Huber Needle Changes
I have just received very interesting orders from a vascular Surgeon in Virginia who is ordering a Huber Needle change every 24 hours and at the very most every 48 hours. Has anyone out there heard of such a procedure? Why would anyone want a port placed if you were only going to get stuck daily anyway? This physician states that it is manufacturer policy that if an active infusion is not being continuously run, it should be changed this often! Any comments? Anyone? Buehler? Buehler?
Submitted By: Jerry Ewancio, P.D., Director of Pharmacy, American HomePatient of Delmarva
Response Summary
There were 5 Listserv responses to Jerry’s question:
Lori L. Duvall, RN, President, Duvall Consulting, L.P., Pittsburgh, PA replied: Almost all our medi-port patients are ordered monthly access and flushing. The most frequent order I've seen is weekly, but this was specifically for lab draws. Who is the manufacturer of this port?
Kelly Buehler, Pharm.D. Franck's Infusion Pharmacystated: Did he say which manufacturer? It would be interesting to discuss this with the manufacturer. It doesn't make sense to me either. I thought I needed to comment since you called me out! Ha
Linda Breakie, RN, CRNI, Managing Member, Complete Infusion Services, LLCresponded with: Here's my comment: Is he nuts? Refer him back to INS standards.
Kelli Krutsinger RN, BSN, CRNI provided the INS standard: I guess you could start with finding out what manufacturer he is referring to and give them a quick call to see if this is truly the case. The Infusion Nursing Standard 45 IMPLANTED PORTS AND PUMPS, practice Criteria H states:
"When ports or pumps are accessed, the non-coring safety needle should be changed at least every 7 days."
There was even some article in the last couple of years discussing leaving Huber needles in place for 14-30 days and just changing the dressings every 7 days.
Kathy J. Miller, Executive Director, Care Partners, Inc., "The Home Health Agency of Mon General Hospital and WVU Hospitals" added: Its manufacturer policy that if an active infusion is not running, you would flush at least daily, not change the Huber. I would find out what manufacturer and clarify the policy. Good luck!
Rock-Pond Analysis
It is always a good practice to site the prevailing standard that the Intravenous Nurses Society presents. The manufacturer, for liability purposes, will present a conservative approach. In this case it appears that the physician has misinterpreted the manufacturers guidelines. Standards of practice should always be evaluated and discussed when conversing with medical practitioners.