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Most of the patients undergoing treatment for cancer require placement of a totally implantable venous access device to facilitate safe delivery of chemotherapy. However, implantable ports also increase the risk of deep vein thrombosis and related complications in this high-risk population. The objective of this study was to assess the incidence of upper-extremity deep vein thrombosis (UEDVT) in patients with breast cancer to determine whether the risk of UEDVT was higher with chest versus arm ports, as well as to determine the importance of previously reported risk factors predisposing to UEDVT in the setting of active cancer. We retrospectively reviewed the medical records of 297 women with breast cancer who had ports placed in our institution between the dates of December 1, 2010, and December 31, 2016. The primary outcome was the development of radiologically confirmed UEDVT ipsilateral to the implanted port. Overall, 17 of 297 study subjects (5.7%) were found to have UEDVT. There was 1 documented case of associated pulmonary embolism. Fourteen (9.5%) of 147 subjects with arm ports experienced UEDVT compared with only 3 (2.0%) of 150 subjects with chest ports (P = .0056). Thus, implantation of arm ports as opposed to chest ports may be associated with a higher rate of UEDVT in patients with breast cancer.

The use of a subcutaneous engineered securement device (SESD) for peripherally inserted central catheters (PICC) in an acute care setting was found to have a direct impact on central line associated bloodstream infection (CLABSI) rates compared to traditional adhesive engineered securement devices (AESD). Objective: While the literature suggests the use of SESDs has had successful results for device securement, it is unknown to what extent they may impact CLABSI rates. Securement and stabilization performance among devices may be a direct risk factor for CLABSIs. Methods: A retrospective quality review of 7,776 cases was conducted at a large academic medical center. The primary researcher implemented a quantitative design which was analyzed with demographics statistics and relative risk ratio. Results: There was a 288% (n = 47) increase in relative risk of CLABSI found in the AESD group compared to the SESD group. The results imply the use of SESDs may improve nursing practice and patient outcomes lowering CLABSI rates in patients with PICCs by a reduction of risks associated with securement design differences.

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