Evaluating Normal Saline Locking With Totally Implanted Vascular Access Devices for Patients on 90-Day Maintenance Flushing.

BACKGROUND

Heparin has been the preferred locking solution for many organizations for totally implanted vascular access devices (TIVADs). Published data are limited on the use of normal saline alone as a locking solution for TIVAD 90-day maintenance flushing.

OBJECTIVES

The purpose of this evidence-based practice initiative was to determine whether locking TIVADs with normal saline alone during a 90-day maintenance flushing protocol resulted in an increase in partial occlusions.

METHODS

A clinical team monitored alteplase administration to measure partial occlusions. Prior to heparin deimplementation, nurses maintained TIVADs using 500 units of heparin upon de-access. Infusion nurses received education about published data, pulsatile flushing, and clamping sequences prior to device deimplementation.

FINDINGS: Encounters (N = 2,908) during six months of heparin locking were compared to encounters (N = 3,239) during six months of normal saline locking. Data demonstrated minimal variance between locking with normal saline compared to heparin.