Does anyone have a policy or thoughts about how to access a port that has not been accessed in over a year? Would you do anything differently in accessing it, other than saying a prayer that you get a blood return? :)
Does anyone have a policy or thoughts about how to access a port that has not been accessed in over a year? Would you do anything differently in accessing it, other than saying a prayer that you get a blood return? :)
Get it out! You have no idea what's been living in that port. Manufacturer guidelines almost universally recommend flushing every 4-8 weeks. You take a lot of risks both medically and legally when you access a port that hasn't been touched in a year. I've worked in several oncology clinics and we would not access a port that had gone without maintenance for six months. Even that is a stretch and a risk in my opinion, for what that's worth.
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
When I did home infusion we flushed unused ports every month. I did get the occasional patient that said the oncologist said every 3 months. I'd be a little nervous if it were a year though....I defer to the chemo nurses.
Jack
There is no published standard or guideline to recommend NOT accessing and flushing a port that has not been accessed and flushed for a given period of time. There are studies reporting that some of their patients have not been accessed or flushed for greater than 200 days. I would aspirate first and discard that fluid. Flushing could still bring a shower of organisms that could cause a temp elevation. If the port is no longer indicated for infusions, it does need to be removed. I realize some patients feel the need to resist removal for fear they will need it again, but they fail to realize that after so much time I probably will not function well and is putting them at increased risk for infection and thrombosis. 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
Thanks, everyone. I can't share the specifics but your comments would have helped the patient - withdrawing and discarding, then flushing specifically. Patient doing well now.
Wendy Erickson RN
Eau Claire WI