SwabCap® – FAQ’s
When and how should I use SwabCap?
SwabCap should be used on the unused needleless connectors on the catheter and tubing sets as soon as the catheter is placed. This ensures a “closed system”. After an access site is used, a new SwabCap should be twisted securely onto it. SwabCap is meant to stay on the needleless connector BETWEEN uses as a way to protect the connector from touch and airborne contamination. Prior to access, the nurse simply removes the SwabCap. This eliminates the time- consuming, variable process of “scrub-the-hub” and dry for 15 – 45 seconds.
Is there clinical evidence that demonstrates the efficacy of SwabCap?
Yes. Results recently published as a Major Article in the January issue of AJIC 2013 Volume 41, #1 pp 33-38. SwabCap has been used in an 18 month, prospective, controlled, multi-center, house- wide clinical trial.
Is SwabCap a push-on / pull-off cap? Does it comply with INS thread design standards 26.3 for add-on luer-lock devices?
Why does SwabCap have a 96-hour limit on its use?
The 96-hour limit was established during the 510(k) clearance process by the FDA.
What is the purpose of the thread cover?
The patent-pending thread cover design helps make the IV set-up a closed system. This closed system helps ensure that the top and threads of the needleless connector are bathed in alcohol and protected from touch and airborne contamination. Disinfectants such as 70% isopropyl alcohol kill bacteria by being in direct contact with them and breaking down their cell walls. The longer the alcohol is in contact with the contaminants, the better the disinfection. The thread cover keeps the majority of the alcohol within the cap and prevents it from drying or leaking out. With other caps, alcohol can leak out and be a source of skin irritation and breakdown.
Can SwabCap be used on dialysis catheters?
SwabCap cannot be used as an end-cap on open female luers. SwabCap can only be used on needleless connectors that have a luer- lock design and a swabbable surface. If the patient has a needleless connector that has a luer-lock connection and a swabbable surface on their dialysis catheter, then SwabCap can be used. SwabCap has been tested on the Tego device and has a letter of compliance from ICU Medical.
Can SwabCap be reattached after a single line access?
No. SwabCap is a single-use medical device only. Once it’s removed, it should be discarded.
What if the alcohol left on the needleless connector after removing a SwabCap is pushed into the patient’s bloodstream?
The amount of alcohol that remains on the needleless connector after SwabCap has been removed is extremely small. In the event that the connector top is not yet dry, the amount of 70% isopropyl alcohol that might be entrained into the IV tubing and patient’s blood stream would be miniscule and have no clinical significance. Excelsior has a technical letter on file available upon request.
What is SwabCap made of?
SwabCap was designed with extensive nursing input. An elastomeric material was preferred by nurses to ensure the product was “grippable”, low-profile, and would be soft on the patient’s skin. It is molded from a medical grade elastomer which allows for the thread cover seal to keep the alcohol in the cap. Its sterile packaging ensures that the outer surface of the device does not inadvertently transfer contaminants to the patient’s skin.
Why does SwabCap contain 70% IPA and not CHG?
70% IPA was chosen for its disinfecting capabilities and its ability to passively kill bacteria without scrubbing. After SwabCap is applied, the alcohol is released from the pad bathing the top and threads of the needleless connector. 70% alcohol diffuses through the cell wall of the bacteria and destroys the cell by inactivating the cell proteins. Laboratory studies have demonstrated complete disinfection (6 log reduction) after the SwabCap has been in place for 5 minutes without scrubbing. CHG is not approved by the FDA for the disinfection of needleless connectors.
Can SwabCap be used on a sterile field?
SwabCap does not come in a sterile field ready package. After the catheter has been placed, flushed with saline, medication has been delivered to the patient and the final flush is delivered, the sterile field is usually removed, thus allowing for SwabCap to be placed after the last flush.
Can SwabCap be re-sterilized?
No, SwabCap currently cannot be re-sterilized.
Does SwabCap’s orange color pose any issues with enteral feeding lines?
No. Enteral feeding lines have now been designed to be incompatible to prevent the misconnection of IV tubes and catheters. Within the United States, there are no established color standards by safety or regulatory agencies for enteral lines. The three largest manufacturers in the enteral nutrition market have changed their tubing colors to lavender and red. Several safety watch groups suggest color coding should not be used to prevent misconnection.
Should we use SwabCap on our peripheral IV catheters?
Yes. SwabCap should be used on all unused needleless connectors on the catheter and tubing sets regardless of the catheter that is placed. This helps ensure a “closed system” and helps nursing in maintaining one protocol for disinfection of all needleless connectors, regardless of the catheter that’s been placed. While most infection control focus has been on central lines, recent studies by infection control expert Leonard Mermel, M.D, and others at Rhode Island Hospital (Providence, R.I) have highlighted the significant risks associated with peripheral IV’s. Click on the link below for more information on this research.
Can SwabCap be used in pediatric and neonatal patients?
SwabCap is currently being used by multiple pediatric hospitals and neonatal units across the country with great success. Some of these facilities have shared their outcomes with fellow clinicians at national conferences such as NACHRI and AVA.
When using SwabFlush or SwabKit, I see that the syringe has an expiration date (day/month/year) and the cap has an expiration date of its own (month/year). Which one should I go by?
When using either one of the integrated delivery systems for SwabCap, you should look at both expiration dates and consider the earlier one to be the expiration date of the delivery system.