{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:42:41Z","timestamp":1792212161640,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPVVM0141"],"award-info":[{"award-number":["CMRPVVM0141"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim (s)<\/jats:title>\n To examine catheter\u2010related complications across different flushing strategies for totally implantable venous access devices when care is delivered through a standardized, nurse\u2010led, protocol\u2010driven framework.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A single\u2010center, prospective, exploratory, randomized, single\u2010blind, three\u2010arm parallel\u2010group clinical trial.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 192 participants, catheter\u2010related complications were rare across all groups. One occlusion occurred in the 10\u2009mL saline group, no occlusions occurred in the 20\u2009mL saline or heparin lock groups, minor bleeding occurred in three participants, and no catheter\u2010related bloodstream infections or severe adverse events were reported. The very low number of events precluded meaningful comparative inference between flushing strategies.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Within a standardized, nurse\u2010led catheter care framework, complication rates were uniformly low regardless of flushing strategy. These exploratory findings do not establish equivalence or comparative effectiveness between flushing strategies.<\/jats:p>\n <\/jats:sec>\n \n Implications for the Profession and\/or Patient Care<\/jats:title>\n For oncology nursing practice, these findings support continued emphasis on standardized, protocol\u2010driven catheter care, competency\u2010based nurse training, and adherence monitoring; they do not establish that saline can replace heparin.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n This study addresses uncertainty about catheter outcomes under different flushing strategies in standardized nursing care. The main finding was uniformly low complication rates across groups. The findings may inform oncology nursing practice, catheter care standardization, and future trial design.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n This study was reported in accordance with the CONSORT 2025 statement and relevant extensions.<\/jats:p>\n <\/jats:sec>\n \n No Patient or Public Contribution<\/jats:title>\n Patients and members of the public were not involved in the design, conduct, analysis, interpretation, or preparation of this manuscript because the study evaluated a protocol\u2010driven inpatient catheter care procedure delivered within routine oncology nursing practice.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov<\/jats:ext-link>\n : NCT05707936 (\n https:\/\/clinicaltrials.gov\/study\/NCT05707936<\/jats:ext-link>\n )\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/nop2.70942","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:16:17Z","timestamp":1792210577000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Flushing Strategies for Totally Implantable Venous Access Devices in Nurse\u2010Led Cancer Care: Exploratory Randomized Clinical Trial"],"prefix":"10.1002","volume":"13","author":[{"given":"Chi\u2010Jia","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Nursing New Taipei City Municipal Tucheng Hospital (Built and Operated by Chang Gung Medical Foundation) New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5547-409X","authenticated-orcid":false,"given":"Jason Chia\u2010Hsun","family":"Hsieh","sequence":"additional","affiliation":[{"name":"College of Medicine Chang Gung University Taoyuan City 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