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Laura Lenihan

Physician ordered daily access and daily deaccess for implanted port, stating to patient that weekly access/deaccess "increases infection". INS states "at least" once weekly huber needle change. I teach, and our usual practice is once weekly access, deaccess.

Please provide guidance for this. I want to call MD to discuss this order to change it to weekly but an unable to quickly find specific INS statements on how frequently is to freqently.

Of COURSE it is 2:50 pm on a Friday.

Thank you in advance!!

There are no studies

There are no studies assessing even the 7 day change. This has always been the recommendation from manufacturers since these were introduced to the market in the early 1980's. INS SOP says there is no evidence to make any recommendation. 7 days is now and has been the prevailing practice since the beginning. Infection risks with implanted ports is low. 

There is another factor to consider. Contact the manufacturer of the brand of port in use. Ask how many punctures their port has been tested for. Then do the math with daily accessing to calculate a reasonable length of time before this port would have too many puncture. A damaged port septum can easily cause leakage. 

The final factor is patient pain from being stuck. Patient needs to be educated about this.Port is located in his/her body, therefore this decision belongs to them, not the physician. Educate patient and let them be the one to decide, then tell the provider what can happen. 

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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