Portocath Hell

Elena,

The route I would go with this one. The risk for infection, especially with an oncology patient. Good luck with your manager.

I have a situation that I have to go to my Dept Head that involves a portocath. I used to do oncology for 3 hospitals and did their IV therapy. In the "Green Acres" community hospital I am in now, we have a doctor that has ordered that a patient's portocath is to be accessed daily. She has multiple metasis sites and is suffering enuf. Her left chest looks like hamburger meat and I just found out about her. She has been accessed for 1 1/2 months, every day. Is there any documentation about portocaths that are accessed too much? I am looking up the hospital policy too. I would like to back it up with research too.

I am glad to be leaving this hospital soon.

Elena:zzzzz

By "accessed" do you mean that the needle set is changed every day!? I don't think you need to look for any more evidence-based research than to have the MD and your supervisor assess the port site to see the results of too-frequent sticks. Whatever happened to 'primo non nocere'? Ports,PICCs and other vascular access devices are intended to make things better for the patient. If the patient's skin is getting that chewed up,time to reassess the daily sticks. The INS standard says "at least every 7 days" for access needle changes. We do ours every 4 days for inpatients. Most of the local outpatients get every 7 days changes.

I feel sorry for the patient.

D

What on earth? That is really bizarre. Seriously go for the infection control side, not to mention the needless pain. Ports are there for many reasons, one of which is to REDUCE needle sticks. Would he have you placing a brand-new IV every day? Or a new PIC/C? I doubt it.

Crazy.

Hello!

I am getting recommended guidelines from ONS & CDC & BARD equipment. Thanks for the feedback.

Elena

the septum of a port is only designed to withstand so many sticks. the numbers i have seen are something like 1000 sticks with a 19g needle; more with a smaller gauge. that is a lot of sticks it can handle, but the overall life of the port is seriously shortened by the frequent sticks.

Hello!

I am getting recommended guidelines from ONS & CDC & BARD equipment. Thanks for the feedback.

Elena

Elena 15

Don't forget the INS Standards Jan/Feb 2006. Standard 45 H under Practice Criteria (pp S47-S48)

poor patient! That doctor needs some education about portacaths for sure. Every 7 days is plenty with a sterile dressing and a biopatch.