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    I had a physician today ask me to place a PICC for TPN. I knew that this particular patient had a port, so I asked what was wrong with the port. The nurse replied,"nothing". I asked why it was not being used for TPN. The nurse replied that the physician said that the port could not be used for TPN because a surgical oncologist she knew said so.Â
    I never really got an answer on WHY that was, but I felt like a PICC had more of a chance to get infected, especially with the home health agencies we have around here, and in turn infect the port, than the port itself getting infected by infusing TPN through it. Does anyone know of a reason that a port cannot be used for TPN. We place plenty for our elective surgery patients for TPN. Seems like if this were true, I would have heard of it by now. Thanks ahead of time for any and all responses.
No valid reason that I can think of. Many patients get ports for TPN, especially if they will be accessing it themselves on a daily basis. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Robbin George RN VA-BC
INS Standards of Practice clearly states in their Parenteral Nutrition section (pg S75, 69, item B) “a central vascular access device with tip placement in the vena cava”. With no differential in the type of central vascular access device to be used.
John Costa, RN
Director of Sales
AccessRN, Inc.
Robyn,
Same thing at my facility. Our oncologists never wanted TPN thru the patient's port, and we woudl place a PICC also. They didnt want the high potential for infection with TPN infusing thru the port.
Cheryl Kelley RN BSN, VA-BC
Karen McKeon Williford RN, CRNI
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Thanks everyone for answering, but I am asking for written proof. Like a study. I know that TPN has high potential for infection, but it is put thru ports a lot, and I know for fact that a PICC has a higher infection and complication rate than the port, so who is to say the PICC will not become infected and infect the port anyway. If the patient goes septic, all lines would have to be removed. It just does not make sense to me to place another source for infection, when the patient already has a perfectly good VAD with lower infection potential already. Any written proof?