Standardizing Venous Port Competency Among Non-Oncology Nurses Helps Reduce Delay Times for Patients with Cancer

Increasing the number of intravenous port nurse champions across a health care system helps to keep oncology nurses with their patients and reduce care delays.

Oncology nurses with the Yale New Haven Health System successfully developed a standardized comprehensive training program for non-oncology nurses to achieve and maintain implanted venous port competency throughout their health care systems. The program was presented as a poster from the 47th Annual Oncology Nursing Society Congress.

“Oncology nurses are not everywhere, but [patients with cancer] tend to be everywhere,” Evanica Rosselli, MSN, RN, OCN, of Yale New Haven Health Smilow Cancer Hospital, said in an interview with Oncology Nursing News®. “And, a lot of our patients have ports.”

Rosselli explained that although the institution had nurses who were considered super users or champions, there was no standardized approach to consistently and appropriately educate them on venous port competencies, and often, oncology nurses would be called in for assistance.

“In cases like that [an oncology nurse] would get pulled off of an oncology unit to go over to another unit, they would be required to find the nurse there, find the patient there, do education ‘in the moment’ with the nurses there,” Rosselli explained. “Obviously, there were times where they were complicated ports, and we were consulted appropriately. But, most of the time, it was for very simple issues that they just really weren't trained in properly. Therefore, we wanted to create something that would give them the tools they needed to actually be super users or champions, and feel comfortable and confident in their abilities.”

Specifically, oncology nurses identified that many non-oncology nurses who were considered venous port champions only held an understanding of port access and de-access. Therefore, investigators compiled educational videos surrounding the following topics:

  1. Gathering supplies,
  2. Power vs non-power ports,
  3. Palpitating the port and selecting a needle length,
  4. Accessing a procedure,
  5. Troubleshooting when there is no blood return,
  6. De-accessing procedure,
  7. And electronic medical record documentation.

These informational videos have been shared across the health care system’s oncology SharePoint website for easy access. An accompanying online learning module is also under development. However, an influx of online modules due to the COVID-19 pandemic has delayed development.

The educational series was deployed across a health care system consisting of 5 hospitals and 2681 licensed beds. The intervention was specifically designed for nurses who identified as implanted venous port champions. The initial validation included both a didactic and hands-on approach.

The didactic approach consisted of the 7 education videos, which were developed and recorded by oncology Nursing Professional Development Specialists (NPDS).

Hands-on training involved a 3-step approach: practicing port access with a mannequin, observing port access on a live patient, and completing a competency checklist while accessing a port on a live patient with NPDS oversight.

The rollout will allow super users to feel more confident in their abilities and consequently less dependent on oncology nurse assistance, the study authors concluded. As of April 2022, 4 NPDS have utilized the resources to educate staff on their units. Furthermore, feedback has been positive, and competency requirements have been well-received.

Moreover, other educators have already reached out to Rosselli’s team about how to better prepare their own staff to be port champions, she shared.

“The educators throughout the health system are really excited about it,” Rosselli added, noting that “they want their nurses to practice at the top of their license, but [before] they didn't necessarily have the tools they needed to be able to teach their nurses, [or] what they should know about ports.”

Next steps for the intervention will include a formal collection of responses to assess super-user port confidence post-intervention.

Reference

Roselli E, Kuck K, Szabo P. Standardizing education for implanted venous port nurse champions across healthcare system. Presented at: 47th Annual Oncology Nursing Society Congress; April 27-May 1, 2022; Anaheim, CA. Abstract P158.