We are trying to put together a policy and finding the evidence has been difficult. A little background, I work at a cancer institute and we have a large amount of patients with chest ports. We strive to keep patients happy but an issue has come up. Are we doing the right thing by using the chest port for routine blood draws, not blood draws associated with chemotherapy visits? Should we be encouraging patients to have blood drawn peripherally? Are we increasing the risk for infection by accessing for blood draws? Is there an increased risk for any other complications related to this practice?
Looking forward to any and all insight.
Thank you,
Kim Venohr BSN, RN, OCN, CRN
Your key word is "routinely" and yes you may be increasing the risk for CLABSI with this practice. INS Standards state you should weigh the risk vs benefits of this practice and gives criteria for each. If there is no other alternative, you may be forced to use a CVAD, including implanted ports, for drawing blood samplkes. Otherwise, you should be using the peripheral veins. There is some evidence about an increased risk of BSI but nothing yet about lumen occlusion, etc. The Standards do give other statements about using a CVAD for blood draws such as removing the needleless connector for blood cultures and several others. See Phlebotomy SOP. 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
Lynn,
I appreciate your answer. In practice, I always kept patient expectations realistic in regards to using the chest port for routine blood draws by explaining why it may or may not be the best option. It is always good to have some affirmation.
Thank you,
Kim Venohr BSN RN OCN CRN