I am looking for best practice for at home flushing for a patient with a Hickman catheter. Our oncologists vary in recommendation for flushing - all utilize saline but orders vary from once daily to three times daily. Manufacturer guidelines still recommend heparin for the flush, is there a best practice when utilizing normal saline for the flush?
There is no evidence based answer to your question. The only thing you can do at this point it to evaluate your own outcomes for flushing resistance, blood return. What frequency performs the best for your patients? Your own data can be used to provide your evidence. The most important thing, in my opinion, is to use the correct flush-clamp-disconnect sequence for the type of needleless connector being used. 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 Lynn. I have been driving myself crazy looking for an answer. I will work internally to determine consistent practice.
Brenda Wolles, RN, OCN
Clinician Coordinator, Oncology
Sanford USD Medical Center
One other suggestion is to look at the INS standard on flushing and locking, then find the applicable studies comparing NS to hep lock. Find those studies to see what frequency they used. I know that one was done in a hospital critical care setting and at least one from Europe was included outpatients also. I don't think they emphasized the frequency, just the solution. 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