|The following article features coverage from the 46th Annual Oncology Nursing Society (ONS) Congress. Click here to read more of Oncology Nurse Advisor‘s conference coverage.|
Use of normal saline to flush central venous catheters in pediatric patients with cancer was as effective as and less costly than using heparin to managing central venous catheters in this patient population. These findings were presented in a poster during the 46th Annual Oncology Nursing Society (ONS) Congress.
For this study, 62 pediatric inpatients and outpatients were recruited at the Kapi’olani Medical Center for Women and Children in Honolulu, Hawai’i. In September of 2020, heparin flushing guidelines were changed from standard port flushes to 10 ml saline. Efficacy of saline flushes via use of alteplase and associated costs were assessed.
Patients were mean age 9.42 years (standard deviation [SD], 6.15) and 42% were girls. The most common diagnoses were B-cell acute lymphoblastic leukemia (24%), osteosarcoma (10%), and T-cell acute lymphoblastic leukemia (8%).
The usage rate of alteplase during heparin and saline flushes was 2.17 and 2.42, respectively, per 1000 line-days (P =.89).
Compared with the cost of using heparin, use of normal saline decreased annual cost per single lumen by approximately $154 ($520.20 vs $366.24).
Although these findings were associated with decreased costs, implementing the change in flushing protocols required additional resources and education for nurses and families.
These findings suggested normal saline was as effective as heparin flushing due to the similar usage of alteplase after protocol change. The use of saline decreased healthcare costs, which may be most important for patient families, as most insurances do not cover the cost of heparin. The study authors recommend current guidelines for central venous catheter maintenance in pediatric patients include a low-heparin, normal saline protocol.
Read more of Oncology Nurse Advisor‘s coverage of the 46th Annual ONS Congress by visiting the conference page.
Omatsu DA, Maglasang B, Thompson K, Yuasa H, Kimata C. Heparin versus normal saline: flushing effectiveness in managing central venous catheters in pediatric oncology patients a process improvement project at Kapi‘olani Medical Center for Women and Children. Oncol Nurs Forum. 2021;48(2):abstr 8782.