Collaborative Intravenous Nursing Service (CINS) Guidelines

Totally Implanted Venous Access Device (TIVAD) e.g. Port-a-Cath Administration of antibiotics/infusion/additives (TIVAD3)Heparin strengths may vary according to the frequency of the flushes required, refer to local policy62ActionEquipment RequiredDressing Pack containing sterile towel and gloves x2Gauze swabs x 3, 10ml syringes x 2Chlorhexidine Gluconate 2% in 70% Isopropyl alcohol or Chlorhexidine Gluconate 2% in70% Isopropyl alcohol impregnated applicator10ml 0.9% Sodium Chloride for injection5ml Heparin 100units/ml in 0.9% Sodium Chloride for injection.Two green needles/filter straw. Sharps containerSurgical tape, Alcohol hand rubNon coring needle (e.g. Huber or gripper needle) with needle free systemHighly permeable dressing and securing device if receiving therapy other than forflushingPlastic apronAntibiotics/additives/infusion as prescribedRationaleExplain procedure to the patient. Ensure that valid consent is gained.Assess the need for local anaesthetic cream.Before the procedure begins make sure that your hands are washed and dried thoroughlyand that they continue to be decontaminated during the procedure. A plastic apron shouldbe worn.Maintain aseptic technique at all timesEnsure that the working area is as clean as possible.Ensure that all equipment is gathered before commencing the procedure and allpackaging is intact and in date.Open sterile pack allowing the inner pack to fall onto the clean working area.Open out sterile pack to create a sterile field. Open remaining equipment ensuring nocontamination of the sterile field.Place 0.9% Sodium Chloride (saline) and Heparin 100 units/ml in 0.9% Sodium Chlorideampoule(s) near to the working area but not on the sterile field. Pour out chlorhexidineEnsures patient compliance andreduces anxietyReduce the risk of infection, toavoid contaminationTo maintain asepsisThe CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10