How long can port-a-cath go without flushing

[fakemusician]

I work for home health. I have a patient who has a VAD (port-a-cath, lifeport) which was due to be flushed the end of last month. She was in the hospital and it didn't get flushed. I am telling her it's long over due (this would be 7th week) but the family feels like it can go just a little bit longer. I've always been told to flush it every 4 weeks but they said they were told different. How long can these devices go without being flushed? Thanks

[KelRN215, BSN, RN]

thecooperhouse said:

I'm a student and I have a question - what would you do you if you had a patient like the above that went a year or more without getting the port flushed?

I know someone said they wouldn't flush it - so what would you do?

Thanks!

I'd also access it and attempt to flush it, but I'd wonder why this patient still had a port if it hadn't been used in over a year.

[IVRUS, BSN, RN]

thecooperhouse said:

I'm a student and I have a question - what would you do you if you had a patient like the above that went a year or more without getting the port flushed?

I know someone said they wouldn't flush it - so what would you do?

Thanks!

Well, I still would NOT flush it, but rather I'd aspirate first and if I could pull off 7cc or so of blood discard then I'd be okay with flushing. No blood return = No flush. And I'd watch the patient for s/s of the "septic storm".

[OCNRN63, RN]

Depending on the dx., some onc. recommend keeping the port in for a while after treatment is finished if there's a high likelihood of recurrence.

[asorn]

Never think your patient doesn't have knowledge of their own illnesses and interventions. Always go to a "reliable" source to find your answer. Here is an example of one site that is research based ("reliable"). It proves some caterers have a longer flush interval than others (your patients knowledge about her type of catheter) and technique and standards for flushing. Remember that as RNs we are held accoutable to perform according to regulatory standards. The Joint Commission and Medicare refers to CDC guidelines often for certain alements such as this and UTI related to catheters Central Venous Catheters | Infection Control and Prevention Plan for Outpatient Oncology Settings | HAI | CDC

[IVRUS, BSN, RN]

asorn said:

Never think your patient doesn't have knowledge of their own illnesses and interventions. Always go to a "reliable" source to find your answer. Here is an example of one site that is research based ("reliable"). It proves some caterers have a longer flush interval than others (your patients knowledge about her type of catheter) and technique and standards for flushing. Remember that as RNs we are held accoutable to perform according to regulatory standards. The Joint Commission and Medicare refers to CDC guidelines often for certain alements such as this and UTI related to catheters Central Venous Catheters | Infection Control and Prevention Plan for Outpatient Oncology Settings | HAI | CDC

Though much of the information on this site is appropriate, however, some of the statements are not in line with Infusion Nurses Society Standards (INS). New Standards will be out this year and will clarify and dispel some inaccuracies.

[BD-RN, BSN, RN]

I would simply inform the patient of the standard of care, and that it won't hurt to flush it. This way the patient has a lower risk of it clogging and needing tpa.

[tblackstockrn]

Our protocol is 6-8 weeks.

[summerly]

I work in onc port draw. We recommend 6-8 weeks as well

[EndemCancer52]

I'm not a nurse, just an Endemetrial carcinosarcom patient. I have Power Port Clear CUE in my chest. It's been a little over 2 years since I had chemo, yet my oncologist feels I should keep my port til I reach my 5 years NED. I use to get my port flushes every 6 weeks but recently my Oncologist's Infusion Dept. changed the flush protocol frequency to a flush every 12 weeks base on the new studies performed on this subject. In the past, during chemo and shortly after, I experienced return issues requiring TPA TO clear my port but this hasn't been a problem recently. I have my first 12 week flush without issues. How many nurses and/or patients have been switched to this port flush frequency? Thank you.