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The practice of home infusion therapy continues to grow with an expanding base of research to guide practice. Recognizing this, a new Standard, Home Infusion Therapy, was added to the 2024 Infusion Therapy Standards of Practice. This new Standard provides guidance for safe transitioning of patients to home infusion and safe practices for a variety of home infusion therapies. This Standard also addresses patient education and ongoing monitoring. In this session, we will detail this new Standard as well as how to incorporate guidance from additional Standards with applicability to home infusion therapy.

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

• Summarize patient-related and organizational factors to be considered when planning for home infusion.
• Examine environmental safety issues that potentially impact the plan for home care.
• Evaluate benefits, issues, and risks associated with the various categories of infusion therapies that can be administered in the home.
• Identify important aspects of patient assessment and ongoing monitoring.
• Recognize the importance of patient/caregiver education and support as critical to safe home infusion therapy. 

Contact Hours: 1
CRNI® RUs: 2

The major shift to the use of peripheral vascular access devices (PVADs) to avoid central line-associated blood stream infections (CLABSIs) has created major patient safety challenges.   Administration of medications inappropriate for peripheral administration, disregard for catheter-to-vein ratio, and repeated replacement of failed catheters is supposedly tolerated as a trade-off for CLABSI reduction. However, CLABSI rates have increased while PVAD bloodstream infection (BSI) rates are nearly equivalent to CLABSI rates, and at the same time, thrombotic events have increased with the loss of peripheral vasculature. Can we improve on these outcomes? The peripheral midclavicular catheter with the tip positioned at the juncture of the axillary and subclavian vein was abandoned in the mid-1990s due to a perceived increase in catheter-related venous thrombosis. More recently, global experience with catheter tip position in the proximal axillary vein and distal subclavian vein has demonstrated improved outcomes compared to other peripheral catheters. What are the differences in practice and evidence on PVADs from the time of the INS and AVA position statements until now? In this session, we will examine the differences in outcomes among PVADs, specifically midclavicular (midline) and midline (mini-midline) catheter tip positions as well as discuss implementation of the midclavicular catheter.

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

• Describe the flow dynamics, anatomical differences, and complications between superficial upper extremity veins, deep basilic or brachial vein, axillary, and subclavian catheter tip positions.
• Explain the appropriate selection and complication risk between PVAD catheter tip positions.  
• Discuss a process for implementation of midclavicular catheters into clinical practice: continuous quality improvement.

Contact Hours: 1
CRNI® RUs: 2

Quality improvement (QI) in vascular access, infusion practices, and overall patient experience is best achieved through a multidisciplinary approach, using both internal and external expertise. In this session, we will discuss how a large community hospital successfully included representation from the industry on QI efforts, including product representatives, clinicians, administrators, and research and development teams. Teams met directly at the bedside, assessing the patient’s current vascular access status, including site assessment, dressing assessment, and administration set management, and discussing with the patient and staff any complications. Data was then documented and aggregated to identifying priorities for improvement and shared with internal stakeholders. This session will describe how building relationships between the hospital and industry partners and working together to optimize device performance and patient outcomes provides a powerful opportunity for both parties to enhance their practice.  

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

• Describe how multidisciplinary rounds can be expanded to include stakeholders outside of the organization, including industry representation.
• Discuss a framework where expertise can be shared to optimize collaboration and address organization priorities.
• Explain key metrics assessed and how data is communicated to facilitate improvements.

Contact Hours: 1
CRNI® RUs: 2

Aseptic Non Touch Technique (ANTT®) is a defined term that includes a clinical practice framework that should be used for all invasive procedures. Nurses Stephen Rowley and Simon Clare developed this framework based on evidence-based principles of effective hand hygiene, appropriate infection control precautions, nontouch technique for all procedures, and the concept that key parts and key sites must only touch other aseptic key parts and key sites. It is important to reiterate that ANTT® is designed and used for all invasive procedures, from major surgery to the simple maintenance of indwelling medical devices. The principles of the ANTT® practice framework incorporate two approaches to maintaining asepsis and include a simple risk assessment for determining the most appropriate approach. This session will discuss how to apply this practice framework in unique settings, including in a person's home, in the field, or when working with those who are unsuitably housed.

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

• Define Aseptic Non Touch Technique.
• Discuss challenges in maintaining aseptic technique in unique settings.
• Debate the use of standard versus surgical ANTT® in a home setting.
• Differentiate key parts and key sites.
• Identify challenges in incorporating ANTT® outside of acute care settings.
• Debunk myths regarding sterile technique, medical asepsis, and other terms used over the past decades.

Contact Hours: 1
CRNI® RUs: 2

Safe and reliable vascular access serves as the cornerstone for medication administration and the regular monitoring of patients in modern health care. However, despite their ubiquity and necessity, vascular access devices are not without risks or complications. Various strategies have been employed to prevent or mitigate intravenous catheter-related complications, including optimizing patency through continuous infusion or intermittent flushes with normal saline, heparin, antibiotics, and/or ethanol locks; less frequent catheter and infusion set changes; the use of in-line filters; and the establishment of designated intravenous therapy teams. Despite these interventions, peripheral intravenous catheters exhibit a failure rate of 20–69% due to occlusion, while central venous catheters' failure rate due to occlusion ranges from 15% to 66%, depending on the type of device, the clinical setting, and the patient population. Repeated catheter insertions necessitated by failed catheters result in multiple penetrations of the skin barrier, increased patient discomfort, extended staff time, and an elevated risk of infection from skin commensals. Such infections can be life-threatening for chronically and critically ill patients. Therefore, methods capable of prolonging the viability of both peripheral and central venous catheters hold significant potential for improving patient outcomes and the quality of care provided by health care organizations. This presentation will delve into current research on the risk and prevalence of complications associated with vascular access devices as well as the current evidence pertaining to flushing, locking, and occlusion management.

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

1. Understand the risks associated with vascular access insertion and utilization.
2. Identify the contributing factors to vascular access device occlusion and failure.
3. Describe current practices and available products used to mitigate the risks of vascular access occlusion and failure.

Contact Hours: 1
CRNI® RUs: 2

Sepsis is a medical emergency that is often challenging to diagnose. During this session we will discuss what sepsis really is, how to treat it, and how vascular access and infusion nurses can make a difference in the lives of septic patients. At the end of the session, attendees will be able to create possible solutions to meet standards of care for the septic patient.  

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

• Describe sepsis and the sepsis 3- and 6-hour bundles.
• Discuss why sepsis care is important.
• Explain how the vascular access and infusion nurse can help patients combat sepsis.
• Apply knowledge about sepsis care to create possible solutions to treat septic patients. 

Contact Hours: 1
CRNI® RUs: 2

This session will describe the development process and outcomes of a pilot program to broaden the vascular access skills of bedside nursing staff to include phlebotomy. It will discuss relevance for this practice, recommended support for this practice, and implementing evidence-based practice. Additional discussion in this session will include outcome monitoring and working through identified barriers to the program.

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

• Describe the value of specialty training for bedside nursing staff to perform ultrasound-guided IV insertion and phlebotomy. 
• Discuss the process for program development and outcomes monitoring.
• Recognize potential barriers to implementation and sustainability.

Contact Hours: 1
CRNI® RUs: 2

Vascular access contains inherent risks. Some complications of access are minor, but others are limb- or life-threatening. Infusion nurses need an understanding of the pathophysiology behind serious adverse vascular access complications to appropriately prevent or respond to these emergencies. In this session, we will review the most serious vascular access emergencies and prepare nurses to respond when every second matters.  

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

• Describe the pathophysiology of 4 vascular access emergencies.
• Identify an imminent or evolving vascular access emergency.
• Anticipate appropriate interventions for 4 vascular access emergencies.

Contact Hours: 1
CRNI® RUs: 2

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