Are most places that use these using them just on CVAD ports or are they being used on saline locks and peripheral lines also. We were placing on all lines and then stopped the peripheral and have come to realize they are not being used on anything at all now. We went from them being on the saline flush to separate caps and they are not being used because of that.
First let me declare that I am a consultant and speaker for Excelsior Medical and Ivera Medical, both manufacturers of disinfection caps.
I do believe that these caps should be used on all VADs - peripheral, midline, and centrals - and on all injections sites for the entire IV administration set. All of these sites have a significant risk of environmental contamination. A peripheral catheter is a single lane road while the CVAD is a super highway, however everything that enters the entire system will enter the bloodstream. This can include a variety of organisms. There are now 3 clinical studies reporting positive outcomes with the use of these caps. These studies all involve CVADs and not peripheral catheters and do not mention use on IV set injection ports.
I am now planning the next group of online journal club discussions and this topic will be high on the list. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
My personal experience with caps. I had a central line r/t pancreatitis from an ercp and procedure. The caps where placed the first time. One of the lumens was used to inject my pain medicine. The cap was taken off and never replaced. The nurses then walked into the room, did not wash their hands, did not glove, did not scrub the hub, and injected the meds. The cap was never replaced (except to put it on then take it off immediately and inject again) I could taste the alcohol each time) the entire time I was in the hospital by any nurse. My wife (BSN) was in the room but not familiar with this cap. Neither was I at the time. I was so sick that It took everything in me to muster the energy to complain. I ended up with a CLABSI, surprise. I don't feel this was an isolated event.
I am all about making things easier to encourage compliance, but I feel these caps promote laziness.
Now before I get flamed, please remember that I did not tell you all the details for brevity sake. I realize it is an education issue. But aren't most things in nursing. I am just not sure we are getting the education to the front lines regarding PIV/CVC/PICC/PORT. IMO
Offering an open invitation to everyone to join BAVAN on November 15, 2013 for an exciting all day educational seminar with outstanding speakers:
Robyn Whitlock PICC History in the Bay Area
Jim Lacy Advancing Our Practice
Rich Lewis Tip Confirmation and Tip Location
Systems
Michelle DeVries Vessel Preservation
Mary Kowatch Infection Prevention Bundles
Nancy Moureau Best Practices/Improving Outcomes
Event will be at the Vintner's Inn, Santa Rosa, CA
Vendor exhibits, food, friends and lots of learning.
Ann Zonderman, BSN, JD, CRNI
So sorry for the Missed placement of my posting
ann
Ann Zonderman, BSN, JD, CRNI
This cap has been used on central lines for about 3 years now in my hospital and I feel that it has been a wonderful addition to our successful (for 3 years) efforts to achieve a zero CLABSI rate. We have good compliance with its use. I anticipate using it on all lines but at this point we haven't required its use on all peripheral IV lines. We do use it on all lines connected to immune compromised patients. That said, the PICC team does rounds on all central lines daily and I am sure that is really helpful in compliance.