Improving Efficiency in Extracorporeal Photopheresis (ECP) Treatment with Use of Specially Designed Implanted Apheresis Port

Abstract

Significance/Background Use of tunneled central venous catheters (CVC) or peripheral intravenous access (PIV) for ECP can lead to increased risk of infection and cause discomfort to patients with repeated needle sticks. Previous implanted apheresis ports, such as the Vortex (VP) implanted port caused discomfort for patient when accessed, had no stabilizing device/dressing during treatment, and blood flow was positional. Due to positional flow of the implanted apheresis ports, a significant amount of alteplase/cathflo was needed frequently to establish brisk blood flow needed to perform the procedure. Purpose The goal of the ECP nursing staff was to find a more comfortable product that could be used in patients receiving regular ECP therapy that provided a smooth uninterrupted treatment. The focus was on getting the new device placed in patients beginning ECP over the last 18 months. Intervention The product representative provided education tools and assisted in training using Bard's new PowerFlow (PF) implanted apheresis port to the ECP nursing staff. Education and training was also provided to the Interventional Radiology providers placing the device. Practice was completed on use of product and competency verified on patient port access. Currently, >85% of active ECP patients have PF implanted apheresis device. Also patients with long term VPs were exchanged to PF ports. Evaluation Since the establishment of the PF in 09/2017, alteplase/cathflo use has decreased from 6.8% in VPs to Discussion/Innovation The decrease in uninterrupted collections, such as early buffy coat collections, in both total number and low volume