Order for Port-a-Cath lab draws?

[jdsp87]

Do you need a doctor's order in order to draw blood for labs from a patient's port-a-cath? None of the nurse's on my shift, including the charge RN, could give a me a definite answer.

On one hand, it would make sense since the port-a-cath is a central line and, like a PICC line, it would require the expertise of a doctor to determine if it is OK to draw labs from.

But then again, another nurse pointed out that the purpose of the port-a-cath is to make it easier for the patient: why would you stick the patient when access is right in front of you.

I really want to hear all your opinions! =)

[applewhitern, BSN, RN]

I have never worked in any facility that allowed phlebotomists to touch a port or central line whatsoever.

[NJNursing, ASN, RN]

Lab gas never been able to access any central line for draws thus needing a Dr order to be able to get labs out. At the beginning of the year we stopped this practice at all from evidence based practice on infections. All labs must be drawn peripherally.

[FlyingScot, RN]

Lab gas never been able to access any central line for draws thus needing a Dr order to be able to get labs out. At the beginning of the year we stopped this practice at all from evidence based practice on infections. All labs must be drawn peripherally.

Just curious, what evidence based practice? Medi-Ports have one of the lowest infection rates.

[decembergrad2011, BSN, RN]

Are we talking initial access to get labs or a port that's already been accessed? I don't see a reason to stick the patient if they have a CVC for a lab draw. Most acute care patients with ports are going to have them accessed if they are being admitted. The entire point of ports is ease of access. An exception that I can think of is when drawing cultures; they are typically drawn from both the CVC and a peripheral stick with a butterfly.

I carry alcohol swabs in my pocket and scrub the hub between each connection. This greatly reduces risk of infection.