port access ?biopatch

[melissahunter2]

I am a home health nurse doing an antibiotic infusion through a port. I have not done one in a while. After the port is accesed do you put the biopatch under the huber needle then cover with tegaderm? Change q 7 days??

[iluvivt, BSN, RN]

Please be aware that it may not always be possible to apply a biopatch at or around the non-coring needle access point into a port. Ideally.you select the right angle needle length that will sit flush with the skin...the most common that I use are the 1 inch and the 3/4th inch....Once I select my needle gauge and length...I access it and IF and only if I have a litle space between the skin over the portal septum and the needle...I open the radial slit of the biopatch and slide it in between the skin and needle.....if you do not have room for it....it is not wise to pull the needle back and make room as you risk barely having the needle through the chamber and risk infiltration/extravasation. Remember that a port has a very low infection risk when compared to other CVCs. In high risk populations I am more apt to try to squeeze one in. It is also imperative that you stabilize the needle so it does not create a big hole as this can cause a drug leakage pathway. bard makes an adjustable port access needle that you an slide to fit the patient perfectly...if you are using this product you can leave a little extra room to slide the biopatch in. Yes you can put the Tegaderm or TSM dressing on after the biopatch

[melissahunter2]

Thank you so much for your reply!! One last question, if I do not use the biopatch then does the dressing and huber needle need to be changed more frequently?

[iluvivt, BSN, RN]

No....still OK to change at least every 7 days unless it is compromised in some way...Yes the bioptach is a good thing...studies show as high as a 60 % decrease in catheter-related bloodstream infections..when used especailly with the higher risk CVCs .so great to use if you can...but ports have a low infection rate especially if care for well (about 2 percent) again try to weigh the risk vs the benefit as well as taking into account patient comfort,dx,product you use and pts risk fro infection and other complications and document why you did what you did. Please use sterile technique but I assume you already know this...have pt turn their head and or give the patient a mask....make certain your CHG...air drys before you access...all that good stuff helps