Maintenance of totally implantable ports in Zhongshan Hospital

Background: Totally implantable port is well known as central venous access device and its cost on implantation and maintenance is very expensive. Currently, the biggest problem regarding the promotion and the use of implantable ports in China is lack of well-trained professional care providers. The nurses’ maintenance level of totally implantable ports is low, and the patients are easy to get complications. Objective: This project aims to reduce the incidence of complications amongst patients, raise the health care safety and improve the care process, strictly complying with current evidence–based criteria simultaneously. Methods: Base line audit on maintenance of totally implantable port, identified from the JBI PACES programme, was done on 25 nurses and 25 patients from 1st April to 15th May. An intervention of education, demonstration, practice, assessment was conducted from 16th May to 15th July. A re-audit post-implementation was completed from 16th July to 10th August. Results: The results of the audit showed that for the 9 audit criteria for totally implantable port maintenance, the compliance rate of Criteria 2 and 3 increased from 0% to 100%, Criterion 1 from 80% to 100%, Criterion 4 from 92% to 100%, Criterion 5 from 68% to 100%, Criterion 6 remained as 100%, Criterion 7 from 12% to 100%, and Criterion 8 from 0% to 96%. Criterion 9 from 88% to 100%. During implementation we found four barriers and took measures to cope with them. Discussion/Conclusion: This project achieves a significant improvement in establishing evidence-based practices of maintenance of totally implantable ports in General Surgery. Strategies in sustaining best practice should be developed in the future.