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Standardizing Best Nursing Practice for Implanted Ports: Applying Evidence-based Professional Guidelines to Prevent
Susanne B Conley1, Paula Buckley, Lisa Magarace
1Dana-Farber Cancer Institute, Boston, Massachusetts, and Brigham and Women's Hospital, Boston, Massachusetts. Susanne B. Conley, MSN, RN, CPON, AOCNS®, is an advanced oncology clinical nurse specialist at Dana-Farber Cancer Institute in Boston, Massachusetts, with more than 35 years of clinical, administrative, and educational experience. Ms Conley is responsible for oversight and development of nursing policies and procedures assuring compliance with current practice and regulatory agency requirements. As a clinical nurse specialist for several oncology specialty practices, she is responsible for assuring evidence-based practice and staff training. Ms Conley is active in national organizations and has served as a project team member for the Oncology Nursing Society Institute for Evidence-Based Practice Change. She has published articles and developed curricula on nursing practice, and has spoken extensively on nursing practice issues. Paula Buckley, BSN, RN, is an intravenous (IV) access nurse at Dana-Farber Cancer Institute in Boston. She serves on the venous access committee and precepts new RN staff with IV skills. Lisa Magarace, BSN, RN, is an IV and apheresis specialist and served for 2 years as the full-time charge nurse on the laboratory services unit at Dana-Farber Cancer Institute. Candace Hsieh, BSN, RN, CIC®, is an infection control nurse specialist. She works for the infection control department of both Brigham and Women's Hospital and Dana-Farber Cancer Institute, where she also works in the pediatric oncology department. She oversees surveillance and monitoring of central line-associated bloodstream infections. She also serves on the venous access, infection control, and nursing policy and procedure committees. Lillian Vitale Pedulla, MSN, BSN, RN, NEA-BC, served as the director of laboratory services, developing the nurse IV access team for Dana-Farber Cancer Institute. She served on the adult nursing practice, venous access, and nursing policy and procedure committees.
Central vascular access devices (CVADs) are crucial for cancer patients but often cause bloodstream infections. Implementing evidence-based nursing practices for CVAD care can effectively prevent these infections.
Area of Science:
- Infection Control
- Vascular Access Devices
- Oncology Nursing
Background:
- Central vascular access devices (CVADs) are vital in healthcare, particularly for oncology patients, with nearly 3 million used annually in the US.
- CVADs are the primary source of central line-associated bloodstream infections (CLABSIs), a preventable complication.
- Adherence to evidence-based practices is key to preventing CLABSIs.
Purpose of the Study:
- To identify strategies for integrating professional, evidence-based standards for implanted port care into nursing practice.
- To improve the safe use of CVADs at the point of care within an ambulatory cancer center.
Main Methods:
- Review and adoption of professional organization guidelines for CVAD care.
- Development and implementation of targeted nursing education and practice interventions.
- Focus on implanted ports, a common type of CVAD in oncology.
Main Results:
- Strategies were identified to bridge the gap between established guidelines and daily nursing practice.
- The implementation aimed to enhance consistency in CVAD care at the point of care.
- Focus on ambulatory cancer care setting.
Conclusions:
- Consistent application of evidence-based practices is essential for preventing CLABSIs associated with CVADs.
- Integrating professional standards into nursing practice at the point of care is achievable.
- This approach supports safer CVAD management in oncology settings.