I guess I have really only seen port-a-cath's placed on the chest, not accessed. I was precepting another nurse the other day and we had a patient that had a port-a-cath already accessed with a huber needle in place (I have never seen this) and we needed to do a blood draw for sodium levels. It is a care home so my preceptor donned mask but not sterile gloves. She swabbed the hub (single lumen) flushed first with 10 mls NS, wasted 10 mls, pulled sample, and then flushed with 10 mls NS again, and 5 mls heparin, push pause but I don't believe she did the positive pressure clamp thing at the end. Then, she said every time they do this draw..every day or more freqently, they change the hubcap on this single lumen extension set. Every 7 days a nurse comes from the outside and does the dressing change.
I've been researching best practice on this and was wondering if you could help me out with proper procedure. Would you really open this system every day to change hubcaps without even having sterile gloves on? Maybe I am way off base as like I said I have zero familiarity here but seems like a great, unnecessary way to introduce infection. In fact, after researching the patient chart, I found that this patient had a recent catheter infection (e-coli). Please help a dumb new grad, LOL