I cannot find a protocol anywhere at work, and googling it has not helped. I work in a SNF. We use a lot of subcutaneous ports for morphine, etc in dying residents. Some nurses flush the tubing with saline after giving the drug, some don't. I always flush, and my rationale is this: If you don't flush, the medication stays in the tubing and the patient doesn't get it. And as is often the case, if multiple drugs are given through the port, for instance, I gave morphine an hour ago and now I'm giving Ativan, if I didn't flush, I'm essentially giving the morphine and the Ativan just sits in the tubing. A couple of nurses have challenged me on this because they were taught not to flush, but like I said, I can't find anything at all in writing, so I'm going with my gut. I wasn't taught anything about SQ ports in school, so I really don't have a frame of reference, other than using the same rationale for this as flushing IV tubing after you push a drug...because otherwise the pt doesn't get the correct dose. Anyone have any resources? If I'm wrong I'd like to know! Thanks!
A couple of nurses have challenged me on this because they were taught not to flush, but like I said, I can't find anything at all in writing, so I'm going with my gut.
You are NOT going with your gut. You're going with your brain!
You have a well-thought-out rationale for your actions. Your colleagues do not if all they can say is, "Because that's what I was taught."
You were saying IV, assessing the IV site for redness/swelling, etc...the device I'm referring to does not have any venous access.
I think I'm not the only one who was confused by your use of the term "port". Let me clarify. Am I correct in thinking what you are talking about are the indwelling SQ needles that are often used for continuous SQ infusions (like insulin or pain medicine) rather than a true subcutaneous port like a medi-port?
Specializes in LTC, home health, critical care, pulmonary nursing.
I think I'm not the only one who was confused by your use of the term "port". Let me clarify. Am I correct in thinking what you are talking about are the indwelling SQ needles that are often used for continuous SQ infusions (like insulin or pain medicine) rather than a true subcutaneous port like a medi-port?
Aaahhh! Now hopefully everyone is on the same page. Perhaps there is a better descriptor for them than "port" as that has clearly caused a certain amount of confusion. I'm kinda glad it wasn't just me.
We don't flush sq "buttons" at our facility. I work for a hospice and we use sq buttons all the time. If someone needs Ativan and Morphine subcutaneously, then they get two sq needles inserted. They are primed only with the medication that they are going to deliver, and they only ever give one medication through that button. They are very well marked. No flushing involved. IMO, if you are only using one sq button, then you would need to flush, but it doesn't seem like a good idea to use only one. Do we really want to push that much fluid into a person's tissue?
What if the pt needs Ativan and Morphine at the same time? It seems like too much to me. It sounds uncomfortable and unnecessary, when all you have to do is add another button somewhere else. Then you don't have to flush and add unnecessary fluid.
"If there is only one medication going into the site, flushing the tubing after medication administration is NOT necessary. If the site is used for more than one medication, flush with a compatible solution after giving the medication. The volume of the flush should be equal to the volume of the tubing. "
"If there is only one medication going into the site, flushing the tubing after medication administration is NOT necessary. If the site is used for more than one medication, flush with a compatible solution after giving the medication. The volume of the flush should be equal to the volume of the tubing. "
Music in My Heart
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You have a well-thought-out rationale for your actions. Your colleagues do not if all they can say is, "Because that's what I was taught."