CT tech accessing ports

IVRUS, BSN, RN · Jan 15, 2016

So does anyone know of or heard of ct,mri, or nm techs accessing ports?? I've never seen this in my experience but at an imaging center I work at they are discussing training a few of their techs to access ports. I know they can use them once accessed but I don't feel comfortable having them actually accessing it. I feel like they are working out of their scope doing this. But maybe I'm wrong and this is a new thing I have not seen yet.. hopefully not though...

The last Infusion Nursing Society (INS) standards released in 2011 (With a new one being released any day now!) reviews that the decision to allow each type of personnel to be involved with IV therapy activities is based on their knowledge base and applicable laws in that state. So... A Nursing Assistive Personnel (NAP) should NOT have the responsibility to perform IV therapy procedures such as insertion of an IV catheter, (including the needle insertion into an implanted port) catheter manitenance procedures or administering ordered meds/fluids into the IV catheter.

A Medical Assistant (MA) however, functions to assist MD's and though their usual ppractice setting is MD's offices, they may actively participate in IVT activities, but should have a designated IV course to assist in assuring optimal patient outcomes.

heinz57 · Jan 15, 2016

The last Infusion Nursing Society (INS) standards released in 2011 (With a new one being released any day now!) reviews that the decision to allow each type of personnel to be involved with IV therapy activities is based on their knowledge base and applicable laws in that state. So... A Nursing Assistive Personnel (NAP) should NOT have the responsibility to perform IV therapy procedures such as insertion of an IV catheter, (including the needle insertion into an implanted port) catheter manitenance procedures or administering ordered meds/fluids into the IV catheter.
A Medical Assistant (MA) however, functions to assist MD's and though their usual ppractice setting is MD's offices, they may actively participate in IVT activities, but should have a designated IV course to assist in assuring optimal patient outcomes.

Nurse Assistive Personnel? These are not MAs or CNAs. They have their own education. They have their own Licensing boards. They have their own Medical Directors and they are not under nursing.

Do you think a Paramedic should never be allowed to access a port, start an IV or given any medications? You have professionals other than nursing starting PICCs, A-Lines and Central Lines.

IVRUS, BSN, RN · Jan 15, 2016

Nurse Assistive Personnel? These are not MAs or CNAs. They have their own education. They have their own Licensing boards. They have their own Medical Directors and they are not under nursing.
Do you think a Paramedic should never be allowed to access a port, start an IV or given any medications?

Nursing assistants may be CNA's, but MA's are a different thing, as are EMT's and Paramedics. I think that as long as the EMT or Paramedic has received training and has proven competency, they surely should be perfoming many different aspects of IV therapy. Where in my previous post did you get the idea that I was suggesting that that should be prohibited?

heinz57 · Jan 15, 2016

Nursing assistants may be CNA's, but MA's are a different thing, as are EMT's and Paramedics. I think that as long as the EMT or Paramedic has received training and has proven competency, they surely should be perfoming many different aspects of IV therapy. Where in my previous post did you get the idea that I was suggesting that that should be prohibited?

The last Infusion Nursing Society (INS)

My point is that Nuclear Med Technologists. CT Technologists, Radiology Technologists, Interventional Radiology Technologists etc are not Nursing Assistants, CNAs, MAs or whatever Nurse Assistive personnel. They are LICENSED and have their own MEDICAL DIRECTORS. They have nothing to do with nursing standards. Most of them probably went to school longer than many RNs to specialize in their profession and perform skills required to do their job.

IVRUS, BSN, RN · Jan 15, 2016

My point is that Nuclear Med Technologists. CT Technologists, Radiology Technologists, Interventional Radiology Technologists etc are not Nursing Assistants, CNAs, MAs or whatever Nurse Assistive personnel. They are LICENSED and have their own MEDICAL DIRECTORS. They have nothing to do with nursing standards. Most of them probably went to school longer than many RNs to specialize in their profession and perform skills required to do their job.

Well, what does the ASRT state? Is it acceptable for RTs to access implanted ports? What does your director of radiology say that your state guidlines are?

heinz57 · Jan 15, 2016

Well, what does the ASRT state? Is it acceptable for RTs to access implanted ports? What does your director of radiology say that your state guidlines are?

For what profession? The OP named CT Radiology, MRI and Nuclear Med Technologists,

If you want to read through their scope of practice you might be enlightened that these are EDUCATED professionals.

http://www.hcpro.com/content/277441.pdf

Read the link. It will explain some of the different professions mentioned by the OP, their education and their scope of practice. Just like nurses, the scope of practice can be fully utilized or limited by the employer or the nature of the job.

Here is one part of their scope:

Performing venipuncture as prescribed by a LIP

Starting and maintaining IV access as prescribed by a LIP

Identifying, preparing, and/or administering medications as prescribed by a LIP

Placing, maintaining, and removing peripherally inserted central catheters as

prescribed by a LIP

And that is just a tiny part of what they do.

We also don't know if one of those the OP mentioned could also have been a Registered Radiologist Assistant which is 6 years of training and education much like a PA or NP.

iluvivt, BSN, RN · Jan 15, 2016

The big deal is that they do not have the experience of working with them and accessing them and may be not be able to identify the complications. They are not trouble free and can be damaged if accessed improperly. Many can be difficult to access and others may be a breeze. My entire body of knowledge about IV therapy comes with me every time I take care of a patient and that is a very valuable asset. Would you rather have a surgeon take out your hot appendix or the scrub nurse who has watched many?

iluvivt, BSN, RN · Jan 15, 2016

ASRT Practice Standards FAQ

NRS86 · Jan 15, 2016

I fully think they are competent, my point was that in my experience I have NEVER seen or heard of them accessing ports. Its the legal aspect of it that I am worried about, especially when they want me to write up the policy and procedure for their company, I do not want my name all over something that implies they can access ports if in fact they cannot. I've been searching all online and have only found they can insert peripheral IVs. The other day I had another CT tech ask me to flush a pt's picc since she cannot do that, so why in the heck would they be able to access a port if they cannot even flush a picc?! Also, the NM tech asked me "so which way is the line facing" and she was pointing the catheter all sorts of different directions. So after that I feel validated that I should question their legal ability to access them.

I didn't mean to come off egotistical, I truly was curious if other nurses on here have come across this in their experience and if anyone could point me in the right direction, thank you to those who provided links! I know it varies state to state too, I just wanted a general idea of whats out there.

Here.I.Stand, BSN, RN · Jan 15, 2016

I have accessed exactly 0 ports in my 13 yr career, so admittedly don't know enough about them to know if it is something you need unique nursing knowledge for, or if it's a *skill* that can be taught.

Not sure if this a great comparison, but I'm thinking of arterial sticks. I didn't learn to do them in nursing school, and everywhere else I've worked, this was something done by the RRT. However where I work now, SICU nurses draw our own ABGs. (I don't believe the MICU nurses do, just bc while floating there once, the RRT called me and apologized that she hadn't gotten to my pt's yet. So it sounded like she had expected to draw it. PICU, NICU, and Burn I don't know about. RRTs do draw them on the floors and stepdown units.) RNs on my unit are taught the skill during orientation. "But we weren't taught it in school, and it's typically not a nursing function...why are they sticking arteries??"

I would think though, if you are truly concerned for your pts' safety, you could access the port yourself before sending the pts for their scans.

sjalv · Jan 15, 2016

Not sure why this is such a big deal. I get that proper assessment needs to be done before accessing a port. However, are there not plans for the Rad Techs to be trained on how to do this and what to look for? I don't see how this is different from a nurse who is new to an area being trained on specific interventions/techniques. For example, I work CVICU. If I had to work in L&D, would it be unheard of for me to monitor fetal heart rates/contractions after having received training? I think not. So why is it not okay for rad techs to do the same with accessing ports for imaging purposes? Rad techs are educated allied health professionals just like RN's. To me, this sounds more like nurses being intimidated that another profession is 'moving on their turf', so to speak.

UTVOL3 · Jan 15, 2016

I worked at an outpatient imaging center and this was done. CT/NucMed techs especially. Is your center outpatient? It is not a new thing. Rad techs work under their own state practice acts ( I think that's what it's called, equivalent to our scope of practice) and the license of the radiologist. Much the same way an MA works under the license of the physician to do things like give injections in the office. T