F0658

D

Lack of RN Competency Validation for Implanted Venous Port Access

Milford, Pennsylvania Survey Completed on 02-20-2026

Penalty

No penalty information released

Summary

The facility failed to ensure that nursing services met professional standards of quality by allowing RNs to access and administer IV medications through an implanted venous port without documented specialized training and demonstrated competency. Facility policy on implanted venous port accessing, last reviewed April 23, 2025, required that medical personnel who access or de-access an implanted venous port complete additional training and demonstrate proven clinical competency prior to performing the procedure. Pennsylvania Code Title 49, State Board of Nursing, 21.11(c) states that an RN may not engage in areas of highly specialized practice without adequate knowledge and skills in the practice area involved.

Clinical record review showed that one resident, admitted with malignant neoplasm of the colon and with a surgically placed port-a-cath in the upper chest, required IV antibiotics. A nursing progress note documented that staff were unable to establish a peripheral IV, and the physician authorized nursing staff to access the port-a-cath with a Huber needle to administer IV antibiotics. Physician orders directed daily IV Ceftriaxone for five days for pneumonia, and the MAR showed that three RNs administered the IV antibiotic through the implanted port over that period. The facility was unable to provide documentation that these RNs had completed additional training or competency validation specific to accessing an implanted venous port with a Huber needle, including lack of skills checklists, return demonstrations, formal education records, or internal training. The DON confirmed that the facility did not maintain evidence of education, specialized training, or competency validation for RNs administering medications through a port-a-cath.