A best-practice implementation project of the maintenance of totally implantable ports: Lessons from one high-volume centre

Tags: Poster
Shen Y1, Xu J2, Zhang X3, Huang H3, Li L3, Hu Y4, Chen Y4, Ge F3
1Zhongshan Hospital,Fudan University; Fudan University Centre for Evidence-Based Nursing: a Joanna Briggs Institute Centre of Excellence, 2Zhongshan Hospital,Fudan University; Fudan University Centre for Evidence-Based Nursing: a Joanna Briggs Institute Centre of Excellenc, 3Zhongshan Hospital,Fudan University, 4School of Nursing, Fudan University; Fudan University Centre for Evidence-Based Nursing: a Joanna Briggs Institute Centre of Excellenc

Background: The totally implantable port is a common central venous access device. however, the cost of implantation and maintenance is very expensive. At present, the main problem of the promotion and the use of implantable ports in China is lack of well-trained professional healthcare providers. Furthermore, maintenance of totally implantable ports by nurses is poor and the patients may easily get complications. Based on previous study, the current study enlarged the sample size.

Objectives: This project aimed to reduce the incidence of complications amongst patients with implantable ports, and improve healthcare safety and care process, strictly in compliance with the current evidence-based criteria.

Methods: A baseline audit on maintenance of totally implantable port was undertaken utilising the Joanna Briggs Institute Practical application of Clinical Evidence System programme from 1 March to 31 May 2016 including 120 nurses and 120 patients. An intervention of education, demonstration, clinical practice and assessment was conducted from 1 June to 31 December. A post-implementation re-audit was performed from January first to February 28th 2017. Baseline audit and post-Baseline re‚Äďaudit of Nurse Knowledge Questionnaire and Patient Questionnaire Notes were performed with complications investigated.

Results: The results for the nine audit criteria for totally implantable port maintenance were as follows: the compliance rate for Criterion 1 from 82.5 to 100% , Criterion 2 from 2.5 to 100%, Criterion 3 from 5.8 to 100%, Criterion 4 from 94 to 100%, Criterion 5 from 77 to 100%, Criterion 6 from 97 to 100%, Criterion 7 from 43 to 100%, Criterion 8 from 18 to 100%, Criterion 9 from 26 to 99.1%.During implementation we found four barriers and took measures to cope address them.

Conclusions: This project achieved a significant improvement in establishing an evidence-based practice regarding maintenance of totally implantable ports. Better sustaining methods should be explored in the future.

[This project was supported by Shanghai Municipal Commmission of Health and Family Planning Foundation(201540352)]