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Extending Maintenance Flush Intervals for Implanted Ports at VA Northeast Ohio Healthcare System (VANEOHS)
At the beginning of the COVID-19 pandemic, the Hematology Oncology Department at VANEOHS looked for ways to continue safe oncologic care delivery while limiting unnecessary in-person visits for our Veterans. The Hematology Oncology team considered extending the interval between maintenance flushes for implanted ports, however wanted to confirm the change aligned with safe practice recommendations. A literature review supported changing the medical center’s current practice of maintenance flushing from every four to six weeks to every twelve weeks. The literature review suggested that this change was safe and effective. Our goal was to ensure this change in practice did not cause an increase in alteplase usage or an increase in port related complications such as infection. A pre-intervention data review from August 1, 2019 to February 2, 2020 (n = 217) showed that 8 orders (4%) were placed for alteplase for oncology patients receiving maintenance port flushes and there were no implanted port infections reported during that timeframe. Interventions included: updating the implanted port order set in Computerized Patient Record System (CPRS) and providing education to Veterans and nurses regarding the change. A post-intervention data review from August 1, 2020 to February 28, 2021 (n = 94) demonstrated that 2 orders (2%) were placed for alteplase for oncology patients receiving maintenance port flushes and there were no implanted port infections reported during that timeframe. This trial confirmed that an implanted port flush maintenance schedule of up to twelve weeks aligned with safe practice recommendations and did not increase port related complications. Due to the positive outcome of implementing an extended interval between maintenance port flushes the medic
At the beginning of the COVID-19 pandemic, the Hematology Oncology Department at VANEOHS looked for ways to continue safe oncologic care delivery while limiting unnecessary in-person visits for our Veterans. The Hematology Oncology team considered extending the interval between maintenance flushes for implanted ports, however wanted to confirm the change aligned with safe practice recommendations. A literature review supported changing the medical center’s current practice of maintenance flushing from every four to six weeks to every twelve weeks. The literature review suggested that this change was safe and effective. Our goal was to ensure this change in practice did not cause an increase in alteplase usage or an increase in port related complications such as infection. A pre-intervention data review from August 1, 2019 to February 2, 2020 (n = 217) showed that 8 orders (4%) were placed for alteplase for oncology patients receiving maintenance port flushes and there were no implanted port infections reported during that timeframe. Interventions included: updating the implanted port order set in Computerized Patient Record System (CPRS) and providing education to Veterans and nurses regarding the change. A post-intervention data review from August 1, 2020 to February 28, 2021 (n = 94) demonstrated that 2 orders (2%) were placed for alteplase for oncology patients receiving maintenance port flushes and there were no implanted port infections reported during that timeframe. This trial confirmed that an implanted port flush maintenance schedule of up to twelve weeks aligned with safe practice recommendations and did not increase port related complications. Due to the positive outcome of implementing an extended interval between maintenance port flushes the medic
At the beginning of the COVID-19 pandemic, the Hematology Oncology Department at VANEOHS looked for ways to continue safe oncologic care delivery while limiting unnecessary in-person visits for our Veterans. The Hematology Oncology team considered extending the interval between maintenance flushes for implanted ports, however wanted to confirm the change aligned with safe practice recommendations. A literature review supported changing the medical center’s current practice of maintenance flushing from every four to six weeks to every twelve weeks. The literature review suggested that this change was safe and effective. Our goal was to ensure this change in practice did not cause an increase in alteplase usage or an increase in port related complications such as infection. A pre-intervention data review from August 1, 2019 to February 2, 2020 (n = 217) showed that 8 orders (4%) were placed for alteplase for oncology patients receiving maintenance port flushes and there were no implanted port infections reported during that timeframe. Interventions included: updating the implanted port order set in Computerized Patient Record System (CPRS) and providing education to Veterans and nurses regarding the change. A post-intervention data review from August 1, 2020 to February 28, 2021 (n = 94) demonstrated that 2 orders (2%) were placed for alteplase for oncology patients receiving maintenance port flushes and there were no implanted port infections reported during that timeframe. This trial confirmed that an implanted port flush maintenance schedule of up to twelve weeks aligned with safe practice recommendations and did not increase port related complications. Due to the positive outcome of implementing an extended interval between maintenance port flushes the medic