Learning Center

When a brisk blood return is not obtained from an implanted vascular access device (IVAD), infusion nurses are faced with difficult questions: Is it safe to use the device? Is starting a peripheral IV always the right answer? Because intermittent patency or occlusion of an IVAD can delay treatments and increase health care costs, infusion nurses are uniquely positioned to impact treatment planning when patency concerns arise. Individualized treatment planning may require deviation from algorithms and consideration of patient-specific factors such as medical history, clinical presentation, living situation, beliefs, and ability to participate in care decisions. In this session, we will critically examine IVAD clinical scenarios and consider potential interventions for suboptimal device patency. 

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

1. Define patency and the three types of occlusions: complete, partial, and withdrawal.
2. Describe the factors used to assess and individualize a patient's treatment plan when IVAD patency is lacking or intermittent. 
3. Identify evidence-based interventions for IVADs presenting without a brisk blood return. 

Contact Hours: 1
CRNI® RUs: 2

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

The evolution of health care has unveiled the significant potential of telehealth, offering a transformative approach to patient care. This session will delve into the integration of telehealth within infusion services/ Vascular Access Specialist Teams (VASTs), which have traditionally been vital components in vascular care and infusion services delivery. Participants will grasp the core functionalities and structures of infusion/ VAST services, from assisting hospitals to supporting mobile infusion/VAST services and ensuring continuous vascular care through home infusion agencies. Emphasis in this session will be placed on the expanded geographic reach, allowing for care in remote and underserved regions. With real-time remote consultations, infusion/VAST services can adeptly address vascular challenges, foster patient engagement, and minimize travel burdens. Moreover, the importance of data security, integration with electronic health records (EHR), and quality assurance will be highlighted, assuring that the adoption of telehealth adheres to institutional standards and elevates patient outcomes. This session will guide attendees on how to incorporate advanced telehealth platforms and equipment, guaranteeing high-quality virtual consultations and assessments.

Learning Objectives: At the end of this session, participants will be able to:

1. Identify and understand the core functionalities and structures of traditional infusion/VAST services, including their role in hospitals, mobile vascular access teams, and home infusion agencies.
2. Differentiate between traditional infusion/VAST services and those enhanced with telehealth, understanding the benefits and challenges of each modality.
3. Describe the equipment and platforms integral to telehealth, ensuring effective virtual consultations, assessments, and continuous patient care.
4. Recognize the significance of expanded geographic reach through telehealth, enabling care delivery in remote and undeserved areas, and understand the ways infusion/VAST services can utilize real-time remote consultations to improve patient outcomes.

Contact Hours: 1
CRNI® RUs: 2

Amy Kyes, MSN, APRN, CRNI®, CV-BC, AGCNS-BC

A scoping review, which mapped nomenclature used in international literature, identified lack of a common language to describe central venous access devices (CVADs), the recording and describing of complications associated with them, and the reasons for premature removal. Lack of standardized terminology in health care negatively impacts patient safety, increases risk of adverse events, and hampers rigorous research. A lack of shared language hampers communication between health care professionals and across organizations as patients transition through their care. Research protocols cannot draw on evidence-informed definitions, and it hampers data sharing and enablement of standardized, evidence-based practice. In this session, we will discuss the rationale for why a standardized CVAD nomenclature is required.

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

• Describe the findings of the scoping review.
• Discuss the implications of the lack of a common language for clinical practice and research.
• Outline national implementation of standardized terminology in cancer care in Australia.

Contact Hours: 1
CRNI® RUs: 2

Kerrie Curtis, MN, BN, RN,

To implement a practice change in an organization, nurses must review the body of evidence, develop a plan, and engage key stakeholders to gain support. This session will present a case study on designing and implementing a nurse-led research study to support an organizational practice change regarding peripherally inserted central catheter (PICC) flushing protocols. The INS Infusion Therapy Standards of Practice provides guidance on central vascular access device (CVAD) flushing protocols, but the standards do not specifically address the unique needs of blood cancer patients. As a result, some organizations may continue to hold onto outdated practices. This session will start with a clinical question about PICC flushing protocols and follow the journey to implement a nurse-led, randomized controlled trial comparing the practice of using heparin versus 0.9% sodium chloride in blood cancer patients with PICC lines. In this session, we will learn about how staff RNs and nursing leaders can gain support in implementing evidence-based practice within their organizations.

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

• Define evidence-based practice.
• Describe the steps involved in implementing a nurse-led research study.
• Discuss the strategies that may be used to engage key stakeholders in implementing an organizational practice change.

Contact Hours: 1
CRNI® RUs: 2

Meredith Allen, BSN, RN, BMTCN,

Linda Denke, PhD, RN, CCRC,

Chemotherapy-induced hypersensitivity reactions (HSRs) represent the third leading cause of fatal drug-induced anaphylaxis in the United States. An estimated 23 million adult patient visits occur annually for cancer treatment in the United States, and approximately 19 million of those visits (84%) are delivered in ambulatory settings. By 2050, the number of cancer cases is expected to double, thereby increasing the use of antineoplastic drugs. Anaphylaxis is life-threatening and early recognition and intervention are key. Delayed biphasic anaphylactic reactions can occur after initial exposure in as many as 20% of patients. This session will provide an overview of chemotherapy-induced HSRs and present the latest evidence on prevention and treatment.

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

• Describe the pathophysiology of infusion-related HSRs to chemotherapy and immunotherapy agents.
• Explain strategies for prevention of infusion-related HSRs.
• Discuss evidence-based guidelines for the management of Infusion-related HSRs.

Contact Hours: 1
CRNI® RUs: 2

Mikaela Olsen, DNP, APRN-CNS, AOCNS®, FAAN

There is a persistent fear of parenteral nutrition (PN) due to a concern for an increase in central line-associated bloodstream infections (CLABSIs). The process of PN dosing, preparation, and administration has changed drastically since its introduction, decreasing many risks associated with this treatment modality. Clinicians must still address concerns of PN-related CLABSIs despite compelling evidence demonstrating that these infections are largely preventable with appropriate PN management and vascular device care. In this session, we will learn about the history of PN, why infection rates were historically elevated compared to other treatment modalities, how infection rates have improved over time, and strategies to administer PN safely.   

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

• Discuss the history and evolution of PN.
• Examine data relating PN use to CLABSIs after implementation of improved processes.
• Describe practices to decrease infections when administering parenteral nutrition.

Contact Hours: 1
CRNI® RUs: 2

Johnathan Voss, PharmD, BCCCP, BCNSP

At a multifacility health system, the vascular access specialty team (VAST) reports up through infection prevention and control and quality. Through collaborative efforts, the VAST has been key to lowering infection rates, including central line associated blood stream infections (CLABSIs). This reduction has been accomplished through modified education, stakeholder meetings, introduction of a de-escalation protocol, and implementation of a device-planning consult. These changes have elevated practice and lead to positive outcomes, including one facility going 12 months CLABSI-free. This unique partnership has created additional opportunities for expansion and elevation of practice. In this session, attendees will learn how to incorporate infection prevention practices into their workflow and how these practices can impact overall outcomes.

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

• Describe the chain of infection.
• List three key infection prevention practices that can be implemented into their workflow.
• Discuss their role in infection prevention.
• Verbalize how they can incorporate vascular access device planning into their program.

Contact Hours: 1
CRNI® RUs: 2

Crystal Heishman, MBA, MSN, RN, ONC, CIC, CRNI®, FAPIC,

Insertion of central venous catheters including peripherally inserted central catheters is a frequent and significant event for children. Unfortunately, timely administration of important medical therapies is frequently disrupted due to central venous catheter (CVC) complications which are often preventable and the result of lack of compliance with best practice. Best practice relating to central venous catheter tip position dictates that upper limb central venous catheter and peripherally inserted central catheter (PICC) tips should be placed in regions where blood flow is greatest and risk of complications such as thrombosis and occlusion are lowest. This interactive presentation will discuss the various modalities for catheter tip confirmation and combine research with clinical practice by using case studies to explore the challenges clinicians face to ensure accurate identification of central tip location, the potential complications associated with suboptimal catheter tip position, and the techniques to remedy displaced catheters.

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

• Understand the importance of accurate tip position in the overall context of central venous access device (CVAD) and outcomes.
• Define appropriate upper and lower limb CVAD tip position.
• Describe the pros and cons of tip confirmation technology to ensure accurate CVAD tip position.
• Understand the published literature including systematic review and meta-analysis in different patient populations and where relevant apply this to their own practice.
• Discuss common challenges during catheter insertion, and how to troubleshoot malpositioned tips.
• Describe complications associated with inappropriate CVAD tip position.

Contact Hours: 1
CRNI® RUs: 2

Tricia Kleidon, MNSc, RN, BNSc,

Intravenous catheters are among the most utilized medical devices in health care, accounting for millions of insertions, maintenance, and access procedures, thereby increasing the risk for infection complications. Information regarding the prevalence and impact of central line-associated bloodstream infections (CLABSIs) raises concerns for patient safety and infection prevention efforts. Recent reports indicate that due to such factors as the COVID-19 pandemic and the Great Resignation of key health care personnel, CLABSI rates increased by 47%, and unfortunately, the incidence of infection associated with other intravascular catheters is unknown because surveillance for non-CLABSI events is not currently mandated under federal regulation. However, the Centers for Medicare and Medicaid Services (CMS) has proposed new rules that will require hospitals to conduct surveillance for all hospital-acquired bacteremia events regardless of medical device use, and thus hospitals will need to assess systems and internal protocols in preparation of pending CMS regulation. Surveillance and subsequent prevention of bacteremia associated with all intravascular catheters will require implementation of new strategies that encompass all strata of health care delivery: leadership support, introduction of a hospital onset bacteremia (HOB) model, diagnostic stewardship, new insights in catheter insertion, patient decolonization, expansion of vascular access teams, and introduction of advanced antimicrobial dressings. During this session, we will explore intravascular catheter use in the United States, CLABSI prevalence and prevention strategies, and new CMS reporting requirements and their implications on health care organizations.

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

• Discuss the main source the mechanism of development of catheter-related BSIs.
• Describe the impact of the Great Resignation and the COVID-19 pandemic on rates of central line-associated bloodstream infections (CLABSIs).
• Discuss the pending national requirements on infection surveillance of all intravascular catheters.
• Evaluate the findings of recent studies on new strategies for the prevention of HOB-BSI.
• Explain the current CLABSI prevention bundle and the actions of chlorhexidine on microorganisms.

Contact Hours: 1
CRNI® RUs: 2

Robert Garcia, MT(ASCP), CIC, FAPIC

The expansion of home infusion therapies, driven by health care trends and accelerated by the pandemic, has heightened the need for home infusion nurses to understand the factors contributing to the safe use of flow-control devices and their role in error prevention. The Infusion Therapy Standards of Practice provides the evidence-based foundation for selecting and safely using flow-control devices across various patient care settings, along with additional standards to support ongoing education and to emphasize important quality considerations for the delivery of home infusion therapy. In this session, key best practices from the updated 2024 Standards are presented as a framework to describe the home infusion nurse's role in ensuring flow-control device safety.

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

• Identify the educational requirements for home infusion nurses to ensure the safe use of flow-control devices.
• Choose appropriate flow-control device(s) for patients in need of home infusion therapies.
• Safely utilize nonelectronic and electronic flow-control devices in a home setting.
• Apply quality control and improvement best practices to enhance the safe use of flow-control devices in a home setting.
• Explain essential educational concepts for teaching patients and/or caregivers in a home care setting.
• Recognize the significance of the home infusion nurse's role in ensuring flow-control device safety.

Contact Hours: 1
CRNI® RUs: 2

Amy Kyes, MSN, APRN, CRNI®, CV-BC, AGCNS-BC