Agency, staff reap rewards and benefits of CRNI

By Kay Coulter, CRNI

Owner, Coulter Consulting

Clearwater, FL

Infusion therapy has enjoyed rapid expansion in today’s health care market. Many patients are discharged home for long-term infusion of medications or solutions. But are most of today’s health care providers knowledgeable and competent to deliver these therapies?

It is often assumed that specific infusion therapy knowledge is provided in general nursing education programs, but this is not always the case. Some nursing programs do provide procedure-specific information and instruction, but very few provide in-depth, comprehensive coverage of current infusion practices. Existing community-based, continuing education, and college programs provide limited and variable education specific to infusion therapy.

Need for infusion therapists on the rise

The procedures of venipuncture and the infusion of medications and solutions have been fairly common in modern health care since the early part of the 20th Century. Today, most health care practitioners recognize infusion therapy as a specialty with a requirement for the clinician to possess advanced skills, knowledge, and expertise.

As medical technology rockets forward and increasing numbers of our world’s population require this high-tech care, there will be a sharp increase in the need for specialized infusion therapists or Certified Registered Nurse in Intravenous Therapy (CRNI).

The CRNI credentialing exam is offered in May and September by the Intravenous Nurses Society’s Credentialing Corporation. As of February 1997, there were 3,400 CRNIs nationwide.

Employers seek CRNIs for many reasons. Staff nurses are typically not widely versed in venous access devices and equipment such as pumps and delivery systems. This can lead to the access device being compromised and increase the risk for infection or other complications.

Multiple insertion attempts can harm

Also, a nurse who is not exceptionally proficient with peripheral access can harm a patient by multiple insertion attempts. On the other hand, a CRNI has had in-depth study and review in anatomy and physiology, principles of infection control, and the techniques of access so there is a much greater chance the CRNI will do the procedure safely, and proficiently in fewer attempts. This advanced knowledge specific to infusion therapies results in numerous benefits to the agency, such as:

Decreased exposure to liability.

CRNIs know to document the teaching done to the patient, along with the patient’s comprehension and compliance or noncompliance. A major piece of information that can potentially protect a nurse or agency from legal liability is through clear, concise documentation of patient education.

Improved customer satisfaction.

Because a CRNI will in all likelihood have a much higher proficiency than a staff nurse, a patient will have less trauma through fewer insertion attempts.

Decreased infusion-related complications.

The increased proficiency and equipment knowledge can reduce sepsis.

A reduced cost of delivery.

The number of nursing visits can be greatly reduced through the use of CRNIs, who are comfortable with the concept of placing long-dwell devices, such as midlines and peripherally inserted central catheters (PICCs). A PICC line used on a six-week antibiotic patient can save hundreds of dollars over a site that must be rotated every two days.

Get the market edge

A combination of the above benefits can give organizations and institutions an obvious edge in the market place for infusion-specific patients, particularly in the rapidly developing managed care environment of closely monitoring costs and patient outcomes.

Nurses also benefit from CRNI status in multiple ways, such as expanded practice opportunities, verified credibility, and an increased comfort level in a high-tech practice.

Certification is voluntary, but it increases responsibility. Many nurses seek CRNI status for professional and personal satisfaction, while others become CRNIs to honor employers’ requests.

Obtaining any certification will increase the nurse’s confidence, skill level, and marketability. The growth of infusion therapy practice and the resulting need for qualified infusion therapists in all care settings will provide most CRNIs with job security.

Candidates who wish to prepare for the exam may resource infusion therapy textbooks, Intravenous Nurses Society videos, attend a two-day CRNI review course, or obtain review audio cassettes and a corresponding workbook. For information on the CRNI exam, contact the Intravenous Nurses Society at (617) 441-3008.