аЯрЁБс>ўџ >@ўџџџ=џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅСM №П8bjbjт=т= )2€W€Wє Cџџџџџџl6666666‚l l l 8Є А |‚л D8 8 (` ` ` ` ` ` ыэээK8:< $" ?$Ž` 6` ` ` ` ` ` Є66` ` u *ЄЄЄ` м6` 6` ыЄ` ыЄ$ ЄШЊŒП66o` , Ph їЦ‚ъl < аKo|Ÿ <л ]Э$ ˜Э$oЄJ j6666й Children’s Cancer Alliance Nursing Policy & Procedure Manual Policy/Procedure Number: 3.4.cEffective Date: 10/01/04 Revised Date: 05/2006________ Version 1.0 Deaccessing an Implanted Venous Access Device (PORT-A-CATHЎ) Definition/Purpose: Specific steps should be followed when de-accessing any implanted venous access device (PORT-A-CATH). All PORT-A-CATHЎ and PORT-A-CATH IIЎ products are designed and intended for single-patient use only. The PORT-A-CATH system consists of a portal with one or two self-sealing septa and a single or dual-lumen catheter and is accessible by percutaneous puncture with a non-coring needle. PORT-A-CATHЎ and PORT-A-CATH IIЎ systems are indicated when patient therapy requires repeated vascular access for injection or infusion therapy and/or blood sampling.  Personnel Responsible: Chemotherapy Nurses, and currently any nurses with FVRH CVC competency. Equipment/Supplies Required: Gloves Tape Nonsterile 2x2 gauze Normal Saline (10 mL) Heplock flush (5 mL/500 units) Alcohol wipes (2 or 3) Policy: Appropriate care and procedures must be followed when de-accessing any implanted venous access device (PORT-A-CATH). Procedural Steps: Prepare patient for procedure. Position patient. Use paper towel or hand towel to protect patient clothing, if necessary. Gather supplies as listed above. Wash hands thoroughly. Put on gloves. Assess port site. If any signs/symptoms of infection are noted, patient should be referred to RN for evaluation before procedure is undertaken. Clean injection cap with alcohol. Flush with 10 mL NS and instill 5 mL Heparin (500 units), if indicated. Clamp off extension tubing. While holding port securely with one hand, grip Huber needle wings firmly and remove needle from septum and skin. (It may be helpful to have patient take a deep breath and exhale as you remove the needle.) Apply pressure to site with 2x2 gauze for 20 to 30 seconds. Tape gauze in place over site or apply Band-Aid. If unable to flush port with NS or Heparin flush: Check placement of needle by palpation and check to assure clamp open. Reposition patient. Have patient take deep breaths and cough. If none of these results in ability to flush, refer patient to M.D.for assessment. Documentation: Medical Record Document procedure done, appearance of site. Document presence/absence of blood return. Document flushes administered (NS and heparin). B. Billing Mark encounter form to bill for supplies used (NS and heparin). Bill Level 1 E&M code (99211-nurse visit) as appropriate.     Procedure 3.4.c, Page  PAGE 2 of  NUMPAGES 2 ?@_wx•–ЁЂЃЄЇЈтухцћ`a$%>‡І‘’ЄС а п v № ѓ є ѕ ї ј њ ћ § ў  !"&'123458§њ§іђьђ§щ§щхсхокщкекщкщкщещкщ§щщааааЮХСХЗХСХСХЗХЮ0J6mHnHu0J6j0J6U6 jUCJaJ5CJCJ(H*aJ 5CJ(CJ 5PJ\5\5PJPJ5>@_x–ЂЃЄЇЈхѕѕобо‰ѕv‰јl ЄHЄh$If$ Цш№ Є<Є<$Ifa$G$$If–lж0”џ””#іііжџџжџџжџџжџџ4ж laі $„ $If^„ a$$ Цш№ „ Є<Є<$If^„ a$ Є<Є<$If є 7ўўхцч&'†‡І­ЩЧЧЧЧЧУvL & F„аЄ<EЦ€˜E!†З№^„аЄx6$$If–l4ж”џ”#$іііжџжџжџжџ4ж laі­ВЧВeL & F„аЄ<EЦ€˜E!†З№^„аL & F„аЄ<EЦ€˜E!†З№^„аЧнќВeL & F„аЄ<EЦ€˜E!†З№^„аL & F„аЄ<EЦ€˜E!†З№^„аќ‘’Є ВАААЊUT & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§ ЦL & F„аЄ<EЦ€˜E!†З№^„а ? V ЊUT & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§T & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§V e ѕ ЊUT & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§T & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§ѕ _ { ЊUT & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§T & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§{ I Ж ЊUT & F Ц8„8„ф§Є<EЦ€˜E!† .^„8`„ф§T & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§Ж ш / ЊaH & FЄ<EЦ€˜E!†.T & F Ц8„8„ф§Є<EЦ€˜E!† .^„8`„ф§/ C m Р С а Жme_Y Ц„H^„H„8Є<^„8H & FЄ<EЦ€˜E!†.H & FЄ<EЦ€˜E!†.а п ЊVS$ & F„T„ф§Є<EЦ€˜E!†.^„T`„ф§a$T & F Ц8„8„ф§Є<EЦ€˜E!†.^„8`„ф§ 7 h v ЋWG ЦрР!„8„ф§Є<^„8`„ф§S$ & F„T„ф§Є<EЦ€˜E!†.^„T`„ф§a$S$ & F„T„ф§Є<EЦ€˜E!†.^„T`„ф§a$v Ж № ё ђ ѓ є і ї љ њ Ў][[[Y[[[[P & F„M„%ўЄ<EЦ€˜E!†.^„M`„%ўP & F„T„ ўЄ<EЦ€˜E!†.^„T`„ ў њ ќ § џ 5678§§§§ћ§§љ'0PАа/ Ар=!А"А # $ %АА№ iH@ёџH Normal5$7$8$9DH$OJQJ_HmH sH tH 6@6 Heading 1$$@&a$CJ4@4 Heading 2$@&5CJ6@6 Heading 3$$@&a$CJ 0@0 Heading 4$@&CJ66 Heading 5 Є№Є<@&CJBB Heading 6 Є№Є<@&6CJOJQJ22 Heading 7 Є№Є<@&66 Heading 8 Є№Є<@&6< < Heading 9 Є№Є<@& 56CJ<A@ђџЁ< Default Paragraph Font,@ђ, Header  ЦрР!, @, Footer  ЦрР!6P6 Body Text 2 „h^„hCJLR@"L Body Text Indent 2„8„h^„8`„hCJDS2D Body Text Indent 3 „h`„hCJ&)@ЂA& Page Number@ўR@  Balloon TextCJOJQJ^JaJ8 2џџџџ џџ z™ џџ z™V8 @_x–ЂЃЄЇЈхцч&'†‡І­ВЧнќ‘’Є?Veѕ_{IЖш/CmРСап 7 h v Ж № ё ђ ѓ є 5 9 Љ0€€Љ0€€Љ0€€Љ0€€Љ0€€™0€€Љ@0€€Љ@0€€™@0€€Љ@0€€™@0€€˜@0€€˜0€€˜@0€€˜0€€˜@0€€˜@0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜@0€€˜@0€€˜@0€€˜@0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜ 0€€˜ 0 €€˜ 0€€˜ 0€€˜ 0€€˜0€€˜@0€€@0€€ 0€€( 0€а( 0€а( 0€а˜@0€7 ˜ 0€7 ˜ 0€7 ˜@0€Д˜@0€Д˜@0€Д80€€š€€š0€€š€€ BBBE8х­Чќ V ѕ { Ж / а v њ 8 7 $+-2=?E!”џ•€”џ•€-.†ЈГQ…№ћ?OмцЉАє є і і ї ї љ њ ќ § џ  " & 4 6 9 ?†Q…№ћ?OмцЉА{ „ є є і і ї ї љ њ ќ § џ  " & 4 6 9 3^_ЁЃЃЊЊДЗззммооцчњњruХХ==Q…‡ІЉЕЕООППйлюћ’ЂЂЄ?evvћћ%'((9;<<?O_{ffggЌДмц-./ABCxxz}~~ЉАСЮЯпh h t t v є є і і ї ї љ њ ќ § џ  " & 9 џџ Jane Seck™C:\Documents and Settings\Jim Orenberg\Desktop\Tab 3 - Clinical Procedures\Policy 3.4.c_Deaccessing Implanted Venous Access Device-PORT-A-CATH_JS_0 4.doc Jane SeckІC:\Documents and Settings\Jim Orenberg\Application Data\Microsoft\Word\AutoRecovery save of Policy 3.4.c_Deaccessing Implanted Venous Access Device-PORT-A-CATH_JS_0 4 Jane SeckВC:\Documents and Settings\Jim Orenberg\Desktop\Nursing P&P 09-14-04\Tab 3 - Med. Admin. - Handling\Policy 3.4.c_Deaccessing Implanted Venous Access Device-PORT-A-CATH_JS_0 4.doc Jane SeckВC:\Documents and Settings\Jim Orenberg\Desktop\Nursing P&P 09-14-04\Tab 3 - Med. Admin. - Handling\Policy 3.4.c_Deaccessing Implanted Venous Access Device-PORT-A-CATH_JS_0 5.doc Jane SeckВC:\Documents and Settings\Jim Orenberg\Desktop\Nursing P&P 09-14-04\Tab 3 - Med. Admin. - Handling\Policy 3.4.c_Deaccessing Implanted Venous Access Device-PORT-A-CATH_JS_0 5.dochelixsf†E:\Nursing P&P 09-15-04\Tab 3 - Med. Admin. - Handling\Policy 3.4.c_Deaccessing Implanted Venous Access Device-PORT-A-CATH_JS_0 5.doceszetoьK:\CLIENTS\NOA\NOU-04-0590 NOA Fall Conference\Editorial & Creative\Nursing Policy & Procedure Manual\Nursing P&P 09-15-04_PM\Tab 3 - Med. Admin. - Handling\Policy 3.4.c_Deaccessing Implanted Venous Access Device-PORT-A-CATH_JS_0 5.docўџџџАлЎЖџџџџџџџџџЄ(0и"џџџџџџџџџ+ЁLТZрVџџџџџџџџџИ оP(0и"џџџџџџџџџ•IвjТZрVџџџџџџџџџeдoТZрVџџџџџџџџџ*@h„„„˜ў^„„`„˜ў.@h„м„˜ў^„м`„˜ў.@h„„„˜ў^„„`„˜ў.@h„ „˜ў^„ `„˜ў.@h„„˜ў^„`„˜ў.ўџџџ$бИ оPeдoЄ•Iвj+ЁLџџџџ0б a@h „h„˜ў^„h`„˜ўOJQJo(З№џџџџџџџџџџџџџџџџџџџџџџџџ_ЂЃЄЇЈхцє і љ ќ џ 6 9 žž–џ@EPSON Stylus Photo 820 SeriesNe00:winspoolEPSON Stylus Photo 820 SeriesEPSON Stylus Photo 820 Series`œf‹€ъ odhh6RLД***Цє xhhDLLName32=E_DU13EE.DLL  ˆd  ˆ2џEPSON Stylus Photo 820 Series  ***ЦEPSON Stylus Photo 820 Series`œf‹€ъ odhh6RLД***Цє xhhDLLName32=E_DU13EE.DLL  ˆd  ˆ2џEPSON Stylus Photo 820 Series  ***Ц €ЬСB8 P@џџUnknown Jane SeckџџџџџџџџџџџџG‡z €џTimes New Roman5€Symbol3& ‡z €џArialW&€ џџџџџџџщ?џ?Arial Unicode MSTahoma5& ‡za€џTahoma"ˆаh˜E!†RjІFMjІF &bуƒl y„ЅРxx€0dЏ Œ № к2ƒQ„џпHXџџOnCare Nursing Policy Lita HovisMaryJane Wainwrightўџр…ŸђљOhЋ‘+'Гй0 ˜ РЬрьј  (4 P \ h t€ˆ˜фOnCare Nursing Policy9nCa Lita Hovisiitaita Normal.dotiMaryJane Wainwright11yMicrosoft Word 9.0@dќN@Žo=Ц@XRЪОН@ь?№ЦbуўџеЭеœ.“—+,љЎ0ќ hp|„Œ” œЄЌД М оф eЏ э OnCare Nursing Policy Title ўџџџ !"#$%&'()*+,ўџџџ./01234ўџџџ6789:;<ўџџџ§џџџ?ўџџџўџџџўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџRoot Entryџџџџџџџџ РF@XїЦA€1TableџџџџџџџџџџџџЭ$WordDocumentџџџџџџџџ)2SummaryInformation(џџџџ-DocumentSummaryInformation8џџџџџџџџџџџџ5CompObjџџџџjObjectPoolџџџџџџџџџџџџ@XїЦ@XїЦџџџџџџџџџџџџўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџўџ џџџџ РFMicrosoft Word Document MSWordDocWord.Document.8є9Вq