We recently admitted a patient to hospice who has an implanted port that has not been accessed for close to a year. Upon evaluation it has been determined there will be no need to use it so I suggested it be left alone. I instructed the nurse to not even attempt to access it. Too dangerous. Has anyone else encountered this and what would you do in this situation? Thanks! Valorie
First, when that VAD was no longer needed, it should have been removed. Now that this is a hospice patient, with a short life expectancy, removing it may not be worth the risk of transfer to a facility to open the port pocket and pull it out. There is no evidence that lack of flushing for XX period produces an increased risk of BSI but it is logical to think that it would. If there is no need for infusion therapy, I would not access and totally leave it alone as you are doing. If there is a need for infusion therapy, then I would assess the patient's peripheral venous access. if it would increase his pain/anxiety level with difficult peripheral access, I would access and use that port. It is a judgment call based on all patient factors if he were to need any type of infusion. But I would not do repeated peripehral sticks when he has this implanted port. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you Lynn. I just needed confirmation my thoughts were the same as others'. I felt no need for intervention if not needed...
Valorie Dunn,BSN, RN, CRNI, PLNC