Program Objectives:
Upon completion of the program, the learner will be able to:
- Define and describe the purpose and indications for port placement
- Identify at least 5 physical attributes and components of an implantable port and port needles
- Identify port placement options and describe the surgical procedure
- Determine the best choice of needle type, length, and gauge on the basis of patient assessment and evaluation in addition to non-coring needle handling.
- List at least 5 complications related to implantable ports and the prevention and appropriate nursing action and for each.
- The learner is able to describe the procedure and rationale for a positive pressure flush
- The learner is able to describe how to access, use and maintain an implantable port.
- Identify key maintenance issues related to implantable ports
Introduction:
Central venous access deviced (CVADs) are used for patients who need long-term intravenous (IV) therapy or for the infusion of solutions that can not be administered through a peripheral line. CVADs are use for the administration of chemotherapy, total parenteral nutrition (TPN), hydration, blood products, medications, as well as blood sampling (Arch, 2007). An implantable port is a CVAD that is placed completely beneath the skin and is accessed by an external non-coring needle into a self sealing septum. Implantable ports have been in use for over 25 years (Wells, 2004). The improvements in design have resulted in a reduction in complications related to product failure. Implantable ports have become very popular for patients who require long-term yet intermittent intravenous therapy. When the port is not in use it does not require a dressing and only needs to be flushed monthly to maintain patency (Deltec, Inc., 2004). This feature allows patients to shower or participate in usual daily activities without the restrictions that are required with tunneled or percutaneously placed CVADs (Arch, 2007).
Indications:
Implantable ports are designed to allow repeated access (Bard Access, 2004). Since these CVADs work well with patients who do not require long-term continuous IV therapies, patients who are candidates for implantable ports include the following:
- Oncology
- HIV/AIDS
- Cystic Fibrosis
- Auto Immune Diseases
- Inflammatory Bowel Disease
- Intermittent Antibiotic therapy
- Intermittent/Short-term Total Parenteral Nutrition (TPN)
Although implantable ports have become a popular choice for home long-term IV therapies other CVADs may be more appropriate for continuous long-term therapies especiallly when the patient will become the primary caretaker of the the CVAD. This would include:
- Pulmonary hypertension
- Flolan/Blood Vessel Dilator Therapy
- Long-term continous TPN
CLICK HERE for "A Physical Description of Implantable Ports"
To continue on the next section of the course, click "Surgical Placement of Implantable Ports" found below under "Useful Links"
