HealthFebruary 21, 2024

Trends, challenges, rewards, and pathways in infusion nursing: Navigating the current landscape

By: Cora Vizcarra, MBA, RN, CRNI, VA-BC
Nursing is evolving. From new technologies and medications to new challenges, infusion therapy also has changed. In this Q&A, Cora Vizcarra, MBA, RN, CRNI, VA-BC, author of the new 5th Edition of Core Curriculum for Infusion Nursing, discusses the challenges and opportunities of infusion nursing.

Q: What are current trends in infusion nursing/therapy?

Innovations in products and technologies are ongoing trends in infusion therapy; from the use of smart infusion pumps with features that can help the infusion nurse prevent medication errors during medication administration to the latest guidance technologies that allow the infusion nurse to select the appropriate vessel and successfully insert vascular access devices in patients receiving infusion therapy.

The ongoing shift in care from hospitals to outpatient and in-home infusion settings continues to be a trend. An aging U.S. population, increase in chronic diseases, the emergence of novel treatments for cancer, the development of biologics, and the surge in new Coronavirus strains contribute to the growth and expansion of the infusion therapy market. The need for highly skilled infusion nurses in various infusion care settings will increase to meet the growing demand.

Infusion nursing has evolved from needing only excellent IV insertion skills to being a nursing specialty requiring not only excellent insertion skills but also assessment skills, clinical knowledge, and competence to deliver complex therapies. Any registered nurse who inserts and administers medications and fluids through an intravenous access such as a peripheral intravenous catheter (PIVC), central vascular access device (CVAD), or implanted ports might be referred to as an “infusion nurse” by patients receiving infusion therapy and their families. However, not all infusion nurses are equal. Today, this specialization requires skills and competence often recognized through certifications such as the CRNI®, the specialty certification for infusion nurses offered by the Infusion Nurses Certification Corporation (INCC).

The trend towards evidence-based practice is most apparent in the Infusion Therapy Standards of Practice published by the Infusion Nurses Society (INS). The comprehensive nature of infusion therapy, including care delivery to all patient populations in all care settings, eliminating complications, promoting vein preservation, and ensuring patient satisfaction commands support for clinicians responsible for the patient outcomes. Adhering to the standards and integrating the best evidence into practice will achieve the best clinical outcomes.

The trend towards evidence-based practice is most apparent in the Infusion Therapy Standards of Practice published by the Infusion Nurses Society (INS). The comprehensive nature of infusion therapy, including care delivery to all patient populations in all care settings, eliminating complications, promoting vein preservation, and ensuring patient satisfaction commands support for clinicians responsible for the patient outcomes.
Cora Vizcarra
Sample: Core Curriculum For Infusion Nursing

Q: What challenges do you see in infusion nursing?

The use of innovative products and advanced technology in the practice of infusion nursing has improved workload efficiency, prevented medication errors, improved patient safety, and promoted good outcomes. However, some of the challenges for infusion nurses are:

A. The occasional steep learning curve when it comes to new equipment or technology; resistance to quickly changing technology; and changes to their workflow and routine. Not all nurses learn or adapt to change at the same rate.

B. The never-ending struggle with infusion product supply shortages and drug recalls caused by manufacturing, economic, and environmental factors, all of which were aggravated by the COVID-19 pandemic. Products commonly used by infusion nurses experienced shortages such as 0.9% Sodium Chloride IV fluid bags, prefilled saline syringes, sterile water for injection, drugs like multivitamins (MVI) and epinephrine; as well as personal protective equipment (PPE) especially during the pandemic. Organizations have developed lists and guidelines on managing shortages and alternatives to help clinicians provide uninterrupted care.

C. Integration of infusion devices to the organization’s system that allow patients to be monitored remotely and allow for the extraction of therapy data via a mobile or web app means cybersecurity is a concern. With the increasing use and reliance on these devices, it is important to ensure that the device and software updates maintain previous functionality and security and conform to the latest in cybersecurity.

Establishing and maintaining competency with the rapidly evolving infusion therapy treatments and medications is another challenge. The medication pipeline is full of new biologics and other specialty infusion drugs that are rapidly released into the market. Advancements in cancer treatments and chronic diseases require the administration of complex treatments to patients who already have complex medical needs. This requires ongoing education and vigilance to stay up to date on medication administration guidelines, adverse reactions, and contraindications.

Infusion nursing is not immune to staffing shortages, staff reduction, and team elimination due to budget cuts. The value of a highly specialized team of skilled, experienced nurses is always closely scrutinized by any healthcare organization, particularly during budget cuts. In some infusion organizations, non-professional healthcare providers are replacing infusion nurses to administer complex infusion therapies. It is important to show the evidence — recognize and document the positive impact of infusion nurses on reduction or elimination of complications, positive patient outcomes, and satisfaction.

Q: What do you find the most rewarding as an infusion nurse?

For me, as an infusion nurse in an outpatient setting and physician's office, one of the most rewarding aspects is the successful placement of vascular access devices safely and effectively, particularly in challenging patients such as those with difficult intravenous access — the older adults, pediatric patients, or those with obesity. These patients would have not been able to receive their infusions if reliable venous access had not been established. As an infusion nurse consultant and educator, I provide education and training to infusion nurses and infusion organizations to ensure standards of care are followed.

While administering infusions or treatments, working closely with patients and their families provides opportunities to educate patients about their illness so they can better cope with it and manage any treatment side effects, and to be their advocate. A delicate balance is needed as the trust relationship evolves and emotional support is needed when patients experience treatment setbacks or death.

Many say that one of the perks of infusion nursing is that infusion nurses work traditional work hours; however, it all depends on the practice setting. While this could be true for those who work in ambulatory/outpatient settings or physicians’ offices, it may not be true for those who work in hospital settings or home infusion. The various infusion practice settings allow the infusion nurse the flexibility to work and apply their skills and knowledge to whatever practice setting they prefer.

Q: What words of advice would you give to nursing students interested in infusion nursing?

Infusion therapy and vascular access are not routinely included in the nursing school academic curriculum, so nursing students are unprepared and lack the knowledge and skills of basic infusion therapy. Only a handful of nursing schools offer infusion therapy and vascular access in their curriculum. To bridge this gap, employers and other organizations offer infusion therapy and vascular access courses with hands-on workshops for nursing students and other registered nurses. Take advantage of this educational program to enhance your knowledge and skills as you begin your journey as a new registered nurse.

Work as a registered nurse in general patient care areas or intensive care to get nursing care experience and clinical knowledge that will serve as a foundation for working as an infusion nurse. If there are infusion-related departments such as outpatient infusion, oncology infusion centers, and home infusion, seek an opportunity to work in that area to improve your clinical assessment, medication administration, vascular access placement skills, and complication management.

Next, if you’re eligible, seek certification in infusion nursing. There are resources available to prepare for the certification exam, such as the Core Curriculum for Infusion Nursing book. The CRNI® certification, the only one in infusion nursing, validates the knowledge and skills of infusion nurses and designates them as experts in infusion nursing.

Generation Z is entering the nursing workforce. They are active, tech-savvy, used to getting quick answers, and have never known life without the internet, and easily adjust to the technological advancements in vascular access placement. However, there are experiences and skills you get only from real-life patient care. My advice to our younger colleagues is, don’t just watch an online video and then insert an IV. What will set you apart is learning from the experts and doing it “right from the start.”

Explore Lippincott® Nursing Education
Cora Vizcarra headshot
Cora Vizcarra, MBA, RN, CRNI, VA-BC
Clinical Educator and Infusion Nurse Consultant, IVSyntrix
Cora Vizcarra was the president of the Infusion Nurses Society in 2008--09. With over 40 years of experience in infusion therapy and vascular access, She has published in medical, nursing journals & textbooks, and is the author of the online blog – She serves on numerous nursing and medical advisory committees as an infusion therapy specialist. An international nurse speaker, she currently is a clinical educator and infusion nurse consultant for IVSyntrix.
Back To Top