Bard recently extended the recommended maintenance flushing interval from 28 days to 90 days with saline-only optional locking for ALL Groshong port catheters. This claim is backed by a retrospective clinical study and has been approved by the FDA. Interested in switching our maintainence flushes to this recommendation. Has anyone made this change and if so, any issues?
thank you!
Shari Tollerud RN
St Lukes Infusion Center
The Bard reps presented this feature of their Groshong ports to us a few months back as a counter to our Angiodynamics Endexo BioFlow Ports we currently use. My first thought was, "If a patient can go three months without a port flush, why do they even need the port?" IHI Central Line Bundle #5: Daily assessment for ongoing need for all vascular access devices with prompt removal when no longer needed.
Granted, many oncology patients will keep their ports in for 6-12 months after completing treatment, but it's primarily because they will have frequent labs and surveillance scans during this time. I say pull that port once they are no longer in the close surveillance phase. It's not a benign, risk-free device. I am always very reluctant to flush a port that hasn't been flushed in several months (because the patient forgot or "didn't know they had to") for any reason.
For the CF, sickle cell and other miscellaneous populations that have ports placed due to long term needs with difficult venous access, I think the benefits need to be seriously weighed before the port is placed and I still would not want to wait three months between flushes. I advocate for vein visualization technology in these cases: IR, nIR, and U/S.
Just my two cents.
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA