An infusion nurse is a registered nurse (RN) who specializes in infusion therapy, administering various types of fluids and medications via an intravenous line (IV).
There are two major types of intravenous lines:
Peripheral IV line — in which the intravenous catheter terminates in a peripheral vein
Central IV line — in which the intravenous catheter terminates in a central vein, such as the subclavian, internal jugular, or femoral veins
In the hospital setting — especially in the emergency department and/or intensive care unit — a patient may have a central venous catheter (CVC) inserted to:
Enable the infusion of fluids and medications that cannot adequately or safely be infused through a peripheral IV line
Monitor cardiovascular status
Provide IV access when it is difficult to insert a peripheral IV line
The various types of central IV lines are used for specific purposes and lengths of time. In addition to those previously described, other types include:
Peripherally inserted central catheters (PICC lines) — which are inserted into the basilic, cephalic, or brachial veins
Tunneled catheters — which are tunneled under the skin
Implanted ports — which are surgically implanted
Midline catheters are similar to PICC lines, but they are shorter and don’t extend to the central veins in the thorax.
What Does an Infusion Nurse Do?
In a recent article for the American Journal of Nursing, Crystal Miller, BSN, CRNI, NE-BC describes the role of infusion nurses.
“An infusion nurse specializes in the practice of infusion therapy—the administration of IV medications or fluids,” Miller writes. “This type of therapy is delivered to patients of all ages and populations across all health care settings. Infusion therapy is essential when a patient’s treatment cannot be given via other routes, such as oral.”
“The infusion nurse’s primary focus is patient safety, as demonstrated through the comprehensive management of all patient infusion needs, including planning for and inserting the vascular access device (VAD),” she adds. “A VAD is used to access the veins and can range from short PIVCs to peripherally inserted central catheters, implanted ports, central venous catheters, and tunneled catheters.”
“We also look beyond the patient’s vasculature, examining a patient’s laboratory values, managing and administering the therapeutic treatment regimen, recognizing and managing complications, and overseeing the conclusion of treatment and VAD discontinuation,” Miller says. “A large part of our role is also education, and as infusion educators we look to see that best clinical practices are being utilized.”
The National Home Infusion Association (NHIA) says infusion therapy involves “the administration of medication through a needle or catheter. It is prescribed when a patient’s condition is so severe that it cannot be treated effectively by oral medications.”
“Typically, ‘infusion therapy’ means that a drug is administered intravenously, but the term also may refer to situations where drugs are provided through other non-oral routes, such as intramuscular injections and epidural routes (into the membranes surrounding the spinal cord),” the NHIA says.
The organization notes that “traditional” prescription drug therapies that are often administered by infusion include:
Antibiotics
Antifungals
Antivirals
Chemotherapeutic agents
Fluids for hydration
Pain management medications
Parenteral nutrition
Additionally, “specialty” infusion medications may be used to treat a “wide assortment of often chronic and sometimes rare diseases,” according to the NHIA.
The duties of an infusion nurse are influenced by the array of potential patient conditions, types of IV lines and infusion therapies in use, and the setting in which care is provided. Additionally, the infusion nurse’s credentials and state practice laws will also have an impact.
As such, the basic duties of an infusion nurse may include:
Assessing and monitoring the patient’s status
Documenting the patient’s medical history and symptoms in the patient record
Creating and updating the patient’s plan of care
Collaborating with the patient
Administering medications and treatments
Performing various procedures
Operating and monitoring medical equipment
Teaching patients and families
More specifically, the NHIA describes the duties of an infusion nurse who provides home and “alternate site” infusion services like this: “Infusion nurses will have special education, training, and expertise in home or other alternate-site administration of drugs and biologics via infusion. Services they typically provide include evaluation and assessment, education and training for the patient or caregiver, inspection and consultation of aseptic home environment, catheter insertion, and patient assessment. Using the education and training provided, many caregivers or patients are successfully able to administer their infusion therapies without the infusion nurse normally being present in the home.”
Where Do Infusion Nurses Work?
Infusion nurses may work in hospital settings and in settings outside of the hospital — including nursing homes, patient homes, and “alternate sites.”
According to the NHIA:
“Patients may shorten or avoid stays in institutions such as hospitals and nursing homes when their infusion therapy can be provided in alternate-site settings including their homes and ambulatory infusion centers.”
“Many home infusion therapy providers operate a health care facility called the Ambulatory Infusion Suite of the home infusion therapy provider, or AIS. The AIS is a setting where the clinical care provided pursuant to physician orders is managed and performed by registered nurses and pharmacists that are highly skilled in provision of infusion/specialty drug administration.”
“Due to the cost-effectiveness of this care and its appropriateness for use with certain patient-therapy situations, there is significant growth in openings of new AIS facilities.”
The NHIA says the AIS is one of three types of Ambulatory Infusion Centers (AICs):
Ambulatory Infusion Suite of the home infusion therapy provider (AIS)
Physician-based infusion clinic
Hospital-based infusion clinic
How Much Does an Infusion Nurse Make Per Year?
According to salary data from the Bureau of Labor Statistics (BLS), the median annual wage for registered nurses was $81,220 in May 2022—with half of nurses earning more than that amount and half earning less. Wages of nurses in the lowest 10 percent averaged $61,250. Wages of nurses in the highest 10 percent averaged $129,400.
The BLS does not provide a pay breakdown according to specialty but does provide median annual wages for registered nurses according to general categories of work location. Since most infusion nurses care for patients in hospitals, homes, physician offices, and clinics, the following median annual salaries may apply:
General medical and surgical hospitals: $90,600
Home healthcare services: $82,920
Offices of physicians: $79,810
Outpatient care centers: $97,200
The salary of an infusion nurse is also influenced by factors such as education, experience, and geographical region of the country.
RNs must also be licensed in the state in which they work. Licensure can be obtained by passing the National Council Licensure Examination (NCLEX-RN) and meeting any additional requirements of the state’s board of nursing. The National Council of State Boards of Nursing (NCSBN) offers a resource to determine state-based nursing licensure requirements.
An infusion nurse can also obtain specialty certification by meeting eligibility requirements and taking the exam to obtain the certified registered nurse infusion (CRNI®) credential.
“A certified registered nurse infusion (CRNI®) is an exceptional nurse who has passed a rigorous exam covering the core areas of infusion nursing. CRNI®s stay ahead by being exposed to the newest advances in technology and practice within the infusion nursing specialty,” the Infusion Nurses Society (INS) says. “Becoming a CRNI® exemplifies a commitment to excellence. This prestigious credential warrants the recognition and respect of patients, peers, and employers because it’s proof of dedication to the pursuit of lifelong learning and the delivery of quality health care. CRNI®s are part of a global community of elite nurses across multiple disciplines—including home care, pediatrics, oncology, and many more—who’ve demonstrated through certification that they are the most informed, most highly qualified infusion nursing specialists. A CRNI® is, first and foremost, an advocate for improving patient care.”
To take the CRNI® exam, applicants must have:
A current, active, unrestricted registered nurse (RN) license in the United States.
A minimum of 1,600 hours of experience in infusion therapy as an RN within the past two years. 1,600 hours of direct bedside care are not required. Nursing experience may be in the areas of nursing education, administration, research, or clinical practice within the infusion specialty.
What Are the Benefits of Being an Infusion Nurse?
There are many benefits to being an infusion nurse, including the ability to:
Help patients and their families during stressful times
Enjoy fast-paced work in a variety of care settings
Embrace opportunities for learning and advancement
Make a great salary while enjoying meaningful work
Additional Resources About Becoming an Infusion Nurse
To learn more about becoming an infusion nurse, these additional resources may help:
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