Table 1.
Care bundle
| A PowerPoint presentation was prepared to educate the nurses about the introduction to various central lines, complications associated with them, and how to look out for these complications. Junior residents prepared a 10-min video as per the standards,[7,8] starting from the preparation, insertion, flushing the line, and removing the needle. The video regarding care and handling of port-a-cath was shown and the observed shortcomings of the preevaluation audit were informed to the nurses and ways to rectify them. At the end of briefing, a question‒answer session was held to discuss and clarify the doubts. The presentation included the following | |
|---|---|
| Characteristics | Methods |
| Identification | Name |
| Hospital ID | |
| Vitals | Blood pressure |
| Heart rate | |
| Respiratory rate | |
| Oxygen saturation | |
| Communication | Verbal consent |
| Procedure explained to the patient and kin | |
| Preparation before insertion | Instruments |
| Involvement of two nursing staff | |
| Cross-checking of the drug expiry date | |
| vials intact cross-checking | |
| Asepsis techniques | Asepsis by the care provider |
| Asepsis on the patient | |
| Needle insertion techniques | Identification of the insertion site |
| Identification of the port-a-cath hub | |
| priming of the needle with saline | |
| perpendicular insertion of the needle | |
| Bleeding back | Bleeding back checked |
| Bleeding back observed | |
| Adequate amount of normal saline flush administered | |
| Positive pressure administration during flushing | |
| Nonbleeding back | Positional changes |
| Heparin (Hep-lock) administration | |
| Urokinase (U-frag 5000 IU) administration | |
| Chest X-ray to look for the position of the catheter tip | |
| Removal techniques | Asepsis to be followed |
| Local reactions | Skin changes |
| Extravasation from port-a-cath site | |
| Needle disposal | Proper disposal |