Accessing a chest port

[JenniferSews]

I'm so confused about this! I have a pt in a LTC/subacute center with a chest port. She was accessed with a huber neeldle but when she was done with her abx course the port was "somehow" deaccessed. Now she needs more IV abx. I've been getting conflicting answers regarding her port. Some say we must be specially certified (no one is in our facility afaik, although some feel they are qualified.) Our pharmacy says any RN can access the port. The PA says he can d/c PICC lines but not Huber needles. Since we weren't allowed within 10 feet of these ports in clinicals, I have no experience as a new grad.

[kids]

De-accessing the port just involves pulling the needle straight out. The access and it's cover dressing should have been changed Q week while she was on the antibiotics. You manage an accessed port just like a central line. During the period when it's not accessed it generally doesn't need a dressing but it does need to be accessed and flushed periodically to keep it patent.

A Huber needle is a non-coring right angle needle. There are a lot of different brands & styles but their basics are all the same. They usually have a pre-attached pigtail. http://www.isips.org/reports/Articles/Safety_Huber_Needles_article.html

Also, it's not as simple as ordering just any Huber needle. You have to use the correct size and length (depth).

Since no one is wanting to take responsibility for this lady and her port it NEEDS to go to the higher ups. They accepted her knowing she had a port they need to figure out how and who is going to care for it. I've never heard of it needing any sort of special certification but that is going to be a company/facility policy. They aren't that difficult to work with once you know how they work, the landmarks to feel for and the s/s of a problem. I do visits for a Hemo clinic that teaches the parents of kids with them how to access & infuse at home.

This really needs to go up the chain. If it means the facility has to pay for someone to come in to do it or to train staff thats just the way it is. They accepted her with a port, either they find a way to care for it or they need to arrange for transfer to a facility that can.

(If I or my loved one had a port and I/they were being subjected to IVs or blood draws rather than using the port I would raise holy heck.)

Some links:

http://safercare.s3.amazonaws.com/support_media/docs/clabsi/VAD_APPX/Appendix_L-Accessing_Deaccessing_Implanted_Central_Venous_Access_Port.pdf

http://nursinglink.monster.com/training/articles/302-the-use-and-maintenance-of-implanted-port-vascular-access-devices

Home care instructions for accessing & care:

http://www.healthsquare.com/mc/fgmc0928.htm

[JenniferSews]

Thank you for the info! I have been maintaining it and doing the sterile dressing changes while it was accessed.