Background: Totally implantable venous access ports (“ports”) are a cornerstone of the treatment and survival of highly vulnerable patients, particularly those requiring chemotherapy for cancer. Because they are a lifeline for such patients, the ability to use ports for indications other than their primary use (e.g., chemotherapy) is often restricted. We sought to describe current institutional policies governing the use of implanted ports in hospitalized medical patients.
Methods: From May 2024 to June 2024, we surveyed 69 hospitals participating in the Michigan Hospital Medicine Safety consortium (HMS) about their institutional policies regarding port access. An electronic survey including nominal and open-ended questions was sent to quality improvement experts at each participating hospital. Descriptive statistics were used to summarize the nominal responses.
Results: Of the 69 (100%) hospitals that responded to our survey, 51 (74%) had a policy governing the access and use of ports whereas 18 (26%) did not. A greater proportion of non-profit hospitals reported having a port policy vs. for profit hospitals (91% vs 43%, p<.05). The presence of a port policy was not associated with hospital size (p=.21), urbanicity (p=.26), or teaching hospital status (p=.98). Among the 51 hospitals reporting a port policy, 24 (47%) hospitals allowed any bedside nurse to access ports, whereas 22 (43%) limited port access to those with specific credentials and/or prior training. Five (10%) hospitals restricted port access to oncology-designated nurses and/or for use with chemotherapy orders only. A competency check-off to access ports was required in 45 (88%) of the 51 hospitals with a policy.
Conclusions: While many of our surveyed hospitals reported a port policy, a quarter did not. There was significant variation in use of ports among hospitals with a port policy. These findings highlight the need to define and standardize best practices to safely access ports in hospitalized medical patients.