Implantable venous port management in the oncology ward: a best practice implementation project

ABSTRACT Introduction: Implantable venous ports (IVPs) are widely used in patients with cancer for administering intravenous medications and fluids. Inadequate IVP care increases the risk of occlusion or infection, necessitating IVP removal. Aim: This project aimed to improve nurses’ IVP management in oncology patients by implementing evidence-based recommendations. Methods: The project was conducted in a medical center in Taiwan. Using the JBI Evidence Implementation Framework, four audit criteria were developed to conduct baseline and follow-up audits. Nurses’ IVP care skills and compliance were evaluated through an objective structured clinical examination (OSCE) and bedside observations. JBI's Getting Research into Practice (GRiP) tool was used to identify barriers and design strategies for project planning and implementation. To address these barriers, nurses were given IVP training (through videos), which enabled them to provide appropriate IVP care at the bedside. Results: Although 62.5% of the nurses had received training on IVP care before project implementation, only 18.8% passed the OSCE. The nurses neither administered topical local anesthetics nor implemented measures to minimize patient discomfort before or during IVP needle insertion. Moreover, nurses did not use normal saline to flush and lock IVPs when not in use, as recommended by best practices. After project implementation, compliance with all four audit criteria increased to 100%. No episodes of occlusion were reported. Furthermore, the IVP infection rate markedly decreased from 8.45‰ to 2‰. Conclusion: Proper IVP management skills are important for oncology nurses in providing good quality of care and preventing IVP infection. Nurse practitioners can play a key role in developing evidence-based care protocols and addressing barriers to IVP care in clinical settings. The evidence-based video training and bedside observations successfully improved oncology nurses’ competence and compliance with best practices for IVP management. Spanish abstract: http://links.lww.com/IJEBH/A408