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Supplement to: January/February 2021 Volume 44 • Number 1S ISSN 1533-1458 www.journalofinfusionnursing.com Journal of Infusion Nursing The Official Publication of the Infusion Nurses Society Infusion Therapy Standards of Practice 8th Edition NANv44n1S-Cover.indd 1 12/30/20 12:57 AM Infusion Therapy Standards of Practice Lisa Gorski, MS, RN, HHCNS-BC, CRNI®, FAAN Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI®, FAAN Lynn Hadaway Lynn Hadaway, MEd, RN, NPD-BC, CRNI® Mary E. Hagle, PhD, RN-BC, FAAN Mary E. Hagle, PhD, RN-BC, FAAN Daphne Broadhurst, MN, RN, CVAA(C) Daphne Broadhurst, MN, RN, CVAA(C) Simon Clare Simon Clare, MRes, BA, RGN Tricia Kleidon, MNSc (Nurs. Prac), BNSc, RN Tricia Kleidon, MNSc (Nurs. Prac), BNSc, RN Britt Meyer, PhD, RN, CRNI®, VA-BC, NE-BC Britt M. Meyer, PhD, RN, CRNI®, VA-BC, NE-BC Barbara Nickel Barb Nickel, APRN-CNS, CCRN, CRNI® Stephen Rowley, MSc, BSc (Hons), RGN, RSCN Stephen Rowley, MSc, BSc (Hons), RGN, RSCN Elizabeth Sharpe, DNP, APRN-CNP, NNP-BC, VA-BC, FNAP, FAANP Elizabeth Sharpe, DNP, APRN-CNP, NNP-BC, VA-BC, FNAP, FAANP, FAAN Mary Alexander, MA, RN, CRNI®, CAE, FAAN Mary Alexander, MA, RN, CRNI®, CAE, FAAN 8TH EDITION 8TH EDITION REVISED 2021 REVISED 2021 One Edgewater Drive, Norwood, MA 02062 One Edgewaterwww.ins1.org Drive, Norwood, MA 02062 www.ins1.org LEARN MORE AT WWW.INCC1.ORG The Art and Science of Infusion Nursing Journal of Infusion Nursing Editor INS Board of Directors Mary Alexander, MA, RN, CRNI®*, President Directors-at-Large ® ® ® ® CAE, FAAN Angie Sims, MSN, RN, CRNI , OCN Nancy Bowles, MHA, RN, OCN , CRNI , NEA-BE, CPC-A President Elect ® Associate Managing Editor Sue Weaver, PhD, RN, CRNI®, NEA-BC Angela Skelton, BSN, RN, CRNI Leslie Nikou Presidential Advisor Public Member Lynn Deutsch, MSN, RN, CRNI®, VA-BC John S. Garrett, MD, FACEP Editorial Offices INS Chief Executive Officer Secretary/Treasurer ® ® Mary Alexander, MA, RN, CRNI , CAE, FAAN Infusion Nurses Society (INS) Inez Nichols, DNP, FNP-BC, CRNI , VA-BC One Edgewater Drive, Suite 209 Norwood, MA 02062 Main Office: (781) 440-9408 www.ins1.org For advertising information: National Account Manager Recruitment Advertising Journal of Infusion Nursing, the official Kelle Ramsay Laury Chervil-Gilles (West) publication of INS, seeks to promote excellence in infusion nursing by presenting [email protected] [email protected] new research, clinical reviews, case studies, (410) 528-4121 (646) 674-6322 and professional development information relevant to the practice of infusion therapy. Monique McLaughlin (East) Articles undergo a process of double-blind peer review. Final selections represent the [email protected] broad scope of the infusion specialty and draw (215) 521-8468 on the expertise of all health care providers who participate in the delivery of infusion. Infusion Therapy Standards of Practice Reviewers The revised Standards, 8th edition, was peer-reviewed by a panel of individuals across health care specialties from 17 countries around the globe. The feedback provided helped to further strengthen the recommendations outlined in this revision. The Standards of Practice Committee would like to thank the following list of reviewers: Cindi Acree, DNP, APRN, NNP-BC, MEd, CPHQ, CPEC Karen Giuliano, PhD, RN, FAAN Andrea Owens, MSN-Ed, RN, CRNI®, VA-BC Jeanette Adams, PhD, APRN, CRNI® Brenda Gray, PharmD, VA-BC, BCNSP, CNSC, CVAA(c), PRS Susan Paparella, MSN, RN Tahani Al Dweikat, BSN, EMHCA, OCN® Vikram Guduri, MBBS France Paquet, MSc(N), BSN, RN, CVAA(c) Grace Al Hakim, MSN, RN, AGCNS-BC Carole Hallam, MSc, BSc, RN Emiliana Perera Parra, MSN, RN Fatima Dawood Aldawood, B.S.Micr, BSN, RN, ICP Jocelyn Hill, MN, RN, CVAA(c), VA-BC Ann Plohal, PhD, APRN, ACNS-BC, CRNI®, VA-BC Evan Alexandrou, PhD, MPH, RN, BHealth, ICU Cert Steve Hill, Dip, Pgd Kathy Puglise, MSN-ED, BSN, RN, CRNI® Sharif D. Alnatour, MBAn(c), MHCM, BScN, CNML, NPD-BC, Klaus Hoerauf, MD, PhD Gillian Ray-Barruel, PhD, RN RN-BC, CPHON Joseph M. Hommes, BSN, RN, VA-BC Tricia L. Romesberg, DNP, MSN, APRN, NNP-BC Jen Andrade, BSN, RN Sun Hong, MSN, RN Marcia Ryder, PhD, MS, RN Alicia Arnold, BSN, RN, CRNI® Cynthia Huff, DNP, RN, OCN®, CRNI®, CNL Tugce Sahin Tirtil, PhD, CRNI® Nabil Bayan, MD, EMA Robin Huneke Rosenberg, MA, RN, CRNI®, VA-BC Ofelia Santiago, BSN, RN, CRNI® Deborah Barrio Belisle, MBA, MSN, BS, RN Kristopher Hunter, BSN, RN, CRNI®, VA-BC Kim Scoggins, BSN, RN, CRNI® Dawn Berndt, DNP, RN CRNI® Mark Robert Hunter, MS, BSN, RN, CRNI®, VA-BC Marvin Siegel, BS, RN, CRNI® Corinne Bishop, RN, CRNI® Pamela Jacobs, MHA, BSN, RN, CRNI®, OCN® Janayna Thais Silva, BSN, RN, WOCN Nancy Bowles, MHA, RN, OCN®, CRNI®, NEA-BE, CPC-A Vladimir Jaksic, MD Angie Sims, MSN, RN, CRNI®, OCN® Susan Bowles, DNP, APRN, RNC-NIC, CBC Caroline Johnson, MSN, RN, PHN Larry Sisei, BSN, RN Daiane Patricia Cais, MSN, RN James M. Joseph, MPH, BSN, RN, CRNI®, VA-BC Mary Smith, RN, VA-BC Elizabeth Campbell, MSN, RN, CRNI® Lori Kaczmarek, MSN, RN, VA-BC Lori Snyder-Sloan, MSN, MA, RN, CIC Trisha Campbell, MSN, RN, CRNI®, OCN® Linda J. Kelly, PhD, RGN, PGC (TLHE), FHEA, TCH Luba Sobolevsky, PharmD Peter Carr, PhD, MMedSc, BSc, RN Patricia C. Kienle, MPA, BCSCP, RPh, FASHP Timothy R. Spencer, DipAppSc, BHSc, RN, APRN, VA-BC Chris Cavanaugh, BSN, RN, CRNI®, VA-BC Christina Klein, MSN, RN, CRNI®, OCN® Brian Stahl, BSN, RN, CRNI®, PLNC Raquel Bauer Cechinel, MSc, MBA, BSN, RN Judith A. LaJoie, MS, BSN, RN, CRNI® Marlene Steinheiser, PhD, RN, CRNI® Lynda Cook, MSN, RN, CRNI® Lynette Lennox, MHLTH, RN Marc Stranz, PharmD Jill Culiner, MSN, RN, ANP Susan Lown, DNP, RN, CNE Haya Shafiq Suiefan, MS Caroline Cullinane, BA (hons) class 1, Dip HE, RN Gail Lusardi, RN Myra Swintz, MSN, RN, CRNI®, AGCNS-BC, HCS-O Kerri Dalton, MSN, APRN, AOCNS Angie Malone, DNP, APRN, ACNS-BC, OCN®, AOCNS, NE-BC Maria Thomas, DNP, MSN, RN Lynn Deutsch, MSN, RN, CRNI®, VA-BC Alicia Mares, BSN, RN, CRNI® Judy Thompson, MSN-Ed, RN, VA-BC Michelle DeVries, MPH, CIC, VA-BC Nicole Marsh, PhD, RN Tracy Torgerson, MSN, RN, CRNI® Ilker Devrim, MD Sheryl McDiarmid, MBA, MEd, BSCN, RN, AOCN®, ACNP, Nancy Trick, RN, CRNI®, VA-BC Alicia Dickenson, BSN, RN, CRNI®, VA-BC CVAA(c), CRNI® Amanda Ullman, PhD, MAppSci, RN Darcy Doellman, MSN, RN, CRNI®, VA-BC Mary McGoldrick, MS, RN, CRNI® Ruth Van Gerpen, MS, RN-BC, APRN-CNS, AOCNS Loretta Dorn, MSN, RN, CRNI® Diana Melton, MSHA, BSN, RN Ton von Boxtel, MSc, RN, PAN Martina Douglas, MSc, RN Crystal Miller, MA, BS, RN, CRNI® Jeff Wang, MD Denise Dreher, RN, CRNI®, VA-BC Shafii Mohammed, DNP, MPH, CIC, FRSPH Sue Weaver, PhD, RN, CRNI®, NEA-BC Melanie Eld, PhD, RN Nancy Moureau, PhD, BSN, RN, CRNI®, VA-BC, CPUI Valya Weston, MSc, BSc, RN (USA), RGN (UK) Kari Ertmer, BSN, RN, PHN, VA-BC Russ Nassof, JD Tara Willemsen, BScN Med, RN, CNOR Beth Fabian, BA, RN, CRNI® Elena Nelson Squires, BSN, RN, OCN®, VA-BC Della Wrightson, MSN, RNC-NIC, APRN Whitney Ficocello, BSN, RN, PHN Jackie Nicholson, MSc, RN Mary Wyckoff, PhD, APRN-BC, CCNS, NNP-BC, FAANP Beverly George, MS, BSN, RN, CRNI® Jill Nolte, BSN, CRNI®, VA-BC Li Xuying, PhD, RN Ginger Gillette-Kent, MSN, MBA, APRN, ANP-BC, NEA-BC Shawn O’Connell, MS, BS, RN Polly Gerber Zimmermann, MBA, MSN, RN-BC, CEN, ONC, FAEN *CRNI is a registered trademark of the Infusion Nurses Certification Corporation. JOIN NOW. LEARN HOW. JOIN TODAY AT WWW.INS1.ORG The Art and Science of Infusion Nursing Contents Note: The “S” in page numbers denotes supplement issue and does not refer to a specific standard. Foreword S1 12. Product Evaluation, 27. Site Selection S81 Integrity, and Defect About the Standards of 28. Implanted Vascular Reporting S45 Practice Committee S3 Access Ports S86 13. Medication Verification S46 Author Disclosures and 29. Vascular Access and Acknowledgments S6 14. Latex Sensitivity or Allergy S49 Hemodialysis S89 Preface S7 15. Hazardous Drugs and 30. Umbilical Catheters S90 Waste S50 Methodology for Developing 31. Vascular Access and the Standards of Practice S8 Therapeutic Apheresis S93 SECTION THREE: Abbreviations and Acronyms S10 INFECTION PREVENTION 32. Pain Management for Strength of the Body of Venipuncture and Evidence S12 AND CONTROL Vascular Access 16. Hand Hygiene S53 Procedures S94 STANDARDS OF PRACTICE 17. Standard Precautions S54 33. Vascular Access Site Preparation SECTION ONE: INFUSION 18. Aseptic Non Touch and Skin Antisepsis S96 Technique (ANTT®) S56 THERAPY PRACTICE 34. Vascular Access Device 1. Patient Care S13 19. Transmission-Based Placement S97 Precautions S58 2. Special Patient Populations: Neonatal, 20. Compounding and SECTION SIX: VASCULAR Pediatric, Pregnant, Preparation of ACCESS DEVICE and Older Adults S13 Parenteral Solutions and Medications S59 MANAGEMENT 3. Scope of Practice S15 35. Filtration S102 21. Medical Waste and 4. Organization of Infusion Sharps Safety S60 36. Needleless Connectors S104 and Vascular Access 37. Other Add-On Devices S107 Services S23 SECTION FOUR: 5. Competency and INFUSION EQUIPMENT 38. Vascular Access Device Competency Assessment S26 Securement S108 22. Vascular Visualization S63 6. Quality Improvement S31 39. Joint Stabilization S111 23. Central Vascular Access 40. Site Protection S112 7. Evidence-Based Practice Device Tip Location S65 and Research S34 41. Flushing and Locking S113 24. Flow-Control Devices S69 8. Patient Education S35 42. Vascular Access Device 25. Blood and Fluid Warming S72 9. Informed Consent S37 Assessment, Care, and Dressing Changes S119 10. Documentation in the SECTION FIVE: Health Record S39 43. Administration Set VASCULAR ACCESS Management S123 DEVICE SELECTION AND SECTION TWO: PATIENT 44.
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  • A Single-Chip MPEG-2 Codec Based on Customizable Media Embedded Processor

    A Single-Chip MPEG-2 Codec Based on Customizable Media Embedded Processor

    530 IEEE JOURNAL OF SOLID-STATE CIRCUITS, VOL. 38, NO. 3, MARCH 2003 A Single-Chip MPEG-2 Codec Based on Customizable Media Embedded Processor Shunichi Ishiwata, Tomoo Yamakage, Yoshiro Tsuboi, Takayoshi Shimazawa, Tomoko Kitazawa, Shuji Michinaka, Kunihiko Yahagi, Hideki Takeda, Akihiro Oue, Tomoya Kodama, Nobu Matsumoto, Takayuki Kamei, Mitsuo Saito, Takashi Miyamori, Goichi Ootomo, and Masataka Matsui, Member, IEEE Abstract—A single-chip MPEG-2 MP@ML codec, integrating microprocessors, such as out-of-order speculative execution, P 3.8M gates on a 72-mm die, is described. The codec employs a branch prediction, and circuit technologies to achieve high heterogeneous multiprocessor architecture in which six micropro- clock frequency, are unsuitable for these application-specific cessors with the same instruction set but different customization execute specific tasks such as video and audio concurrently. processors. On the other hand, the addition of application-spe- The microprocessor, developed for digital media processing, cific instructions and/or hardware engines to accelerate heavy provides various extensions such as a very-long-instruction-word iteration of relatively simple tasks often results in a large gain coprocessor, digital signal processor instructions, and hardware in performance at little additional cost, especially in DSP ap- engines. Making full use of the extensions and optimizing the plications. A heterogeneous multiprocessor architecture using architecture of each microprocessor based upon the nature of specific tasks, the chip can execute not only MPEG-2 MP@ML simple and small microprocessors achieves a better cost–per- video/audio/system encoding and decoding concurrently, but also formance tradeoff than a single high-end general-purpose MPEG-2 MP@HL decoding in real time.