A question today from our oncology dept. A pt with ? infected mediport and the MD wanted blood cultures from the un accessed mediport. The RN refused because they felt they may introduce the infection systemically by accessing the port (?). They cite a study from 2002, quoted below as reasons to not access the mediport. I wonder how you can establish the port is infected if you do not access it and draw blood cultures. Anyone have any ideas, or better yet articles whether to access or not?
However, if patients present with signs
and symptoms of port-pocket infections, obtaining
cultures through unaccessed devices
is not recommended (Rumsey & Richardson,
1995; Wickham et al., 1992). By placing a
needle through an infection, the possibility
exists of tracking infectious material through
the skin into the port septum. This can allow
microorganisms to enter the bloodstream, and
a systemic infection may result (Rumsey &
Richardson).
You need to find and follow the following set of guidelines that was originally published in the infectious disease literature and then republished in JIN. There are specific guidelines for the management of each type of catheter and yes, you can draw a blood culture.
1. Mermel L, Farr B, Sherertz R, et al. Guidelines for the management of intravascular catheter-related infections. Journal of Infusion Nursing. 2001;24(3):180-205.
The authors are well-known infectious disease physicians, so your ID docs should not have a problem with accepting these recommendations. 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