Journal of Infusion Nursing - Current Table Of Contents
Journal of Infusion Nursing - November/December 2008, Volume 31, Issue 6

• IV Safety: A Matter of Life and Death.
  Page: 325DOI: 10.1097/NAN.0b013e31819195ceAuthors: Alexander, Mary MA, RN, CRNI(R), CAE, FAAN, INS Chief Executive Officer, Editor
• PUBLISHER'S NOTE.
  Page: 328DOI: 10.1097/NAN.0b013e318194bf83
• President Bush and CMS Issue Rule in "Backhanded Compliment" to Hospice.
  Page: 331DOI: 10.1097/NAN.0b013e31818c07aaAuthors: Ober, Stacey BSN, JD; Craven, Gloria BSN, MSN; Craven & Ober Policy Strategists, LLC
• Part 2-Standard 48: Administration Set Change.
  Page: 333DOI: 10.1097/NAN.0b013e31818c08adAuthors: Gorski, Lisa A. MS, HHCNS-BC, CRNI(R), FAAN
• Advances in Prostanoid Infusion Therapy for Pulmonary Arterial Hypertension.
  Pulmonary arterial hypertension is a rare but progressive and life-threatening disease that presents considerable challenges for both the patient and the caregiver. Though complex, intravenous epoprostenol and treprostinil may improve long-term survival, exercise capacity, hemodynamics, and other clinical symptoms of pulmonary arterial hypertension. Recent advances in infusion pump technology offer ambulatory pump sizes as small as a pager and continuous infusion flow rates as low as 0.1 mL/h, which may provide quality-of-life advantages for patients treated with treprostinil. Transition methods from epoprostenol to treprostinil vary and require close patient monitoring for up to several months. Patients and clinicians must be aware of the differences among delivery systems and the potential for adverse events.Page: 336DOI: 10.1097/NAN.0b013e31818c09b1Authors: Doran, Aimee MS, RN, CPNP; Harris, Stephanie BSN, RN; Goetz, Brett RN
• The Intravenous Cannula for Newborn Infants Requiring Only Intravenous Medication: Continuous Infusion or Intermittent Flushing?.
  In August 2003, the practice in the Royal Brisbane and Women's Hospital neonatal unit changed to the use of intermittent flushing of intravenous cannulas (instead of running a continuous infusion) for infants who only required an intravenous cannula for medications. In this historical cohort comparison study, the authors determined that the duration of cannula use and the numbers of cannulas needing removal were similar before and after the change. The authors conclude that the use of intermittent flushing for intravenous cannulas is a safe and viable alternative to continuous infusion for well term infants who only require intermittent intravenous antibiotics.Page: 346DOI: 10.1097/NAN.0b013e31818c0d4aAuthors: Flint, Anndrea BN, MHS, RN, RM, NICC; Davies, Mark MBBS, FRACP, DCH
• Nursing Considerations for Infusion Therapy in Rheumatoid Arthritis Versus Malignancy.
  Therapeutic agents in use for years may receive Food and Drug Administration approval for new indications, challenging infusion nurses to keep in mind differences in therapy for more than 1 disease state. For example, many infusion nurses are familiar with using rituximab in an oncology setting; however, because it has been approved relatively recently (February 2006) for treatment of rheumatoid arthritis (RA), infusion specialists must improve their understanding of how dosing and administration differ in the RA setting. This article focuses on the specific pathophysiology of the RA disease state and patient characteristics that may affect infusion therapy, illustrated by a case study.Page: 350DOI: 10.1097/NAN.0b013e31818c0d78Authors: Furfaro, Nicole MSN, ARNP; Mease, Philip J. MD
• Challenges of Nutrition Intervention for Malnourished Dialysis Patients.
  Malnutrition, or protein energy wasting (PEW), is prevalent in patients with chronic kidney disease stage 5 dialysis (CKD-5). One criterion of PEW strongly associated with morbidity and mortality in CKD-5 dialysis patients is the serum albumin level. Serum albumin levels have not improved over the past 10 years. Typical intervention strategies need to be reevaluated. Intradialytic parenteral nutrition (IDPN) is a form of parenteral nutrition delivered during dialysis that is a convenient and assured route of nutrition alimentation for high-nutrition-risk PEW patients who cannot improve nutrition status by oral and enteral routes. Recent qualification criteria for IDPN changes in Medicare part D have made this therapy an available option for many more of these high-nutrition-risk PEW patients. Nutrition support knowledge in clinicians is essential to administer IDPN effectively and to optimize clinical response. An improved understanding of the milieu of uremia and PEW of CKD-5, as well as the study of nutrition interventions inclusive of IDPN, will allow for effective strategies toward improved outcomes in the future.Page: 361DOI: 10.1097/NAN.0b013e31818c0e3fAuthors: Moore, Eileen CNSD, RD, LD
• Home Intravenous Therapy and the Ability to Perform Self-care Activities of Daily Living.
  This prospective cohort study examined the variables that affect the ability of 92 patients receiving home intravenous (IV) therapy to perform self-care activities of daily living and whether there was a difference in their ability based on vascular access device (VAD) location and type or other IV-related variables. Analysis revealed that 4 IV-related variables were significant predictors of self-care ability score: IV delivery method (β = - .212, P = .018), VAD placement in the dominant hand (β = - .208, P = .017), VAD dressing (β = - .215, P = .013), and IV solution (β = - .206, P = .022). These findings provide community-based nurses with evidence-based information regarding the variables that have an impact on the ability of patients receiving home IV therapy to perform the activities of daily living.Page: 367DOI: 10.1097/NAN.0b013e31818c0e7cAuthors: O'Halloran, Linda MScN, RN; El-Masri, Maher M. PhD, RN; Fox-Wasylyshyn, Susan M. PhD, RN
• New Products and Services.
  Page: 375DOI: 10.1097/NAN.0b013e31818c0fd4