Learning Center

Selecting the safest and most appropriate device for patients with cancer remains a challenge in health care. While various devices are available, the best way to match a device to a patient’s anatomy, cancer type, and chemotherapy regimen is unclear. To address this gap, the HMS Collaborative has developed the Michigan Appropriateness Guide for Intravenous Catheters – Oncology (MAGIC*Oncology). These guidelines are developed using the RAND/UCLA Appropriateness Method (RAM) that was used to develop the original MAGIC criteria, which are now in use in hundreds of hospitals in the United States and the world. This session will describe the rationale and development of MAGIC Oncology, key findings and recommendations, and how these guidelines can be used to inform practice.

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

• Describe practice patterns (from a statewide multihospital collaborative) related to the use of vascular access devices in patients hospitalized with cancer and/or for cancer-related treatments;

• Describe the risk of vascular access device-related adverse events in patients hospitalized with cancer and/or for cancer-related treatment;

• Identify appropriate use of vascular access devices in patients hospitalized with cancer and/or for cancer-related treatments

Contact Hours: 1
CRNI® RUs: 2

Vineet Chopra

While patient and caregiver education are important in all health care settings, effective patient education is essential to the safety of home infusion therapy. According to the Gorski Model for Safe Home Infusion Therapy, patient education is 1 of the 5 critical aspects of care that impact patient outcomes. Experienced nurses transitioning to home care may feel confident in their ability to administer infusions and care for vascular access devices. However, they soon realize that while technical skills in infusion therapy are essential, the ability to educate patients and caregivers to perform these procedures is equally vital. This presentation will explore current evidence supporting the development of patient educational plans, barriers and facilitators affecting readiness and ability to learn, and effective teaching strategies, including the use of technology. Available patient educational resources will be highlighted. 

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

• Identify the impact of patient education upon the home infusion therapy outcomes.    

• Summarize barriers and facilitators to learning home infusion therapy procedures    

• Develop effective educational plans considering content, home visit frequency, and alternative strategies to provide patient/caregiver support    

• Identify available educational resources

Contact Hours: 1
CRNI® RUs: 2

Lisa Gorski, MS, RN, HHCNS-BC, CRNI®, FAAN

As our chronically ill patient population grows, so do the challenges for short- and long-term vascular access. This session will address the indications and contraindications, as well as the advantages and disadvantages of vascular access via the femoral vein approach. A literature review will be presented demonstrating the significant growth in use of this site as well as the data proving its safety and efficacy. From phlebotomy to midline, peripherally inserted central catheter (PICC) to tunneled centrally inserted central catheter (CICC), ultrasound to electrocardiogram (ECG) tip confirmation, femoral access will be examined from the neonatal to the adult patient population.

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

• Understand and interpret 3 different methods to confirm lower extremity central venous catheter terminal tip position: Radiograph, ECG, and Ultrasound    

• Discuss 3 ultrasound-guided approaches to femoral venous cannulation: peripheral intravenous (PIV) cannulation, Seldinger, and micropuncture with modified Seldinger technique    

• Upon completion, participants will be able to share the indications and contraindications, and advantages and disadvantages of the femoral approach

Contact Hours: 1
CRNI® RUs: 2

Matthew Ostroff, MSN, VA-BC

This session will explore best practices for administering immunoglobulin (Ig) replacement therapy, covering various Ig products available, and delineate the differences between subcutaneous immunoglobulin (SCIG), intravenous immunoglobulin (IVIG), and facilitated SCIG. Additionally, approved indications for Ig therapy will be reviewed.

The focus will then shift to nursing considerations and best practices for managing patients receiving Ig therapy. The objective of this session is to educate infusion nurses on the technical aspects of Ig therapy and emphasize the importance of enhancing patient tolerability to foster a positive infusion experience. Fostering a positive infusion experience is essential, as immunoglobulin therapy is a long-term treatment, and adherence to this regimen directly influences the patient’s overall clinical outcomes.

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

• Describe current Ig indications and how Ig can be infused through a highly technical infusion requiring knowledgeable nurses to provide a good infusion experience for the patient     

• Discuss black box warnings associated with Ig products, common adverse drug reactions, how to minimize the risk of adverse drug reactions (ADRs) during and after infusions, and how to treat ADRs if they do occur  

• Explain the importance of technical aspects of Ig infusion, risks associated with Ig therapy, diligent monitoring of patient tolerability during the infusion (vital signs, physical assessment, questioning the patient), obtaining a full medical and medication history from the patient, the importance of patient education regarding potential serious ADRs and how to respond, as well as their disease state

Contact Hours: 1
CRNI® RUs: 2

Suzanne Strasters, MSN-FNP, IgCN

This session builds on the recently published guidance document, Standards of Care for Peripheral Intravenous Catheters: Evidence-Based Expert Consensus to address 3 crucial domains of peripheral intravenous catheters (PIVC) practice: pain reduction and comfort strategies, maximizing first insertion success, and removal and replacement only when clinically necessary. Translating evidence into practical implementation, this session offers health care providers actionable insights for improving patient comfort and reducing complications during PIVC insertion and management.

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

• Discuss new literature titled, Standards of Care for Peripheral Intravenous Catheters: Evidence-Based Expert Consensus, and how it serves as additional guidance to the INS Infusion Therapy Standards of Practice     

• Implement strategies for escalating care in cases of difficult intravenous access (DIVA) to ensure optimal PIVC insertion success    

• Train clinicians to apply evidence-based pain management techniques during PIVC insertion and removal to enhance patient comfort and procedural success    

• Develop and apply clinical protocols for the removal and replacement of PIVCs, ensuring adherence to evidence-based guidelines and minimizing unnecessary replacements

Contact Hours: 1
CRNI® RUs: 2

Marlene Steinheiser, PhD, RN, CRNI®

Taryn Lee, DNP, APRN, FNP-C, CRNI®, VA-BC, CPHRM

According to the National Institute for Occupational Safety and Health, over 8.5 million United States health care workers are potentially exposed to hazardous drugs annually, including antineoplastic drugs, which are increasingly used to treat nonmalignant conditions. Therefore, safe handling of these drugs is a critical issue. Exposed health care workers are at increased risk for adverse health effects, including nausea and vomiting, alopecia, damage to organs and organ systems, adverse birth outcomes, and even cancer. Evidence of health care worker exposure to hazardous drugs has increased since the 1970s, despite improvement in policies and practices. In this session, the current evidence-based recommendations for practice, with a focus on USP 800 and the 4th edition of Safe Handling of Hazardous Drugs, published in 2024 by the Oncology Nursing Society, will be discussed.

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

• Review the health risks for nurses associated with handling hazardous drugs and the types of drugs that have hazardous potential   

• Describe at least 3 national standards for the safe handling of hazardous drugs    

• Identify barriers to nursing compliance with safe handling standards and strategies to overcome these barriers

Contact Hours: 1
CRNI® RUs: 2

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

The Joint Commission and other accreditation bodies note that knowledge deficits and lack of clinical competency are contributing factors in patient safety errors. Studies from the Institute of Medicine (IOM) have demonstrated that specialty certified nurses have higher rates of patient satisfaction in addition to lower rates of work-related patient care errors. As the delivery of health care has become increasingly complex, in addition to new technologies introduced in clinical practice, it is understandable that Americans prefer organizations that employ competent and certified clinicians. Competency is critical in the day-to-day tasks performed. Being accountable and responsible is the individual’s “job” to provide safe, effective patient care. The INS Standard for competency and competency assessment is to ensure patient safety and public protection. In addition, it is to ensure that clinicians meet licensing requirements and core competencies according to the clinician’s profession.

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

• Discuss competency versus certification    

• Discuss barriers to certification    

• Describe the ways certification demonstrates expertise to patients, colleagues, and employers

Contact Hours: 1
CRNI® RUs: 2

Kathy Puglise, MSN, CRNI®

Felicia Schaps, MSN-Ed, RN, CRNI®, OCN®, CNSC, lgCN, VA-BC

The use of IVSPs is associated with increased cognitive workload for nurses, usability errors due to poor system design, and flow-related medication errors that are difficult to detect at the point-of-care. The presenters will review results from their large body of research on IVSP usability and describe causes and mitigation strategies for many known issues related to flow rate accuracy. Several real-world, case study examples will be used to clearly illustrate related concepts within the context of nursing practice and patient safety. This session will review the evidence related to IVSP usability and accuracy, including a discussion of implications for nursing workflow and patient care.

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

• Understand common sources of errors related to IVSP use    

• Discuss the issue of flow rate accuracy and the implications of inaccurate flow rates    

• Employ critical thinking strategies to improve patient safety when using IVSPs

Contact Hours: 1
CRNI® RUs: 2

Jeannine W.C. Blake, PhD, RN

Karen Giuliano, PhD, RN

Within the complex and unique roles of the inpatient pharmacist and the bedside registered nurse, significant areas of shared responsibility exist in the realm of infusion therapy. Collaboration is crucial to optimize patient outcomes in areas such as extravasation prevention and management, dose accuracy, and medication preparation. This session will use a case study approach to review innovative application of the Infusion Nurses Society’s Infusion Therapy Standards of Practice to optimize infusion-related patient outcomes through pharmacy-nursing collaboration.

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

• Describe the impact of effective interdisciplinary collaboration on patient outcomes    

• Identify barriers to effective interdisciplinary collaboration    

• Discuss best practices for pharmacy/nursing collaboration in case studies, including extravasation, dose accuracy, and medication preparation

Contact Hours: 1
CRNI® RUs: 2

Barb Nickel, APRN-CNS, CCRN, CRNI®

Scott Murray, RPh, PharmD