port-a-cath dressing change--needle change?

[veronica butterfly, ADN, RN]

When doing a weekly dressing change to a port that is being continuously infused, do you change the huber needle? Our procedure says we are supposed to, but none of our nurses concur. Are we just squeamish and none of us like poking a new needle into a port? We're not cancer nurses, just good old med/surg nurses! Seems like if it's infusing and in the skin, it's higher risk of infection to monkey with it...

[IVRUS, BSN, RN]

When doing a weekly dressing change to a port that is being continuously infused, do you change the huber needle? Our procedure says we are supposed to, but none of our nurses concur. Are we just squeamish and none of us like poking a new needle into a port? We're not cancer nurses, just good old med/surg nurses! Seems like if it's infusing and in the skin, it's higher risk of infection to monkey with it...

Veronica,

If you, or any of your fellow nurses were called into a Court of Law to defend any IV procedure, It's INS (Infusion Nurses Society) standards which are used as a benchmark for safe practice.

INS states that an implanted port needs reaccessing with a new huber needle every week, and PRN when intermittent/continuous fluids or medications are administered.

Your orders and MAR's need to reflect this.

[barefootlady, ADN, RN]

Maybe I am thick headed, but why is following policy an issue? This is a proven, well documented policy. Here, you better do it, do it in a sterile manner, and document the change. What does being an oncology nurse have to do with it?These ports are used in many types of patients. This has been a real issue between the younger nurses and the older nurses here. Once a month someone pulls out the P/P book and tries to justify not following policy. If you do not know how to do it, ask for help, ask for help if you are rusty, but do not do a halfa$$ job on patient care.

[grantyRN06]

Please correct me of I am wrong, but I thought that implanted ports are primarily used for patients undergoing chemotherapy. Veronica, I also work on med/surg..and periodically we get oncology overflow. Once a port is accessed, it has to be deaccessed and reaccessed weekly. We can not do this..only our IV team or oncology nurses who are port certified. Most patients are very protective of their ports, so we try to prevent BSI's and only allow the experienced / certified inividuals to change them to prevent any damage. I guess changing the huber needle is kinda the same reason for changing peripheral IV's after a certain amount of days.

[veronica butterfly, ADN, RN]

Thanks to all who replied. Great advice and thanks for the reminder about not doing a half-a$$ job of pt care.

[aposRN]

recently had patient admitted to SNF with portacath. No current policy on books for changing huber needle. found this somewhat helpful