Implanted Venous Port Education Sets Sail in the ED

Abstract

Session I presented Saturday, September 29, 10:00-11:00 am Purpose: Patient feedback prompted us to evaluate our nursing competency for implanted venous ports. Using an interdisciplinary approach and staff engagement, we determined knowledge gaps, barriers to practice, modernized the education program for Emergency Department (ED) nurses, while keeping access to care, patient safety and satisfaction on the forefront. Design: Staff development project. Setting: A teaching, suburban, 70,000 visit ED in a 359 bed non-profit acute care hospital. Participants/Subjects: 20 ED nurses participated in a questionnaire, sampling educational topics for an annual education fair. 83 ED nurses were provided education on Implanted Venous Ports based on professional evidence-based standards and guidelines for implanted port care. Methods: The patient feedback interdisciplinary group determined that: the number of port certified ED nurses was insufficient; the education process for nurses was lengthy and daunting; and a list of certified nurses was unattainable for staff. Additionally, nursing staff was asked to suggest topics for an education fair: Accessing ports was a recurring theme. The ED nurse educator worked collaboratively with port certified staff and the IV/Infusion nurse manager to upgrade the educational material and competency checklists. A computer-based learning (CBL) program, video, and 5 question test was developed, utilizing evidenced-based standards of practice. Successful port access/de-access demonstration on a mannequin at the education fair provided staff with a checklist, requiring 2 additional port access under real-time conditions to complete the certification process. ED staff already port certified served as unit champions and observed nurses during the process. An evaluation tool using a Likert-like scale, was given to all nurses upon exiting the fair to assess: knowledge, effectiveness of teaching method, applicability to practice, and confidence in applying knowledge to practice. Results/Outcomes: At the beginning of this project, it was found that 18% of nurses (n= 14) were certified to access ports. Of that, half were per-diem nurses. 69 nurses attended the two-day education fair. 59 nurses completed and returned the post-evaluation tool. Two months following the education fair, the percentage of staff nurses increased by 128%. There are now 25 nurses certified to access ports in the ED; 16 of those are staff nurses, 9 are per-diem nurses. Utilizing our existing port certified staff as unit-based champions was an important factor for staff buy-in and the programs success. Our goal is to have at least 30% of staff nurses certified in the ED by March 2018. All new ED nurses are enrolled into the Implanted Port education program , with mannequin demonstration performed for the nurse educator during orientation. A complete list of nurses certified to access ports was also created and uploaded into the hospital-wide staff resource database. Implications: Implanted ports are the most common central vascular access device and are an important provision of supportive care for cancer patients presenting to the ED for treatment. Timely delivery of intravenous fluids, medications, and/or blood products is essential in emergency care. This project incorporated themes of interdisciplinary collaboration, communication, shared governance, and evidence-based practice. It will undoubtedly enhance the delivery of safe, quality patient care to this special population.