Port Care question

  1. I work hospice, and I had a patient call the hospice today demanding someone come out and access her port, to flush it. she was in the hospital 1 month ago, and her port wasn't accessed at that time--they were doing peripheral sticks.

    Does a port need to be accessed every month? to be flushed and heplocked?

    Thanks for your help.
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  2. 9 Comments

  3. by   canoehead
    I've always thought they should be flushed monthly, and that's what our orders are for. Does anyone else have other guidelines?
  4. by   NurseyBaby'05
    I don't know. I work inpatient and we've accessed them when they have been untouched for months and have not really had any problems. Karen, Jnette, any other home care nurse care to chime in??
  5. by   NurseyBaby'05
    As for the patient wanting the port accessed today, what for? If it hasn't been accessed for awhile, a few more days until you get some clarification isn't going to hurt. Besides, if she's on hospice, are you using it for comfort care?
  6. by   AtlantaRN
    Quote from NurseyBaby'05
    As for the patient wanting the port accessed today, what for? If it hasn't been accessed for awhile, a few more days until you get some clarification isn't going to hurt. Besides, if she's on hospice, are you using it for comfort care?
    Nope, we aren't using it at all, and when she was inpatient, they didn't access it at that time either, she had peripheral lines.

    Truth be told, she either has brain mets (primary is lung cancer), or she has some affect disorder issues. I KNOW she is going through the hardest thing in her life. She was sooooo angery for the first 3 weeks, super ultra suspicious...but last week she seemed more receptive to hospice. I've told her on every visit that hospice can be involved as much or as little as she requires. 2 weeks ago she yelled at me saying "its not your business what funeral home i will use....however, after I explained the information was to help HER CHILDREN at the time of her death...."

    She goes from anger, to suspicion, back to anger, to suspicion....

    linda
  7. by   AtlantaRN
    thank you for your help.....I don't have any order to access said port.

    It is my understanding she called her cardiologist for an appointment and she heard "no you are on hospice, we aren't going to treat you..." she has been suspicious since admission to home hospice.
  8. by   Cattitude
    Quote from atlantarn
    i work hospice, and i had a patient call the hospice today demanding someone come out and access her port, to flush it. she was in the hospital 1 month ago, and her port wasn't accessed at that time--they were doing peripheral sticks.

    does a port need to be accessed every month? to be flushed and heplocked?

    thanks for your help.
    it should be flushed q months but doesn't "need" to be. i've seen them go months and still be patent. but each agency has their own policiy.. if you're not using it why does she want it flushed?
    btw, how do you like hospice? i may go that route in a few years..(working,not as a pt!!!!)
  9. by   AtlantaRN
    I like hospice, except when they call me when I'm not on call...but I talked with them today and they said "we just wanted you to know what was going on".

    see thread:

    http://allnurses.com/forums/f25/hosp...ll-202602.html

    this one particular patient gets fixated on things, i believe strongly she has brain mets...she called the office yesterday and went into a rant for 10 minutes about how she called her MD, and they said she "was on hospice", she asked the team coordinater "who signed me up for this.....and......they had no right", wanted copies of everything (which is in her home right next to her recliner)...so...anywho, can be challenging...

    Every case is different, and there are ALOT of WHACKED family dynamics, but that is EVERYWHERE. Death and Dying, by Kubler-ross really helped me, because at first I was so ANGRY at some of the families -not this one inparticular--(saying we "want to help mamma"....but then taking 1 month off leave of absense from their job, and NEVER being at the house with mamma.)

    another good book is understanding death and dying. got on www.campusi.com; a great resource for any books/textbooks. stuff there is cheap cheap.

    Anywhoo, a good job, but different from hospital setting (that is what i've been used to).

    Thank you for the information about the port.
  10. by   teejayrn
    Quote from canoehead
    I've always thought they should be flushed monthly, and that's what our orders are for. Does anyone else have other guidelines?

    We flush ours every month as well. Even if it is not being used for anything else.
  11. by   SWRN84
    We have always flushed ports once monthly if they aren't being used. They may last longer than that without flushing, but in the 20 years I have been doing home health, both agencies' policies have been monthly flushes for those ports that aren't being accessed on a routine basis.

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