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Port Access by ER and training


I am a Vascular Access RN in Salem Oregon, and I had a few questions regarding Port-A-Cath Access training specifically by RNs in the ER. Our ER is proposing that all 144 RNs be port trained. Currently, it's only charge RNs and resources who are trained at our hospital. Before we change our protocol, I wanted to see how other places are similar to this practice or differ.

Do other hospitals restrict the number of RNs that they train in the ER for port access? Or does every ER nurse get trained? Does that affect your CLABSI rates?

Additionally, how many port attempts is considered certified for port access? Do any hospitals have their Vascular Access team perform all the port accesses?

Thanks in advance,

Natasha Sullivan, RN BSN

There is no "certified"

There is no "certified" method as that word does not apply. Joint Commission and the INS SOP use competency assessment. This is definitely not a certification of any kind. Competency includes knowledge acquisition followed by work in a simulation lab, followed by supervised clinical practice on patients. Accessing an implanted port represents and expansion of nursing practice for this group of ER nurses, therefore documented competency is required. There are no magic numbers of any procedure that equates to competency. Supervised clinical practice extends until each person has mastered the procedure. If you have an average of 3 successful attempts per nurse X 144 that would mean 432 patients needed for documented competency for each nurse. Some will take longer than other so 5 successful attempts per nurses would be 720 patients. Now look at the number of patients with an implanted port coming into your ER and determine how long this process would take. A simple 15-30 minute training is simply not enough. Nurses without this skill have been known to cause serious damage to the port body and catheter. Also this entire group must know how to manage it when there is no blood return. It cannot be used until the reason has been diagnosed and corrected. So knowledge and skill are required. 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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