HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 9-22
Infusion Therapy: Maintaining The Groshong Catheter __RN
PURPOSE:
To maintain a patent line for continuous or intermittent drug, fluid
infusion or blood withdrawal.
CONSIDERATIONS:
1. The Groshong catheter has a patented, three-position,
pressure-sensitive valve that does not require the use of
heparin or clamping.
2. Clamping may damage the catheter.
3. Never use acetone or acetone-based products on or around
catheter. Acetone erodes silicone or silastic tubing.
4. Keep all sharp objects (e.g., pins, scissors) away from the
catheter.
5. If leaking or breaking of the catheter occurs, cover the
broken part with a sterile gauze pad. Do not clamp. (See
CVC: Temporary Repair of Breakage, No. 9.25.)
6. Always flush catheter with 5-10cc 0.9 % sodium chloride,
injection, after blood withdrawal.
7. If blood is noted in catheter, flush with 20cc normal saline0.9
% sodium chloride, injection.
8. If unable to flush the catheter, call physician for further
orders.
9. Heavy straining or lifting may cause back flow of blood into
the catheter.
A. FLUSHING GROSHONG CATHETER WITHOUT
CHANGING INJECTION PORT
The Groshong catheter requires flushing with 5-10 cc normal
saline every 7 days. Flush with 205-10cc of normal saline0.9 %
sodium chloride, injection after infusion of blood, when blood is
observed in the catheter, and after drawing a blood sample. If
withdrawing blood after infusion of TPN, flush the catheter with
20cc of normal saline 0.9 % sodium chloride, injection, before
obtaining blood sample.
EQUIPMENT:
Gloves
Alcohol applicator (wipe/swab/disk/ampule)
10cc to 20cc syringe with needle or needleless adaptor
Normal saline0.9 % sodium chloride, injection
Tape
Puncture-proof container
Impervious trash bag
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain procedure and purpose to patient/caregiver.
3. Wash hands, don gloves and Assemble equipment on a
clean surface, close to the patient.
4. Place patient in comfortable position making sure that site is
accessible.
5. Ensure adequate lighting.
6. Clean top of normal saline vial with alcohol applicator, using
friction. Allow to air dry. Withdraw 5-20cc of normal saline.
7. Clean injection port with alcohol applicator, using friction.
Allow to air dry.
8. Insert the needle or needleless adaptor of normal saline
filled syringe into center of injection port.
9. Flush briskly. Before syringe is completely empty, apply
pressure on plunger of syringe while removing the needle or
syringe from the injection port. (Positive pressure.)
10. Loop the catheter and secure with tape.
11. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Date, time, procedure and observations.
b. Appearance of central venous access site.
c. Amount of normal saline flush.
d. Patient's response to procedure.
e. Instructions given to patient/caregiver.
B. FLUSHING AND CHANGING INJECTION PORT
OF GROSHONG CATHETER
The injection port must be changed at least every 7 days when
not in use, twice a week when in use and PRN when they
become loose or leakage is noted. Following a blood draw, the
injection port must be changed.
EQUIPMENT:
Gloves
Alcohol applicator (wipe/swab/disk/ampule)
10cc or 20cc syringe with needle or needleless adaptor
Normal saline0.9 % sodium chloride, injection
Tape
Puncture-proof container
Impervious trash bag
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain procedure and purpose to patient/caregiver.
3. Wash hands, don gloves and Assemble equipment on a
clean surface, close to the patient.
4. Place patient in comfortable position making sure that site is
accessible.
5. Ensure adequate lighting.
6. Prepare syringe with normal saline0.9 % sodium chloride,
injection. Remove air from syringe.
7. Open protective package of injection port.
8. Insert needle or needleless adaptor straight into center of
new injection port.
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