Totally Implantable Ports Placed by Specialist Nurses at a Tertiary London Hospital: A Review of 65 Consecutive Patients

• TIPs are regarded as a superior approach for long-term access.
• Collaborative working resulted in the development of a nurse-led TIP service.
• Out of the 65 cases, only one case experienced a complication.
• This is the first nurse-led TIP service study in peer-review literature.

Totally implantable ports (TIP) are placed beneath the skin for external connection to the intravenous system. The objective of the study was to demonstrate the feasibility of the nurse-led TIP service at a tertiary London hospital. The outcomes for safety and efficacy of the service were evaluated for 65 consecutive TIP cases inserted by two clinical nurse specialists (CNSs), from October 2010 to March 2013 (30 months). All data were collected retrospectively. Follow-up of patient outcomes were at least 12 months long unless the patient deceased prior. We included procedure details of a TIP insertion. A literature review was performed to identify studies in nurse-led implantable venous access services. Ninety-one percent of the ports were inserted for malignancy treatment. Eight cases experienced insertion-site difficulties, but only two cases required a second attempt. The mean follow-up time of the study was 14 months. Only one case required unplanned removal due to inflammation at the insertion site. The complication rate was at an acceptable 1.5%. The delegation of work to a CNS will release radiologist resources and have positive cost implications for the hospital. This case series is the first study in peer review literature demonstrating a nurse-led TIP service is safe, feasible, and sustainable.