I am looking for a policy related to administration of CathFlo through a Port-a-Cath.
Our hospital policy allows RNs who have had special training to administer the fibrinolytic through a PICC, but not through a Port-a-Cath.
Any Suggestions?
I am looking for a policy related to administration of CathFlo through a Port-a-Cath.
Our hospital policy allows RNs who have had special training to administer the fibrinolytic through a PICC, but not through a Port-a-Cath.
Any Suggestions?
The procedure is the same and all VADs should fall under the same policy for which RNs can do this procedure and what training is required. Sorry I don't have a written p&p to share but it sounds like you already have the procedure. INS Standards have a standard of catheter clearance. So you would need to be in compliance with that standard. There is nothing in that standard that highlights a difference between implanted ports and other VADs. You can purchase this document in a pdf online at www.ins1.org. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
The only difference I see between a port and any other tunneled, non-tunneled or PICC CVC is that, if you can't flush or withdraw from a port, you can deaccess, prime a new non-coring needle set with cath-flo, then access again. You've now put your cath-flo closer to where the problem is rather than trying to work it down through the needle set tubing.
Yes, this may be true unless the problem is in the catheter lumen attached to the port body. The occlusion could be either place. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
If you send me your email, I will be happy to send you our policy at Chester County Hospital.
Lois Rajcan, MSN, RN, CRNI
IV/PICC Team Leader - The Chester County Hospital
If I understand Lynn's comment, that a port can also be clotted in the catheter lumen, that is certainly true. My comment about reaccessing with a cath-flo primed non-coring needle set still puts the tpa closer to the clot by not having to work it down the existing needle set which is usually about 12 inches long.
Are ther any IV teams that declot all CVCs in their location? A sticky point where I work is that the bedside nurses do not declot CVCs and our team only declots PICCs at this time. The bedside RNs are dependant on out skills to declot CVCs of all types because we are the IV team and would like us to do this. If our team does not declot the line, confusion as to who does it and who to contact erupts. This to me seems not to be the best patient care that we can provide. We utilize a Mosby procedure as the competency on our team which I beleive encompasses all CVCs.
What do other IV teams do regarding declotting lines beyond PICCs?
David Dempsey MS, RN
In the clinical world where I have worked, the IV Team does everything that must be done to ALL CVADs including any catheter clearance procedures like declotting. I strongly believe that this requires the knowledge and skill of a specialist. Staff nurses do not have the same knowledge and skill about VADs, many do not have the desire to obtain the knowledge and skill and they do not have the time. Read the Infusion Nursing Standard #56 on Catheter Clearance and then decide if your staff nurses can meet this standard. That is what should be deciding factor in my opinion. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Our Central Line Team does declotting of all vascualr access devices. However, if they are not immediately available, the nurse caring for the patient is expected to begin the process immediately - getting the order from the MD for TPA, getting the TPA form Pharmacy, initiating the declotting, until the CLT member arrives.
Prior to the development of our Central Line Team, all nurses were trained in declotting so they do know how to get things started. It is a yearly competence for any nurse working with central lines.
Wendy Erickson RN
Eau Claire WI
would appreciate a copy of your policy
[email protected]
thank you
michael stevens
st marys passaic nj