generation intravenous H1-antihistamine recommended is cetirizine. In this session, the presenter will review key clinical data available with IV cetirizine as well as clinical profiles of first- and second-generation H1 antihistamines used to manage infusion reactions.
Protecting Clinicians from Hazardous Drug Exposures
The National Institute for Occupational Safety and Health (NIOSH) provides an ongoing, continually revised list of drugs and biologic agents that meet the definition of hazardous drugs (HDs). Clinicians who prepare and administer hazardous drugs are potentially at risk by direct and indirect contact. Safe handling requirements, by the Occupational Safety and Health Administration (OSHA), NIOSH, USP 800, and INS 2021 Infusion Therapy Standards of Practice (SOPs), provide guidance to protect clinicians from hazardous drug exposure. Specifically, NIOSH recommends health care workers use a close system transfer device (CSTD) throughout the hazardous drug-handling chain, from drug compounding to administration. In this presentation, we will define hazardous drugs and clinician risk, discuss various safety requirements, evaluate various CSTDs, and learn to apply the INS 2021 SOPs into practice.
Understanding Iron Deficiency Anemia
Iron deficiency anemia (IDA) is a common diagnosis which occurs when body iron stores fall below the necessary levels to maintain steady state hemoglobin. IDA can be categorized into two main causes, low iron input (inadequate dietary intake or malabsorption) or increased iron output (usually from blood loss and rarely with urinary iron loss such as in nephrotic syndrome).
Vascular Access Device Care and Management: A Comprehensive Organizational Approach
The Infusion Nurses Society asserts that a comprehensive organizational approach to vascular access device (VAD) care and management is imperative to ensure safe and efficacious patient care. It is essential that each organization (1) develops policies and procedures to align VAD care and management with recognized standards of practice; (2) integrates unique aspects of organization-selected VAD care products into policies and procedures and establishes expectations for adherence to these organizational directives; (3) develops a framework for gathering and analyzing clinical data related to patient outcomes for VAD care and management; (4) utilizes quality outcome data to facilitate evidence-based best practices within the organization; and (5) evaluates and facilitates educational programming to validate clinician competency. [Approved April 2020]
Report Card on the Handling of Hazardous Drugs: Is Your Facility Ready for USP Chapter <800>?
​Is your facility ready for the new chemotherapy handling requirements? A survey sponsored by BD shows that pharmacists and nurses may not be as ready as we think…