What is the safest approach to initiating a new chemotherapy order in a patient with a central line?

• A. Verify line patency, confirm no signs of infection at the exit site, confirm patient identity and order details, and flush with saline per protocol before administration.
• B. Skipping line patency check.
• C. Only verify identity, ignore order details.
• D. Do not flush with saline.

Answer: (A)

Initiating a new chemotherapy order through a central line requires a careful, safety-focused sequence. Verifying line patency ensures the catheter is open and capable of delivering the infusion, preventing drug from leaking into tissue or failing to reach the bloodstream. Checking the exit site for signs of infection reduces the risk of catheter-related bloodstream infection, which is especially important in patients receiving chemotherapy. Confirming the patient’s identity and the order details guards against med errors—giving the wrong drug, dose, or schedule to the wrong person. Flushing with saline per protocol before administration helps clear the line, maintain patency, and prevent drug–line interactions or occlusion. Together, these steps address mechanical, infectious, and medication safety concerns, making the approach the safest. Skipping patency, ignoring order details, or not flushing saline would leave the patient exposed to preventable complications.