HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 9-22
Infusion Therapy: Maintaining The Groshong Catheter __RN
9. Slowly inject flush to fill dead space of injection port and
then remove needle or needleless adaptor.
10. Clean old intermittent injection port and catheter at junction
with alcohol applicator, using friction. Allow to air dry.
11. Wrap new alcohol wipe around connection and hold in place
until you disconnect the injection port.
12. Ask patient to hold breath or wait until patient is exhaling
before removing old injection port.
13. Remove old intermittent injection port.
14. Remove protective cover from new intermittent injection
port.
15. Attach new pre-filled intermittent injection port, twisting
firmly to secure.
16. With new injection port in place, flush catheter briskly with
5cc normal saline0.9 % sodium chloride, injection.
17. Before syringe is completely empty apply pressure on
plunger while removing the needle or syringe from the
injection port (positive pressure).
18. Tape connection (optional).Connection should be a leur-lok
type.
19. Loop the catheter and secure.
20. 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.
C. BLOOD WITHDRAWAL FROM GROSHONG
CATHETER
EQUIPMENT:
Gloves
Alcohol applicator (wipe/swab/disk/ampule)
20cc syringe for lab sample and flush (2)
10cc syringe for discard
Appropriate lab tubes
20-gauge needle, 1" (2)
Normal saline0.9 % Sodium Chloride, injection, solution
Injection port
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 2 syringes, one with 10cc normal saline0.9 %
sodium chloride, injection, and one with 20cc normal
saline0.9 % sodium chloride, Injection.
7. Open protective package of injection port and prefill dead
space with normal saline0.9 % sodium chloride, injection.
(See B. Flushing and Changing Injection Port of Groshong
Catheter.)
8. Clean old intermittent injection port and catheter at junction
with applicator, using friction. Allow to air dry.
9. Wrap new alcohol wipe around connection and hold in place
until you disconnect the injection port.
10. Disconnect injection port from catheter. Attach 10cc normal
saline0.9 % sodium chloride, injection, filled syringe and
flush line (if TPN infusing use 20cc of normal saline0.9 %
sodium chloride, injection,). Using same connected syringe
pull back 5cc of blood for discard.
11. Discard blood-filled syringe in puncture-proof container.
12. Attach new 20cc syringe directly to catheter and withdraw
appropriate amount of blood for specimens.
13. Disconnect blood sample syringe from catheter. Attach
needle no larger than 20-gauge to blood sample syringe.
Attach 20cc normal saline0.9 % sodium chloride, injection,
filled syringe directly to catheter and flush catheter briskly.
Attach new pre-filled injection port.
14. Fill blood specimen tubes.
15. Loop the catheter and secure.
16. 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. Blood samples drawn, identity and location of laboratory
where specimens taken.
d. Amount of normal saline flush.
e. Patient's response to procedure.
f. Instructions given to patient/caregiver.
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