Core Curriculum for Infusion Nursing: An Official Publication of the Infusion Nurses Society PDF
Preview Core Curriculum for Infusion Nursing: An Official Publication of the Infusion Nurses Society
(c) 2015 Wolters Kluwer. All Rights Reserved. Core Curriculum for Infusion Nursing FOURTH EDITION (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_fm_pi-xii.indd 1 21/03/13 4:04 PM FOURTH EDITION Core Curriculum for Infusion Nursing INFUSION NURSES SOCIETY NORWOOD, MASSACHUSETTS E D I T O R S Editor-in-Chief Mary Alexander, MA, RN, CRNI®, CAE, FAAN Chief Executive Officer Infusion Nurses Society Norwood, MA Editors Ann Corrigan, MS, BSN, RN, CRNI® Customer Account Manager PackRoom, LLC Stone Mountain, GA Lisa A. Gorski, MS, HHCNS-BC, CRNI®, FAAN Clinical Nurse Specialist Wheaton Franciscan Home Health & Hospice Milwaukee, WI Lynn Phillips, MSN, RN, CRNI® Professor Emeritus, Butte College Nursing Education Consultant Chico, CA (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_fm_pi-xii.indd 3 21/03/13 4:04 PM Acquisitions Editor: Shannon Magee Developmental Editor: Leslie H. Nicoll Product Manager: Ashley Fischer Production Project Manager: Marian Bellus Design: Holly Reid Mclaughlin Manufacturing Manager: Beth Welsh Production Services: Integra Software Services Pvt. Ltd. Printer: RR Donnelley Asia 4th Edition Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Two Commerce Square 2001 Market Street Philadelphia, PA 19103 Copyright © 2004, 2000 by Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means—electronic, mechanical, photocopy, recording, or otherwise—without prior written permission of the publisher, except for brief quotations embodied in critical articles and reviews and testing and evaluation materials provided by the publisher to instructors whose schools have adopted its accompanying textbook. Printed in the United States of America. For information write Lippincott Williams & Wilkins, 530 Walnut Street, Philadelphia, PA 19106. Materials appearing in this book prepared by individuals as part of their official duties as U.S. G overnment employees are not covered by the above-mentioned copyright. 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in Publication Data Core curriculum for infusion nursing / Infusion Nurses Society ; editor-in-chief, Mary A lexander ; editors, Ann Corrigan, Lisa A. Gorski, Lynn Phillips. — Fourth edition. p. ; cm. Infusion nursing Includes bibliographical references and index. ISBN 978-1-4511-8409-9 I. Alexander, Mary, 1955- editor of compilation. II. Corrigan, Ann, 1948- editor of compilation. III. Gorski, Lisa A., editor of compilation. IV. Phillips, Lynn Dianne, 1947- editor of compilation. V. Infusion Nurses Society, issuing body. VI. Title: Infusion nursing. [DNLM: 1. Infusions, Parenteral—nursing—Outlines. 2. Fluid Therapy—nursing—O utlines. 3. Parenteral Nutrition—nursing—Outlines. WY 18.2] RM170 615.8’55—dc23 2013007057 Care has been taken to confirm the accuracy of the information presented and to describe g enerally accepted practices. However, the authors, editors, and publisher are not r esponsible for errors or omissions or for any consequences from application of the i nformation in this book and make no warranty, express or implied, with respect to the content of the publication. The authors, editors, and publisher have exerted every effort to ensure that drug se lection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly i mportant when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in his or her clinical practice. (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_fm_pi-xii.indd 4 21/03/13 4:04 PM Contributors Chapter 1: Technical And Clinical Chapter 3: Pharmacology Application Michelle S. Turner, Pharm. D., BCPS Mary Alexander, MA, RN, CRNI®, Clinical Pharmacist CAE, FAAN Cone Health—The Moses H. Cone Memorial Chief Executive Officer Hospital Infusion Nurses Society Greensboro, North Carolina Norwood, Massachusetts Susan K. Poole, MS, BSN, RN, CRNI®, CNSNCIC Lisa A. Gorski, MS, HHCNS-BC, Principal CRNI®, FAAN Southwest Horizons Consulting Clinical Nurse Specialist Peoria, Arizona Wheaton Franciscan Home Health & Hospice Chapter 4: Infection Prevention Milwaukee, Wisconsin Mary McGoldrick, MS, RN, CRNI® Home Care and Hospice Consultant Ann Corrigan, MS, BSN, RN, CRNI® Home Health Systems, Inc. Customer Account Manager Saint Simons Island, Georgia PackRoom, LLC Stone Mountain, Georgia Chapter 5: Pediatrics Darcy Doellman, MSN, RN, CRNI®, VA-BC Melody Bullock, MS, BSN, RN, CRNI® Vascular Access Nurse Assistant Director Pediatrics and PICU Cincinnati Children’s Hospital Medical Center Cone Health System Cincinnati, Ohio Greensboro, North Carolina Chapter 6: Transfusion Therapy Alicia Dickenson, RN, CRNI® Deb Richardson, MS, RN, CNS Staff Nurse Vascular Access Consultant & Educator Tuality Healthcare President/Owner—Deb Richardson & Associates Hillsboro, Oregon Houston, Texas Ann Earhart, MSN, RN, ACNS-BC, CRNI® Chapter 7: Antineoplastic And Biologic Clinical Nurse Specialist-Vascular Therapy Access/Infusion Therapy Lynn M. Czaplewski, MS, RN, ACNS-BC, Banner Good Samaritan Medical Center CRNI®, AOCNS® Phoenix, Arizona Oncology Clinical Nurse Specialist Columbia St. Mary’s Hospital Chapter 2: Fluid and Electrolyte Milwaukee, Wisconsin Balance Lynn Phillips, MSN, RN, CRNI® Cora Vizcarra, MBA, RN, CRNI® Professor Emeritus, Butte College President/CEO Nursing Education Consultant MCV & Associates Healthcare, Inc. Chico, California Indianapolis, Indiana v (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_fm_pi-xii.indd 5 21/03/13 4:04 PM vi C o n t r i b u t o r s Chapter 8: Parenteral Nutrition Chapter 9: Quality Improvement Elizabeth Krzywda, MSN, APNP Grace Fletcher, MSN, RN, CRNI®, CPHQ Nurse Practitioner Director of Quality Assurance and Regulatory Medical College of Wisconsin Compliance Milwaukee, Wisconsin Vital Care, Inc. Meridian, Mississippi Doug Meyer, RPh, MBA, BCNSP Assistant Dean for Student Affairs and Assistant Professor Pacific University School of Pharmacy Hillsboro, Oregon (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_fm_pi-xii.indd 6 21/03/13 4:04 PM Preface Recognized as the global authority in infusion therapy, the Infusion Nurses Society (INS) is dedi- cated to exceeding the public’s expectations of excellence by setting the standard for infusion care. We set the standard by developing and disseminating standards of practice, advancing the specialty through evidence-based practice and research, and supporting professional certification. The Core Curriculum for Infusion Nursing is an example of our commitment to education and certification. It is designed for use as a comprehensive, preparatory resource for clinicians taking the Certified Registered Nurse Infusion (CRNI®) exam administered through our sister organiza- tion, the Infusion Nurses Certification Corporation (INCC), and as a framework from which infusion-related educational programs and courses can be developed. With the current changes in health care in general and nursing in particular, it is imperative that the information contained within the Core Curriculum is accurate and current. Historically, there have been nine major domains of practice identified as content categories. While the format of this edition of the Core Curriculum still has nine core content areas, INCC has made two changes. As a result of feedback received from a recent role delineation study, there will be eight content categories and a new domain “Special Populations” will replace “Pediatrics.” The Pediatrics category was broadened to reflect the current practice and will be included in the Special Populations category along with topics related to older adults and pregnancy. INCC conducts role delineation studies approximately every five years to survey infusion nurs- es about their practice, and update the examination detailed content outline (DCO) to reflect cur- rent practice. In the most recent role delineation study, completed in 2012, the Role Delineation Advisory Committee (RDAC) discussed whether the performance improvement topics and tasks should remain as a freestanding content category on the outline or be integrated throughout the outline. On the survey, eight topics were listed within the performance improvement domain, and those topics were rated by the survey respondents as significant to practice. Following discussion, the RDAC decided to drop “Performance Improvement” as a separate content category in favor of including items on performance improvement throughout the DCO to better reflect infusion nursing practice. Although not listed as a separate domain, the RN Examination Council will ensure that five to ten percent of the examination will cover performance improvement. The goal of this revised edition of the Core Curriculum is to provide information related to new technological advances and the expansion of the specialty practice of infusion nursing. The information contained in each chapter provides a basis for the development of test questions for the CRNI® exam. In addition, a bibliography is supplied to provide the nurse with additional resources. The content of this publication is also suited for those seeking continuing education and professional development opportunities while providing a broader understanding of the spe- cialty practice. Whether it is in preparation to take the CRNI® exam or to expand one’s knowledge base of the specialty practice, the Core Curriculum for Infusion Nursing is an invaluable resource. Certification, coupled with life-long learning, will enhance the fundamentals of nursing practice so that compe- tent clinicians are delivering the safe, efficient, quality care that our patients deserve. Mary Alexander, MA, RN, CRNI®, CAE, FAAN Editor-in-Chief vii (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_fm_pi-xii.indd 7 21/03/13 4:04 PM Acknowledgments INS recognizes the significance that the certification serves for the specialty practice of infusion nursing. Hence, providing reliable resources for potential exam candidates is critical for their suc- cess. Without our clinical editors and contributors, INS would not have been able to revise the Core Curriculum for Infusion Nursing, 4th edition. I thank the authors for their thoughtful reviews and revisions. I appreciate their time, commit- ment, and contributions made to revise this edition of the Core. I am especially grateful to the Core’s clinical editors, Ann Corrigan, Lisa Gorski, and Lynn Phil- lips. At every phase of the revision process, they supported each contributor. As accomplished authors themselves, their knowledge and expertise were invaluable as we completed this project. Lastly, I thank the Wolters Kluwer Health—Lippincott Wilkins & Wilkins staff for their profes- sionalism and skill in improving this work. Of note, I’d like to recognize Leslie Nicoll, Develop- mental Editor, for her assistance with chapter reviews. Mary Alexander, MA, RN, CRNI®, CAE, FAAN Editor-in-Chief ix (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_fm_pi-xii.indd 9 21/03/13 4:04 PM Contents Contributors v Preface vii Acknowledgments ix 1 C H A P T E R Technical and Clinical Application 1 Mary Alexander, Lisa A. Gorski, Ann Corrigan, Melody Bullock, Alicia Dickenson, Ann Earhart 2 C H A P T E R Fluid and Electrolyte Balance 86 Lynn Phillips 3 C H A P T E R Pharmacology 131 Michelle S. Turner, Susan K. Poole 4 C H A P T E R Infection Prevention and Control 163 Mary McGoldrick 5 C H A P T E R Pediatrics 192 Darcy Doellman 6 C H A P T E R Transfusion Therapy 235 Deb Richardson 7 C H A P T E R Antineoplastic and Biologic Therapy 258 Lynn M. Czaplewski, Cora Vizcarra 8 C H A P T E R Parenteral Nutrition 309 Elizabeth Krzywda, Doug Meyer 9 C H A P T E R Quality Improvement 356 Grace Fletcher Index 371 xi (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_fm_pi-xii.indd 11 21/03/13 4:04 PM 1 C H A P T E R Technical and Clinical Application Mary Alexander, MA, RN, CRNI®, CAE, FAAN Lisa A. Gorski, MS, HHCNS-BC, CRNI®, FAAN Ann Corrigan, MS, BSN, RN, CRNI® Melody Bullock, MS, BSN, RN, CRNI® Alicia Dickenson, RN, CRNI® Ann Earhart, MSN, RN, ACNS-BC, CRNI® Part I: Anatomy and Physiology I. Vascular System A. Cardiac Circulation 1. Heart a. A hollow muscular organ made of four chambers that functions as a two-sided pump 1) Right side is a low-pressure system pumping venous or deoxygenated blood to the lung 2) Left side is a high-pressure system pumping arterial or oxygenated blood to systemic circulation b. Right atrium (RA) is a thin-walled muscle that acts as a receiving chamber 1) It receives systemic venous blood from the superior vena cava (SVC), which drains blood from the upper part of the body, and from the inferior vena cava (IVC), which drains blood from the lower extremities 2) It receives blood from myocardial circulation by the coronary sinus 3) Blood flow to RA occurs during inspiration a) RA pressure drops below the pressure in veins outside the chest cavity b) Blood flows from the area of high pressure to the area of low pressure c. Right ventricle (RV) is the most anterior chamber of the heart, lying directly beneath the sternum 1) Functions as both an inflow and an outflow tract 1 (c) 2015 Wolters Kluwer. All Rights Reserved. 84099_ch01_p001-085.indd 1 22/03/13 12:15 PM
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