Care of an Implant Port Policy

Anticipated outcome

The patient will have an implanted port which is:

• Patent and when accessed that the needle is correctly secured
• Free from signs of infiltration, extravasation, thrombosis, and/or infection and where these complications do occur that they are managed effectively

Nursing Interventions

Accessing the Port:

• Apply tropical local anaesthetic cream 30-60 minutes (depending on type) prior to accessing port
• Ensure comfort and correct positioning of patient whilst accessing
• ONLY use non coring (Huber) safety needles and 10ml or larger syringes
• Check for blood return once needle is inserted and use appropriate methods to check position e.g. position, deep breathing, if blood return is sluggish or absent
• Flush with 0.9% sodium chloride to check there is no pain or swelling at site

Maintaining a patent device:

• Check for blood return each time port accessed
• If no blood returned contact hospital / doctor
• Flush all devices with at least 10ml 0.9% sodium chloride at start of drug administration, in between drugs and after drug administration or according to instructions by hospital or doctor
• ONLY 10ml or larger syringes to be used for all drug administration
• When not in constant use flush the implanted port with 500 units heparin in 5ml 0.9% sodium chloride every 8 weeks or as directed by hospital or doctor

Preventing infection:

• Use an aseptic technique whenever the device is manipulated
• Requires no dressing unless port is accessed the use gauze to support needle and cover with Opsite IV 3000 and change dressing at weekly needle change
• Label dressing with date
• If allergic to transparent dressing then apply appropriate dressing
• Change port needle and extension set/clave connector every 7 days if in continuous use

Prevent movement or dislodgement of needle:

• Tape administration/extension set to prevent the tubing from pulling on device

Monitor site for signs of local complications:

• Observe site for erythema, oedema, blanching and ask the patient if any pain or discomfort experienced
• If extravasation occurs contact the hospital or doctor
• If signs of infection, swab insertion site and send for M, C & S, do not use port and inform doctor

Monitor patient for signs of systemic infection (rigors, pyrexia, tachycardia):

• Inform the doctor if temperature rises above 38°C or any of above signs
• Take blood for blood cultures from peripheral veins (where appropriate) and implanted port

Monitor patient for thrombosis – pain and/or swelling in neck, shoulder or arm:

• Inform doctor of any of the above symptoms
• Ensure appropriate anti-coagulant is prescribed and administered as required

Identify any complication and inform doctor of any complications during administration of treatment via implanted port.

Patient Education

Inform and discuss with patient/carer/parent:

• Advise the patient to report if any of the following occurs after the insertion of implanted port: feelings of breathlessness and cough, chest pain, pain over shoulder
• The function, potential side effects and implications of the implanted port including potential thrombosis (swelling in neck or arm), potential infection (pain/redness at implanted port site), potential occlusion, and advise the patient how to mobilise and care for the implanted port in situ
• Advise the patient of the importance in reporting to the nurse / doctor if they have any symptoms, and that a record is kept for future therapy

Date:  January 2024

Version: 5 (Review)

Source:  The Royal Marsden Hospital