Implanted Vascular Access Port Flush Frequency: Striking the Balance Between Patient Convenience and Clinical Safety

OBJECTIVE: Guidelines from the Oncology Nursing Society (ONS) and Infusion Nurses Society (INS) were reviewed to establish a flushing protocol. No consensus on implanted vascular access port (IVAP) flush frequency was recommended. Guidelines suggest extending up to 12 weeks may be safe based on functionality. However, limited research on the risks associated with stagnant reservoir contents leaves this practice under debate. METHODS: An oncology clinic studied IVAP flush practices during the COVID-19 pandemic when routine care was delayed. Concerns arose about biofilm, clots, or other harmful substances being flushed into patients. A new approach was developed to observe IVAP reservoir contents, allowing abnormal substances to be aspirated and discarded before flushing. RESULTS: In 150 patients observed from 5 to 17+ weeks, visible clots and altered reservoir contents were found in 52% of cases. CONCLUSION: Findings suggest that prolonged intervals between flushes may increase risks associated with stagnant IVAP contents. This research highlights the need for further studies to establish safe and evidence-based flush frequencies. The new observational method offers a proactive approach to identify and remove harmful substances, helping to mitigate risks when routine IVAP maintenance is delayed. Ensuring patient safety requires further investigation into the physiological impacts of extended flush intervals.