Policy Manual sample

MDT Home Health Care Agency, Inc. 69 MDT Home Health Care Agency, Inc. INTRAVENOUS ACCESS DEVICE MAINTENANCE CATHETER ROUTINE FLUSH MINIMUM FLUSHING FLUSHING POST BLOOD DRAW DRESSING CHANGE TYPE DRESSING CHANGE FREQUENCY CLAMPING VS. NONCLAMPI NG SPECIFIC THERAPIES INTERNAL VOLUME Non- tunneled Central Catheter (i.e., subolevian) 1. 3-5 ml saline before and after medication administration. 2. 3-heparin solution 10-100 units/ml When not in use, once every day 3- 5ml heparin solution 10u/ml per lumen 1. 10-20ml 0.9% NaCl 2. 3-5ml heparin 10u/ml Sterile TSM-weekly and prn Gauze-every 48-72 hours (e.g., M-W-F) Use slide clamp on catheter or extension tubing A11 0.3-0.5ml plus extension Tunneled Central Catheter (i.e., Hickman, Broviac) 1. 3-5ml saline before and after medication administration. 2. 3-5ml heparin solution 10-100 units/ml When not in use, once every day 3- 5ml heparin solution 10u/ml per lumen 1. 10-20ml 0.9% NaCl 2. 3-5ml heparin 10u/ml Sterile-after initial placement, until stitches removed and when patient immunocomp romised Clean-if immune status, diagnosis allow with MD order TSM-weekly and prn Gauze-every 48-72 hours (e.g., M-W-F) May use clamp attached to line. If clamp closed and line flushed, catheter rupture can occur A11 0.15 to 1.8ml plus extension Groshong Central Catheter, port or Groshong PICC 1. Before and after medication with 5ml 0.9% NaCl 5cc 0.9% NaCl 5ml per lumen once weekly 1. Do not use vacutainer 2. 20ml 0.9% Sterile-after initial placement, until stitches removed and when patient immunocomp romised Clean-if immune status, diagnosis allow**Must use sterile for PICC line** TSM-weekly and prn Gauze-every 48-72 hours (e.g., M-W-F) No clamping necessary due to distal end of catheter design. *Clamps should not be used as this may damage the integrity of the valve A11 0.9ml plus extension for port or central catheter 0.33 plus extension for Groshong PICC Implanted Venous Ports (peripheral and central) placement 1. 3-5ml saline before and after medication administration. 2. 3-5 ml heparin solution 100 units/ml Once every 4 weeks with 5cc 100/uml heparin 1. 10-+20cc 0.9% NaCl 2. 3-5cc 100u/ml heparin Sterile TSM-change at least weekly and/or with huber needle change Use clamp attached to huber needle extension part A11 0.5 to 1.5ml plus extension