Securement for Patients Receiving Home Based Infusion Chemotherapy Using Continuous Ambulatory Device
Care Continuum
National University Health System Quality Improvement
National University Health System
25 March 2026
To aim for Zero incidence of port-a-Cath related issues including needle dislodgement and needle tugging at outpatient.
Year Submitted: 2025
Published Date: 25 March 2026
Tags: Care Continuum, Chronic Care, Intermediate and Long Term Care ＆ Community Care, Home Care, Quality Improvement, Clinical Practice Improvement, Risk Management, Adverse Outcome Reduction, Value Based Care, Patient Satisfaction
About this Content
Aims
To aim for Zero incidence of port-a-Cath related issues including needle dislodgement and needle tugging at outpatient oncology chemotherapy Unit within 12 months after implementation of a standardized secondary securement of Grip-LOk.
Background
Significant growth in home-based chemotherapy using continuous ambulatory delivery devices (CADD) via port-a-cath between 2022 and 2024 led to increased needle-related complications such as dislodgment and tugging, despite standard dressings and micropore tape securement. These complications pose serious risks including cytotoxic medication exposure, extravasation, and potential skin problems requiring dermatological intervention, disrupting chemotherapy schedules and causing psychological distress for patients.
Methods
Literature review to identify better securement materials, baseline survey of patients and staff satisfaction, PDSA cycles testing GRIP-LOK securement on staff with simulated PICC placement over one week, one-month pilot study with patients receiving home chemotherapy, staff training and roll call briefings, standardised application technique validation, and post-evaluation collection from patients.
Results
90% of patients and staff reported current micropore tape was inadequate
95% of patients felt more secure using GRIP-LOK compared to previous method
Nearly 100% of patients reported increased stability and feeling more capable of managing pumps at home
Decreased instances of needle-related issues
No dislodgement observed in patients who experienced falls
No skin irritation observed with GRIP-LOK securement
Keywords
port-a-cath, home chemotherapy, needle securement, GRIP-LOK, patient safety, oncology, CADD pump, QI
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | Ng Teng Fong General Hospital |
Platform(s) | National University Health System Quality Improvement |
Healthcare Professional Group(s) | Medical, Nursing |
Applicable Specialty or Discipline | Oncology |
Project Lead(s) | Krystle Tang Huey Weng |
Project Member(s) | Huang Ke |
Connect with this contributor!
Krystle Tang Huey Weng - krystle_tang_huey_weng@nuhs.edu.sg
Project Attachment
Implement Secondary Securement for patients receiving home-based infusion chemotherapy.pdf