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Implanted venous port access
- 3. REFERENCE CENTRES FOR DISEASE CONTROL Guidelines For The Prevention of Intravascular Catheter-Related Infections 2011
- 4. MEMORY AID • • • • • • • Wash Your Hands First. Use Body Fluid Precautions. Sterile Gloves Must Be Worn During Access. Aseptic Care Of Vascular Access Devices. The Fluid Pathway Must Remain Sterile. All Cleaning Solutions Must Be Allowed To Dry. The Access Needle And Tubing Must Be Stable and Secured.
- 11. HUBER TIP NEEDLE • Is designed with a deflected/non-coring tip to eliminate the potential for “coring” or cutting a plug from the skin and silicone septum of an implanted port. • When the needle is removed the septum reseals itself.
- 17. SKIN CLEANING SOLUTIONS • >.5% Chlorhexidine. • Povidone-Iodine. • 70% Alcohol.
- 18. ACCESS • Obtain an order to access the implanted port. • Identify the patient and explain the procedure. • Assess for pain tolerance and requirement for transdermal anesthetic. • Assess port site for redness, pain, drainage, swelling or erosion and if present document and report to MRP.
- 19. ACCESS • Wash hands thoroughly and palpate the infusion port site wearing clean gloves. • Assess for the appropriate non-coring Huber tipped needle. The patient may be aware of their usual needle gauge and length. Ideally when the Huber tipped needle is fully inserted, the right angle turn should rest as close to the skin as possible for maximum stability.
- 20. ACCESS • Assemble Supplies and set up the aseptic field. • Wear Sterile Gloves To Prepare Supplies. • Change Sterile Gloves. • Clean the skin over the port. Allow to dry completely then clean a second time and allow to dry completely. Include the whole area that will be under the transparent dressing.
- 21. ACCESS • Stabilize the implanted port with your nondominant hand. • Insert the Huber tipped needle perpendicularly through the skin and septum of the implanted port using steady pressure until the needle touches the base of the port reservoir. • Confirm correct needle placement by blood aspiration.
- 22. ACCESS • Confirm patency by a blood return and the ability to flush the implanted port without evidence of infiltration. • Dress the implanted port. • For continuous infusions the Huber tipped access needle gets changed routinely every 7 days.
- 23. IMPLANTED PORT DRESSING • Transparent Dressings get changed every 7 days and prn. • If sterile gauze is used under a transparent dressing to stabilize the wings of the access needle and it does not obscure the access site it may be considered a transparent dressing. • Gauze and Tape Dressings get changed every 48 hours and prn.
- 24. IMPLANTED PORT FLUSHING • When not accessed - the implanted port gets accessed and flushed every 4-6 weeks. MRP to order. • 5mls heparinized saline for non-valved implanted ports is appropriate.
- 25. DOCUMENT • • • • • Assessment of the implanted venous port site. Aseptic access. Gauge and length of Huber tipped needle. Blood return and ease of flushing. Any changes from the standard and why. There must be documentation that the MRP is aware and agrees and there is an order.
- 26. DOCUMENT • Any complications or problems and what you did about it. • How the patient tolerated the procedure.