In the hospital where I work questions have come up about using a portacath for TPN. I am wondering what the latest info is on this?? The infectious disease department is having issues with this. I have tried to research the topic and everything I am finding is really old, can't seem to find anything in the INS policies .
Celia RN, CRNI, OCN, VA-BC
From a personal standpoint, if I had an implanted port and required ANY type of infusion therapy, including TPN, I would insist on using that port. Have you checked the standards and guidelines from ASPEN? I have not read anything that would contradict use of the port for TPN. Can you explain in more detail about why this is a concern for your ID doc? If they tell you that they want a "virgin" line for TPN, you will also not find any literature supporting this concept either. A dedicated lumen is very different from a virgin line or one that has just been inserted and not used for anything else. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you Lynn...I know the issue isn't for a virgin line, I know in the policy at the hospital they do want a designated line for TPN which is why we will place a piccline. I will have to ask the man from the education dept. what the specifics were for questioning the TPN via a portacath. I will get that info to you as soon as I get it.
Celia Wedge RN, CRNI, OCN, VA-BC
Ivteamrn
Hi Celia,
We had your exact problem last year. It took me a fair amount of digging to find out exactly who (usually one persons opinion) had the issue in ID and then why. In our institution the patients were usually oncology patients going onto requiring TPN for a period of time. The ID guys had a concern re higher risk of infection related to both co morbidities and that the majority of our TPN patients have hickman lines, so they were worried about staff's level of knowledge in line management.
With no evidence to support thier concerns we convinced them to start using the port. Just as Lynn said these patient have them for a reason, it's their life line and should be used for whatever IV therapy required. Also ports have the least risk of infection if well looked after so if you can have a good educational staff roll out plan to show the ID team they hopefully will be happy!
Since changing we haven't had a problem.
Cheers
Gavin