Our hospital is having to explain the cost benefits of using swab caps. Does anyone know of anything out there that will benefit us in using these? Cost vs decreased infection rates?
It does contain cost data. It has only been released in electronic format but will be published soon in American Journal of Infection Control and can be purchased now.
Basically, 3 hospitals collected 1.5 mLs of blood for culture from PICCs beginning on day 5 of dwell. The study was done in 3 phases - phase 1 with manual disinfection with alcohol pad, phase 2 use of protective cap, phase 3 went back to manual disinfection and stopped using the cap.
In the study phase 2 as you mentioned; did they use manual disinfection too?? doesnt the swab cap only elimnate the initial scrubbing with alcohol when the cap is removed, then any further accessing of the connecter still needs scrubbed with alcohol then upon completion a new cap placed. I am curios was that phase including the proper protocol or striclty the cap only?
I am really concerned about nurses thinking when they use this cap they think they dont have to use alcohol for any accesses. Apparently it has been promoted as such at other sister faciliies and some feed back coming to me as nurses are bragging on this. I think I even saw on one of the flyers for this product that it says it eliminates the use of alcohol wipes.
I do share your concerns about this aspect. I don't think the study addressed this issue specifically for any phase of the study. I also do not think that Excelsior Medical for Swabcap or Ivera Medical for Curos endorses the fact that you do not need to clean the NC on these subsequent attachments. Or at least that is not the official company statements, but one has no control over what a local sales rep may or may not state verbally. I know I have addressed this issue at past AVA meetings following a presentation on a study of Swabcap and Excelsior people were in the room. I always explain that proper catheter assessment includes blood aspiration so that first saline syringe could leave blood-tinged fluid on the surface. Then the short infusion set is attached and is lying in the bed with the patient for 30-60 minutes. Detachment could leave drug residue on the surface. Then the second saline syringe is attached and could also leave fluid on the surface. So cleaning before each attachment is needed. These disinfection caps do protect the NC from environmental contamination between uses when the burden of organisms would probably be higher than in between these attachments. This study did show some very significant differences between these 3 phases. Lynn
Yes, new study is out with cost info. Author is Marc-Oliver Wright in AJIC. Will provide complete reference when back in my office next week. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Here is the link to the study on Swabcap
Continuous passive disinfection of catheter hubs prevents contamination and bloodstream infection
It does contain cost data. It has only been released in electronic format but will be published soon in American Journal of Infection Control and can be purchased now.
Basically, 3 hospitals collected 1.5 mLs of blood for culture from PICCs beginning on day 5 of dwell. The study was done in 3 phases - phase 1 with manual disinfection with alcohol pad, phase 2 use of protective cap, phase 3 went back to manual disinfection and stopped using the cap.
Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
In the study phase 2 as you mentioned; did they use manual disinfection too?? doesnt the swab cap only elimnate the initial scrubbing with alcohol when the cap is removed, then any further accessing of the connecter still needs scrubbed with alcohol then upon completion a new cap placed. I am curios was that phase including the proper protocol or striclty the cap only?
I am really concerned about nurses thinking when they use this cap they think they dont have to use alcohol for any accesses. Apparently it has been promoted as such at other sister faciliies and some feed back coming to me as nurses are bragging on this. I think I even saw on one of the flyers for this product that it says it eliminates the use of alcohol wipes.
Thanks, Gina
Gina Ward R.N., VA-BC
I do share your concerns about this aspect. I don't think the study addressed this issue specifically for any phase of the study. I also do not think that Excelsior Medical for Swabcap or Ivera Medical for Curos endorses the fact that you do not need to clean the NC on these subsequent attachments. Or at least that is not the official company statements, but one has no control over what a local sales rep may or may not state verbally. I know I have addressed this issue at past AVA meetings following a presentation on a study of Swabcap and Excelsior people were in the room. I always explain that proper catheter assessment includes blood aspiration so that first saline syringe could leave blood-tinged fluid on the surface. Then the short infusion set is attached and is lying in the bed with the patient for 30-60 minutes. Detachment could leave drug residue on the surface. Then the second saline syringe is attached and could also leave fluid on the surface. So cleaning before each attachment is needed. These disinfection caps do protect the NC from environmental contamination between uses when the burden of organisms would probably be higher than in between these attachments. This study did show some very significant differences between these 3 phases. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861