The first set of Standards for infusion therapy were introduced in the Journal of Intravenous Nursing (JIN) in 1980. Spearheaded by the National Intravenous Association's (NITA's) Special Interest Group on Hyperalimentation, a total of 3 practice recommendations emphasized that the quality of patient care improves significantly when given by a competent, educated parenteral nutrition intravenous nurse.1 Published as a 3-page article, these Standards were limited to the adult, nonburned patient receiving central venous total parenteral nutrition in the hospital and included recommendations of practice, role definitions, and education requirements.1
In 1982, the content expanded to 16 pages and 32 standards, covering such topics as infection control, blood component therapy, quality assurance, and recommendations for home IV therapy programs. A model for those practicing IV nursing, the philosophy of this set of Standards outlined NITA's intent to provide optimal care and protection to the patient and an awareness of IV nurses' responsibility to cultivate a safe practice.2
The Standards was first published as a supplement to JIN in 1990, with 98 pages of content. Standards related to complications were added that discussed phlebitis, infiltration/extravasation, and infection. Major topics were organized by 3 subsections: principle, standard, and interpretation.3 Readers were encouraged to incorporate the Standards into the development of policies and procedures within their respective practice settings.
Fast forward to present day where NITA is now known as the Infusion Nurses Society and the Journal of Infusion Nursing is known as JIN, INS has revised the Standards every 5 years since 2006. In 2021, the 8th edition was released, and at 233 pages, 11 authors, and 66 standards, last year's edition was by far the most comprehensive and global in nature. The Standards of Practice Committee brought together a group of international nurses with a wealth of clinical knowledge and expertise in the domains of infusion therapy and vascular access device planning, placement, and management. The staggering number of references cited speaks to how rapidly the science of infusion therapy and vascular access has advanced.
Throughout its evolution in size and scope, each group of authors has remained committed to presenting the most well-researched practice recommendations based on the best available evidence. Once written as "professional standards for nurses,"4 the practice of infusion therapy now requires interprofessional collaboration among all clinicians as it is not "owned" by one group of clinicians; but is the responsibility of any clinician involved in the practice. Yet the goal for all editions of the Standards has remained constant: all patients deserve to receive safe infusion care from competent clinicians. Technology has helped disseminate the Standards worldwide, with both digital and print availability, and with authors who can communicate to the infusion community via in-person or virtual educational presentations.
As infusion- and vascular access-related research continues to be published at a rapid pace, it makes sense to update the Standards on a more frequent basis than every 5 years. I am pleased to announce that the 9th edition of the Standards will be released in the first quarter of 2024 with Barb Nickel, APRN-CNS, CCRN, CRNI(R) taking over the reins as committee chair. Barb, a clinical nurse specialist and previous Standards of Practice committee member, is already hard at work identifying areas of expansion in vascular access research that includes vascular access planning with focus on the difficult intravenous access (DIVA) definition, vascular access selection (including increasing research on midline catheter use and central line placement options), securement options, and peripheral line management and outcomes. Barb reiterates that the Standards is "built from clearly universal statements that are well supported in literature. "
Lisa Gorski, MS, RN, HHCNS-BC, CRNI(R), FAAN will serve as the Standards of Practice committee co-chair after chairing the last 3 editions in 2011, 2016, and 2021. "It has been most exciting for me to witness the growing global impact of the Standards," Lisa tells INS, "...and I have had the opportunity to present and meet nurses and physicians in multiple countries from Asia to Latin America, Europe, the Middle East, and Africa. This has led to some long-term relationships and ongoing communication with a number of nurses. Clearly, while we may function under different regulations and policies and our resources may differ, the goal of providing evidence-based practice for our patients who require vascular access devices and infusion administration is universal."
The new committee, composed of subject matter experts with global representation, will convene in the first quarter of 2022 and begin the work. Revising each edition encompasses performing literature reviews, synthesizing and ranking the evidence, writing new content, and addressing comments from peer reviewers. Each item of evidence will be evaluated from many perspectives, and the highest, most robust evidence supporting the practice recommendations will be used.
As INS continues to "Set the Standard for Infusion Care," we remain focused on how best to deliver patient-centered infusion care, strive for consistency in practice, enhance competency, and provide a guide for clinical decision-making around the globe.
Mary Alexander
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