Task Force Improves Mediport Infection Rates in Ambulatory Patients With Cancer

Creating a task force of key stakeholders to conduct a systematic review of current processes helped gain staff buy-in and create a common goal of reducing mediport infections at a National Cancer Institute-designated comprehensive cancer center. These findings were presented at the 47th Annual Oncology Nursing Society (ONS) Congress.

Researchers identified an increase in mediport infections at Karmanos Cancer Institute (KCI), with most infections occurring in ambulatory patients. To explore the potential causes and resolutions, a task force of key stakeholders was created to conduct a systematic review of current practice and practice deviations, explained Jesse Martinovich, MSN, RN, nurse educator at KCI in Detroit, Michigan, during her presentation.

The review included processes for patient education prior to port placement, initiation of port placement, and maintenance and care in the ambulatory setting.

Identified gaps started with patient education regarding CHG bathing. A script was developed to standardize preport education and CHG bathing instruction. Patient education materials were identified and listed in the education script. Required documentation was entered in the electronic medical record via Clin Doc.

Real-time observations in areas where mediports are accessed and maintained revealed practice gaps in ambulatory areas. Infusion staff had modified their practices and were using gauze dressings instead of Tegaderm dressings. Staff was re-educated on accessing and flushing standards. A central line bundle was created that included applying a Bio-patch to port insertion site in the infusion center.

Interventional radiology (IR) staff were involved in initial meetings and planning. However, no gaps were noted in IR placement of mediport. Despite this, they received education regarding CHG bathing and central line care bundle.

An unexpected challenge was the COVID-19 pandemic. This put meetings, gatherings, and nonessential changes on hold. The plan to convene the task force began prior to pandemic restrictions, and staffing challenges and changes made reconvening difficult. Staffing issues and pandemic burnout decreased staff buy-in.

Nevertheless, the number of port infections in the ambulatory setting has decreased since the implementation of the task force. The number of port infections identified in the ambulatory setting was 33 in 2020 overall, and as of August 2021, 12 mediport infections were identified in the ambulatory setting.

“A systematic review of current process from start to finish, as well as standardization of care with clear expectations of all areas can decrease infections,” concluded Martinovich. Forming a task force of key stakeholders helped gain buy-in and hold staff accountable, creating a common goal of preventing infections.

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Read more of Oncology Nurse Advisor‘s coverage of the 47th Annual ONS Congress by visiting the conference page.

Reference

Martinovich J, Beaver C. Creation of an ambulatory port task force to address mediport infections. Oral presentation at: 47th Annual ONS Congress; April 27-May 1, 2022; Anaheim, California.