A significant number of Skilled Nursing Facilities in the community that I work are using the Red Cap from B Braun in the place of a disinfection cap, attaching it to the needleless end-cap when the CVAD is not being used. My concern with this practice is that because of the construction of the Red Cap, when it is applied to a needleless cap, the internal mechanism of the needleless cap is engaged, opening up the fluid pathway in a non-valved line and negating the function of the end-cap in helping to prevent blood reflux into the line. If it is a valved PICC, might it also open the internal valve of the PICC? Is my concern well founded, and can you think of other problems this practice might produce? What alternative might you recommend, as these facilities are unwilling to spend the money on supplying engineered disinfection caps?
Robyn Smith, RN, BSN, VA-BC, CPUI