Heparin Versus Saline: A Comparative Study to Support Practice Change Within an Organization

Area of Science:

• Oncology Nursing
• Vascular Access Devices
• Pharmacology

Background:

• Peripherally inserted central catheters (PICCs) are crucial for blood cancer patients.
• Maintaining PICC patency is essential for treatment delivery and patient safety.
• Current practices often involve heparin or saline for catheter locking.

Purpose of the Study:

• To compare the effectiveness of heparin versus 0.9% sodium chloride for locking PICCs in patients with blood cancer.
• To evaluate differences in catheter patency, side effects, costs, and nursing time.

Main Methods:

• A nurse-led randomized study.
• Patients with blood cancer received either heparin or 0.9% sodium chloride for PICC locking.
• Catheter patency was assessed over a period of up to 7 days.

Main Results:

• No significant difference in PICC patency was observed between heparin and 0.9% sodium chloride locking.
• Heparin use was linked to increased side effects, higher costs, and greater nursing time.
• 0.9% sodium chloride demonstrated comparable efficacy with fewer adverse events and resource utilization.

Conclusions:

• 0.9% sodium chloride is a safe and cost-effective alternative to heparin for maintaining PICC patency in blood cancer patients.
• Adopting 0.9% sodium chloride can enhance patient safety and reduce healthcare expenses.
• This evidence supports a shift in clinical practice towards saline for PICC maintenance.