Evaluating Normal Saline Locking With Totally Implanted Vascular Access Devices for Patients on 90-Day Maintenance...

Area of Science:

• Vascular Access Device Management
• Evidence-Based Practice
• Clinical Nursing

Background:

• Heparin is a common locking solution for totally implanted vascular access devices (TIVADs).
• Limited data exist on using normal saline alone for TIVAD maintenance flushing over 90 days.

Purpose of the Study:

• To evaluate if using normal saline alone as a locking solution for TIVADs increases partial occlusions during a 90-day maintenance protocol.

Main Methods:

• A clinical team monitored alteplase administration to track partial occlusions.
• Nurses were educated on device maintenance, including pulsatile flushing and clamping techniques.
• Heparin use was deimplemented, transitioning to normal saline for TIVAD locking.

Main Results:

• A comparison was made between 2,908 encounters with heparin locking and 3,239 encounters with normal saline locking.
• Minimal variance in partial occlusions was observed between the two locking solutions.

Conclusions:

• Normal saline alone can be effectively used as a locking solution for TIVADs.
• The transition from heparin to normal saline did not result in a significant increase in device occlusions.