Using a permacath for med administration in end-of-life care.

[Martie S]

I work in an Inpatient hospice unit, many of our patients are here for acute symptom management and if we are lucky enough to get them with a PICC, Central Line, or Medioport we will access those and use them for med administration.  We will often get patients with ESRD and come to us with a permcath that had been used for dialysis but is no longer in use. Our policy has been that we do not use it and change to SQ route.  We have a new manager who insists that we can use them (even though no one has been trained on them, and there is no policy in place for using them).

My question is...  if these are not being used for HD any longer, and we are giving meds at least every 4 hours ATC and sometimes more often, has anyone used a Permcath on a regular basis during end-of-life care in an acute setting. 

[NrsGuy]

Hey, I haven't used a permacath for end of life situations. The rationale between not using it for anything but HD is to preserve the line for HD - prevent any issues that would contaminate the line or require it to be changed. In this case, because the patient is EOL and will likely not need HD again, in theory, it would be clinically acceptable to use for med administration. That said, you need to follow the policy of your facility. If I were in your position, I would likely get an order from the doc that states, "okay to use permacath for med administration during hospice care.” 
 

good luck! 

[Martie S]

Thank you, we do not have a policy in place at this time. We are in the process of developing one with the same reasoning in mind you mentioned. I appreciate the input! 

[mrphil79]

NrsGuy said:

If I were in your position, I would likely get an order from the doc that states, "okay to use permacath for med administration during hospice care.” 
 

This is a great answer. 

[SnickRN BSN RN CCRN]

I work ICU and if we are in a crisis, we'll use it and beg for forgiveness later. I have used a permcath for med administration but only after I have an order from  Nephrology & the Attending. Why add more pain when we are providing transitional comfort?