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Discussion

Port a cath question

In a home health situation can a registered nurse teach the patient how to remove their Huber needle from their Port-A-Cath? This is not a sterile technique.

nurses are allowed in Home Health to teach how to remove a wound VAC in case it fails and to use a possible wet to dry dressing until the nurse can come and service that wound VAC. There are other situations where nurses teach things like how to perform G-tube care and feedings to that G-tube. TPN, IV administration of fluids, IV anabiotic‘s can be taught in the home. 
 

Can a registered nurse teach a patient how to remove a Port-A-Cath needle because it is a non-sterile technique? Is this against the law? Is this against a nurses practice? Is this against most facilities policies?

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    Many of our patients are taught how to access and de-access their own or their ports. They also are taught how to change CVC dressings and flush their lines. Your responsibility would come in assessing their capability to correctly perform the procedure and then monitoring for issues. 

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    Wuzzie is correct.You have to determine whether or not a caretaker and\or the patient can successfully complete the task. I have encountered so many patients who do not want to even learn to access and deaccess their ports.The one population that I have found that does want to do this is are the parents of pediatric patients. It is critical to document your teaching and the level of competence achieved and if the patient and or caregiver are fully independent. 

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    I did this when my husband had chemo that he went home with. The nurses at the infusion clinic went over the steps in how to silence the alarm on the portable CADD pump, safely disconnect, flush, add heparin and deaccess the port. They also knew I was a nurse familiar with central lines. I was given the chemo gloves, flushes, alcohol wipes and a zip top bag for the pump.

    The nurses said they went on a case by case basis. Most of the patients returned to the clinic to be taken down if they or their families were not comfortable doing this themselves. 

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