The following speech was delivered at INS 2016 in Ft. Lauderdale, Florida, on May 16, 2016.
In my presidential address a year ago, I urged you to embrace change and to remember the phoenix, the mythical bird that, when it perceives its own death, ignites itself into flames and then rises from the ashes, reinvigorated and fully alive. As the year progressed, it became even more apparent that change is the 1 thing we can count on. For many of us, our experience in nursing has been one of tradition and, frequently, holding on to our "sacred cows." However, for us to be invigorated and fully alive, it's essential we embrace the changes we face, control them, and shape our own future.
In 2010, the Institute of Medicine (IOM) proposed a new direction for nurses in The Future of Nursing: Leading Change, Advancing Health.1 The premise of the report is that the vision set forth by the Affordable Care Act (ACA), also called Obamacare, is to transform the US "health care system to provide seamless, affordable, quality care that is accessible to all, patient-centered, and evidence-based, and leads to improved health outcomes."1(p1) The ACA has introduced the most expansive changes to health care since the 1965 creation of the Medicare and Medicaid programs. Furthermore, it proposed that nurses were the providers who could overcome barriers to this vision. To support the work of nurses, the IOM offered 4 recommendations:
1. Ensure that nurses can practice to the full extent of their education and training. This can be accomplished through legislation that expands the scope of practice for nurses-for example, ensuring that each state Board of Nursing includes insertion of central vascular access devices (CVADs) in the registered nurse (RN) scope of practice. Currently, the Infusion Nurses Society's (INS') Board of Directors is preparing a position statement on the RN role in placement of nontunneled CVADs.
2. Improve nursing education. Nurses need to have an educational background equal to the other health care professionals on their teams. The Certified Registered Nurse Infusion (CRNI(R)) credential is highly respected and is another way you can demonstrate your extensive knowledge.
3. Provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement efforts. There are a multitude of leadership opportunities within INS.
4. Improve data collection for workforce planning and policy making. Evidence is needed to evaluate the efficacy of new programs. INS is offering more programs on research and evidence-based practice. The Gardner Foundation offers a research grant annually.
The future changes and challenges in health care can be daunting. But as a member of INS you have access to a lot of support.
BENEFITS OF BEING A MEMBER OF INS
Knowledge
INS is here to support you through these challenges. We are excited to announce that INS has added many educational resources to its online LEARNING CENTER during the past year. There are now more than 120 educational offerings on the INS Web site, which can be accessed for instant viewing. These are in the form of Webinars, podcasts, position papers, and anytime learning programs. A digital library is available, too, so that you can download recent publications, such as Policies and Procedures for Infusion Therapy (5th edition, 2016) and the 2016 Infusion Therapy Standards of Practice (the Standards).
Your colleagues on the National Council on Education (NCOE) work diligently to organize 2 major educational conferences a year. We all enjoy these conferences and the impressive speakers, but most of us have no idea of the amount of work it takes to pull these together. The work that is done by NCOE on our behalf is most appreciated.
One of our most significant accomplishments during the past year has been the publication of the Standards. I'm sure you've noticed that "nursing" is no longer in the title. This publication sets the standards for multidisciplinary infusion care and meets criteria for use of evidence-based practice. A committee of 6 INS leaders worked diligently to produce the revised version, which is supported by higher levels of evidence: Chair Lisa Gorski, MS, RN, HHCNS-BC, CRNI(R), FAAN; Lynn Hadaway, MEd, RN-BC, CRNI(R); Mary E. Hagle, PhD, RN-BC, FAAN; Mary McGoldrick, MS, RN, CRNI(R); Marsha Orr, MS, RN; and Darcy Doellman, MSN, RN, CRNI(R), VA-BC. The 2016 Standards is referenced by 350 more sources than the 2011 edition of the Standards. The percentage of references providing Level I evidence, the highest level, increased from 3.8% in the 2011 edition to 5.8% in 2016. The percentage of references providing Level V evidence, the lowest level, decreased from 67% in 2011 to 46% in 2016. As a member of INS, you have received a free copy of the Standards. A crosswalk between the 2011 and 2016 editions of the Standards is available in INS' online LEARNING CENTER.
CRNI(R) Academy
Support for obtaining and maintaining the valued CRNI(R) credential has expanded. There are now multiple ways to prepare for the CRNI(R) exam. A new online study program, the CRNI(R) Academy, has been developed to expand and enhance the study resources available to candidates. In addition, over the years there have been concerns regarding the length of the annual conference and the requirement that 30 CRNI(R) recertification units be obtained by attending it. You spoke, and both INS and INCC listened. As a result, virtual conference offerings, accessible on the INS Web site, will be available to supplement conference attendance. CRNI(R)s will be able to apply the recertification units (RUs) from these sessions toward the meeting requirement of recertification.
We are also happy to announce that beginning with INS 2017, our annual convention will take place over 4 days instead of 6. The demand for your time continues to increase, while your ability to be away from work and family decreases. While the meeting will be shortened, you will still be able to earn 40 RUs toward your CRNI(R) credential. Please look for upcoming announcements that will explain the new meeting structure in more detail.
Networking Opportunities
Infusion therapy is a dynamic and exciting field. To stay abreast of the changes and developments in our practice, we need to be able to confer with peers, colleagues, and industry partners. The INS Fall National Academy of Infusion Therapy and the Spring National Academy, along with the Annual Convention and Industrial Exhibition, provide extensive opportunities for networking. Each year, approximately 1400 nurses and 100 industry partners convene at INS conferences.
In addition, the INS Web site provides opportunities for ongoing communication and networking through the Clinical Community Discussion Forum. And a new feature, the Member Directory, can help you find colleagues and connect easily.
Awards and Recognition
As a nursing specialty organization always striving for excellence, it's important that INS recognizes excellence. Each year, we recognize a Member of the Year, a Chapter Leader of the Year, and a CRNI(R) of the Year. This year, INS also is awarding 17 scholarships and 1 research grant. To learn more, go to the INS Web site at Gardner Scholarships. Take advantage of this benefit.
Another way you can recognize colleagues is through INS Shout Outs. Give props to your peeps! Let us know when someone does something great, and we'll put it on the INS Web site. It is a fun way to appreciate others.
ADDING TO THE SCIENCE OF EVIDENCE-BASED PRACTICE
INS is the society that sets the standard for infusion care. Because of this mandate, the INS Board of Directors is engaged in and dedicated to supporting research, data collection, analysis, synthesis, and translation of evidence. If you noticed, the fourth point made by the IOM is to improve data collection for workforce planning and policy making. We need high-quality evidence to influence legislators and corporate stakeholders to invest in the resources we know are needed to provide excellence in infusion care.
The INS Research Committee has been working diligently to determine the research priorities for our organization. Some of you have been invited to participate in focus surveys to this aim. Thank you to those who have participated and contributed your valued opinions. It is our vision to have many of you involved in data collection and a logical, scientific approach to the evaluation of your processes and products. The health of our nation depends on it. We hope you'll look forward to hearing more from the INS Research Committee, and that you'll ask about joining.
At this time, INS is collaborating with faculty at Purdue University to conduct a nationwide survey that will explore the changing nature of infusion work. The survey will be sent to thousands of nurses across the country, including you. We are all aware that infusion teams are coming and going, but we do not know the current state of infusion teams in the United States. Infusion therapy is hardwired into all patient care settings. Your skills and knowledge will always be essential. We do not know what size teams and service offerings in what settings are best to provide high-quality care at an affordable cost. We need to know what infusion teams look like and how their characteristics relate to patient outcomes. This descriptive study will provide a large sample for a baseline description of the characteristics of these teams and services across the country.
As an INS representative, I recently attended a nursing roundtable in Washington, DC, hosted by the Patient-Centered Outcomes Research Institute (PCORI). In 2010, the organization was authorized by Congress to fund research focused on producing evidence that will help patients and providers make the best decisions in choosing health care options. It brought a group of 50 specialty nursing organizations together to inform it of their mission and to appeal for proposals. Its mission is to identify critical research questions, fund patient-centered comparative clinical effectiveness research, and disseminate the results in ways that patients and providers will find useful.2 This funding source represents a wonderful opportunity for infusion nurses.
CONCLUSION
In conclusion, I have been humbled and honored to serve as your president for the past year. I am especially pleased to be associated with such a high-quality and professional organization. I have had the honor to attend meetings of the Nursing Organizations Alliance and the American Nurses Association, as well as the PCORI roundtable, where INS is included in the elite group of premier specialty organizations driving the profession of nursing forward.
Your task at each turn and change in health care is to rise from the ashes like the phoenix you are and show your colors, leading change and advancing health.
REFERENCES