A registered nurse is preparing to access a client's implanted venous access port (Port-a-Cath) to administer a scheduled intravenous infusion. Arrange the following steps in the correct chronological order to safely perform this procedure.
- 1Don a face mask, instruct the client to turn their head away from the port site, and perform hand hygiene.
- 2Open the sterile access kit, don sterile gloves, and prime the non-coring (Huber) needle and extension tubing with normal saline.
- 3Cleanse the skin over the port septum with a chlorhexidine swab using a back-and-forth motion and allow it to air-dry completely.
- 4Immobilize the port reservoir with the non-dominant hand and insert the needle firmly at a 90-degree angle.
- 5Aspirate for a brisk blood return to confirm correct needle placement within the reservoir.
- 6Flush the device with the prescribed volume of normal saline and apply a sterile transparent occlusive dressing.
Answer
The correct sequence begins with standard preparation (mask, positioning, hand hygiene), followed by preparing the sterile equipment. Next, the skin is cleansed with chlorhexidine. Once dry, the nurse accesses the port with a 90-degree insertion, immediately aspirates to verify blood return, and finally flushes the line and secures the dressing.
Accessing an implanted port requires strict adherence to sterile technique and procedural sequencing to prevent central line-associated bloodstream infections (CLABSI) and mechanical complications. The sequence transitions systematically from environmental control (masks, hand hygiene) to sterile preparation (gloves, priming), then to patient preparation (chlorhexidine scrub). Once the site is prepared and dry, mechanical access is safely achieved by stabilizing the port and inserting the non-coring needle. Finally, verifying patency via aspiration must immediately precede flushing and securing the device.
Step-by-Step Solution
Key Concept
Implanted Venous Access Port (Port-a-Cath) Access Procedure