Abstract:
A system for cleaning a site of a medical implement is disclosed. The system can include a strip of flexible material and a plurality of cleaning devices attached to the strip. Each cleaning device can include a cap, one or more protrusions, and a cleaning agent. The cap can be selectively removable from the strip of flexible material and can have an inner cavity that is sealed when the cleaning device is attached to the strip and unsealed upon removal of the cleaning device from the strip. The inner cavity can receive a site of the medical implement. The one or more protrusions can extend inwardly from the inner cavity and can engage corresponding protrusions on the site of the medical implement. The cleaning agent can occupy at least some of the inner cavity and can be formulated to clean the site of the medical implement.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 13/466,976 filed on May 8, 2012, entitled, “Medical Implement Cleaning Device,” which is a continuation of U.S. patent application Ser. No. 13/189,457 filed on Jul. 22, 2011, issued on Jun. 26, 2012 as U.S. Pat. No. 8,206,514, and entitled, “Medical Implement Cleaning Device,” which is a continuation of U.S. patent application Ser. No. 12/860,825 filed on Aug. 20, 2010, issued on Jul. 26, 2011 as U.S. Pat. No. 7,985,302, and entitled “Medical Implement Cleaning Device,” which is a continuation of U.S. patent application Ser. No. 11/705,805 filed on Feb. 12, 2007, issued on Aug. 24, 2010 as U.S. Pat. No. 7,780,794, and entitled “Medical Implement Cleaning Device,” which claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 60/832,437 filed on Jul. 21, 2006 and entitled “Disinfecting Cap” and also claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 60/850,438 filed on Oct. 10, 2006 and entitled “Disinfecting Cap.” The disclosures of all applications to which the current application claims priority are incorporated by reference herein in their entireties. 
    
    
     BACKGROUND 
     Within the medical field, and in particular the area of infusion of fluids or aspiration of fluids to or from a patient, there is a need to prevent the transmission of pathogens into or onto a patient from a potentially contaminated surface of a medical implement, or “site”. Such pathogens include microorganisms such as bacteria and viruses. The transmission of pathogens into a patient may result in an infection that could be life threatening. Specific to healthcare settings, the term “nosocomial infection” describes those infections that originate from or occur in a hospital or hospital-like setting. In the U.S., nosocomial infections are estimated to occur in at least 5% of all acute care hospitalizations. The estimated incidence is more than two million cases per year, resulting in an added expenditure in excess of $4.5 billion. Nosocomial infections are estimated to more than double the mortality and morbidity risks of any admitted patient, and likely result in about 90,000 deaths a year in the United States. Common sites for such transmissions are found on such medical implements as a luer port, vial, needle free valve, or an injection port of a vessel, tubing, or catheter. Even non-intrusive medical implements such as stethoscopes can transmit pathogens to a patient. The incidence of infection in patients is presently numerous and increasing, and Infection Control Practitioners (ICP&#39;s) often cite improper cleaning of sites as a major source of these infections. 
     Traditionally, cleaning a potentially contaminated surface includes a protocol of alcohol swabbing prior to making the necessary connections to the site. Today alcohol swabs, a small pad of cotton gauze soaked in isopropyl alcohol, are packed individually in a foil package. The foil package is relatively inexpensive, and is used to retain the alcohol within the package and to prevent evaporation. Properly used, the package is opened at or near the site to be swabbed. With gloved hands, the pad is removed by a healthcare provider and wiped across the top and side surfaces of the site, and the pad and foil package are discarded. The site should be allowed to dry, usually twenty to thirty seconds, immediately prior to making any connection. This “drying” period is important: when alcohol dries, it breaks open the cellular walls of microorganisms, thereby killing them. 
     Unfortunately, because of increased duties and responsibilities, shrinking nursing staffs, and inadequate training, swabbing is often overlooked or is poorly executed. A poorly swabbed site can carry microorganisms that, if allowed to enter a patient&#39;s body, can cause serious infection. In addition, supervisory oversight is nearly impossible, because unless a supervisor can actually observe the swabbing being performed, the supervisor cannot know whether or not it was done properly or performed at all. Further, without at least a sufficient microscopic examination for microbial residue, there may be no evidence of an alcohol swab being performed. Thus, a need exists for an apparatus and technique for cleaning a site on a medical implement prior to contact with a patient, and which will eliminate technique-related issues and training issues, and provide an unequivocal indicator that a site is clean prior to accessing a patient&#39;s vascular system. 
     SUMMARY 
     A cleaning device, system and method for a medical environment is disclosed. In one aspect, the system includes a strip of flexible material and a plurality of cleaning devices attached to the strip of flexible material. Each of the plurality of cleaning devices includes a cap that is selectively removable from the strip of flexible material. The cap includes an inner cavity that is sealed when the cleaning device is attached to the strip of flexible material and configured to be unsealed upon removal of the cleaning device from the strip of flexible material. The inner cavity receives a site of the medical implement. Each of the plurality of cleaning devices further includes one or more protrusions that extend inwardly from the inner cavity. The one or more protrusions engage corresponding protrusions on the site of the medical implement to maintain the cap on the site of the medical implement after the site of the medical implement is received into the inner cavity of the cap. Each of the plurality of cleaning devices further includes a cleaning agent that occupies at least some of the inner cavity. The cleaning agent is formulated to clean the site of the medical implement as the inner cavity of the cap receives the site of the medical implement and when the cap is maintained on the site of the medical implement. 
     The above system can, in some implementations, further include one or more of the following features. 
     Each of the plurality of cleaning devices can further include at least one aperture to the inner cavity after the site of the medical implement is received into the inner cavity of the cap. The at least one aperture can be configured to release pressure in the inner cavity of the cap as the inner cavity of the cap receives the site of the medical implement. 
     The at least one aperture can be further configured to allow evacuation of at least some of the cleaning agent from the inner cavity when the inner cavity of the cap receives the site of the medical implement. 
     The strip of flexible material can include at least one hole. 
     The inner cavity of the cap of each of the plurality of cleaning devices can be sealed by the strip of flexible material before the cleaning device is removed from the strip of flexible material. 
     In another aspect, a system for cleaning a site of a medical implement includes a plurality of cleaning devices. Each of the plurality of cleaning devices includes a cap having an inner cavity for receiving a site of the medical implement. Each of the plurality of cleaning devices further includes one or more protrusions that extend inwardly from the inner cavity. The one or more protrusions engage corresponding protrusions on the site of the medical implement to maintain the cap on the site of the medical implement after the site of the medical implement is received into the inner cavity of the cap. Each of the plurality of cleaning devices further includes a cleaning agent that occupies at least some of the inner cavity. The cleaning agent is formulated to clean the site of the medical implement as the inner cavity of the cap receives the site of the medical implement and when the cap is maintained on the site of the medical implement. Each of the plurality of cleaning devices further includes a removable seal that seals the cleaning agent within the inner cavity prior to the inner cavity of the cap receiving the site of the medical implement. The system further includes a strip of flexible material attached to the plurality of cleaning devices. Each of the plurality of cleaning devices can be individually removed from the strip of flexible material. 
     The above system can, in some implementations, further include one or more of the following features. 
     Each of the plurality of cleaning devices can further include at least one aperture to the inner cavity after the site of the medical implement is received into the inner cavity of the cap. The at least one aperture can be configured to release pressure in the inner cavity of the cap as the inner cavity of the cap receives the site of the medical implement. 
     At least one aperture can be further configured to allow evacuation of at least some of the cleaning agent from the inner cavity when the inner cavity of the cap receives the site of the medical implement. 
     The strip of flexible material can include at least one hole. 
     The inner cavity of the cap of each of the plurality of cleaning devices can be sealed by the strip of flexible material before the cleaning device is removed from the strip of flexible material. 
     In yet another aspect, a cleaning system for a medical connector having an access site includes a strip of material having at least one hole. The cleaning system further includes a plurality of cleaning devices. Each cleaning device is removably attached to the strip of material. Each cleaning device includes a cap having an inner cavity for receiving the access site of the medical connector upon removal from the strip of material. The inner cavity is sealed when the cap is attached to the strip of material. Each cleaning device further includes one or more protrusions that extend inwardly at least partially around an inside surface of the inner cavity of the cap. The one or more protrusions engage an outer surface of the access site of the medical connector to maintain the cap on the access site of the medical connector when the cap is removed from the strip of material. Each cleaning device further includes a cleaning agent that occupies at least some of the inner cavity of the cap. The cleaning agent is formulated to clean the access site of the medical connector when the opening of the cap receives the access site of the medical connector. 
     The above cleaning system can, in some implementations, further include one or more of the following features. 
     The one or more protrusions can include threading. 
     In yet another aspect, a cleaning system for a medical implement includes a plurality of caps. Each of the plurality of caps includes an inner cavity that receives a site of the medical implement into the inner cavity. Each of the plurality of caps further includes a cleaning material in the inner cavity that is adapted to provide axial compression against the site of the medical implement. The cleaning material contains a cleaning agent prior to receipt of the site of the medical implement into the inner cavity. The cleaning agent is adapted to clean the site of the medical implement. Each of the plurality of caps further includes threading in the inner cavity near the opening to the cap. The threads correspond to threads on the medical implement. The cleaning system further includes a strip attached to the plurality of caps, and from which individual caps of the plurality of caps can be selectively removed to be used for cleaning the site of the medical implement. 
     The details of one or more embodiments are set forth in the accompanying drawings and the description below. Other features and advantages will be apparent from the description and drawings, and from the claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       These and other aspects will now be described in detail with reference to the following drawings. 
         FIG. 1  is a cross-sectional, exploded view of a cleaning device. 
         FIG. 2  is a cross-sectional view of an assembled cleaning device. 
         FIG. 3  illustrates operation of a cleaning device for connection to a site of a medical implement. 
         FIG. 4  illustrates a cleaning device connected to a medical implement and cleaning a site of the medical implement. 
         FIG. 5  shows another embodiment of an assembled cleaning device. 
         FIG. 6  is a cross-sectional view of an assembled cleaning device in accordance with an embodiment. 
         FIG. 7  is a perspective view of another cleaning device. 
         FIG. 8  is a cross section of a cleaning device. 
         FIGS. 9 and 10  show a cleaning device being used to clean a site of a medical implement. 
         FIG. 11  is a perspective view of a ring that attaches to a corresponding structure of a medical implement. 
         FIG. 12  is a cross sectional view of another alternative embodiment of a cleaning device. 
         FIG. 13  shows yet another alternative embodiment of a cleaning device. 
         FIG. 14  shows a cap of a cleaning device in accordance with some embodiments. 
     
    
    
     Like reference symbols in the various drawings indicate like elements. 
     DETAILED DESCRIPTION 
     In accordance with preferred embodiments, a cleaning device includes a cap having a shape and/or external features to promote easy gripping and a cleaning material in the cap that holds or is in contact with a cleaning agent, such as isopropyl alcohol, for application of the cleaning agent to a site of a medical implement. 
     The cleaning material can be any substance that can conform, mold or compress in a manner that enables the effective wiping of the site, including the top surface of the site, side surface, and any threads or grooves, if present, and provide the cleaning agent at least at a surface level. Examples of the cleaning material include cotton, open or closed cell foam such as polyethylene foam, or other substance that can hold or carry the cleaning agent. The cleaning agent can be any chemical, substance or material that cleans the site of bacterial or even viral microorganisms, or any carrier that contains such chemical, substance or material. Examples of a cleaning agent include isopropyl alcohol, chlorhexidine, povidone-iodine, hydrogen peroxide, soap, and hydrochloric acid. 
     The term “medical implement” is used to denote any tool or object that can be used in a medical setting and that can connect to a site cleaning device as described herein according to a number of embodiments. Examples of medical implements include, but are not limited to, access ports on tubing sets (extension sets, T-connectors and IV sets), access ports on catheters (both peripheral and central lines), needle free valves, stopcocks, luer connectors, stethoscopes and other components or devices whereby regular cleaning is desired. Medical implements are commercially available in standard sizes. Thus, the end or opening of a site cleaning device can be provided with fittings to accommodate such standard size medical implements. 
     The cap of the cleaning device is made of a material that is compatible with the cleaning materials and agents to be used, examples of materials would include, sealed foam, plastic, glass, or metal. The cleaning device may need to undergo sterilization. For securing the cleaning device to another device, the cleaning device can include attachment mechanisms such as “snap-fit” mechanisms or clamps to hold it in place on the other device. Alternatively the cleaning material in the cap may conform to the sides of the medical implement to thereby “grip” and remain secured to the medical implement. The cap also may have threading to secure it in place on a medical implement. The cap may have some cutaway portions on its walls to enable the use of some undercuts during the molding process, and to allow the cleaning material to flex outward both during use. The cap can be made from polyethylene or another material that is stable when in the presence of alcohol or other cleaning agent. 
     In preferred exemplary embodiments, prior to being applied to a site, and after the cleaning material is provided with a cleaning agent, the opening of the cap is sealed with a foil-based seal or other material suitable for retaining a cleaning agent in the cleaning material and preventing evaporation of the cleaning agent. The cap seal may also be formed in a manner whereby several caps could be attached i.e. a strip, where individual caps can be peeled from the strip in order to be used. These strips of caps can be made conveniently accessible, i.e. hung from intravenous (IV) poles or IV sets, in patient rooms and medication carts, to name just a few. The strips provide the convenience of having several caps available in one location. 
     The cleaning material in the cap can be an alcohol-soaked piece of gauze, foam or similar cleaning material. The cleaning material can be formed into the general interior shape of the cap from one or more pieces. For instance, the cleaning material can include a ring for circumscriptive coverage and cleaning of the site, and further include a cylinder within the ring for coverage and cleaning on a distal end of the site. A single piece of cleaning material may also be cut or formed to perform the same coverage and cleaning functions as the two pieces described above. The cleaning material may also cover the threads and/or be formed as part of the threads. 
     In still further embodiments, the cleaning material may be made entirely or partially of the cleaning agent. For example, the cleaning material can be formed of an open cell foam or plastic that is chemically or physically impregnated with a cleaning agent such as povidone or iodine, or isopropyl alcohol. 
     To further illustrate and describe these concepts, reference is now made to  FIG. 1 , which shows a cross-sectional, exploded view of a cleaning device, embodied as a cap  10  with a housing  4  that defines an inner cavity  20  of the cap  10 . A foil seal  1  is configured to attach to a sealing surface  2  of the housing  4 . The housing  4  further includes internal threads  3 . In a preferred exemplary embodiment, the internal threads  3  are sized and arranged to accommodate luer threads, i.e. standardized male threads designed to mate with the female threads on a medical implement to which the cap  10  attaches. The housing  4  also has a mating surface  5  for attachment of a bottom portion  6 . 
     Within housing  4  is a first cleaning material  7 . The first cleaning material  7  may be attached to the walls of housing  4  by glue, solvent or some other attachment composition or mechanism, or may be held in the housing  4  by compression or trapped between the bottom portion  6  and housing  4 . Ribs or protrusions on the inside of the housing  4  may also be used to prevent the cleaning material  7  from slipping or rotating. The first cleaning material  7  is compressible, and is preferably doughnut-shaped or ring-shaped. The first cleaning material  7  is positioned and configured to compress radially in an outwardly direction to scrub or wipe the circumscriptive surface of the site and the surface of the threads of an inserted medical implement. 
     A second cleaning material  8  is designed to compress in the axial direction upon insertion of the medical implement and is designed to wipe the distal end and distal surface of the inserted medical implement. The second cleaning material  8  may be attached to the walls of bottom portion  6  by glue, solvent or some other attachment composition or mechanism, or affixed to first material  7  by glue, solvent or some other attachment composition or mechanism. Protrusions on the inside of the bottom portion  6  may also be used to prevent the cleaning material  8  from rotating or removal. The first cleaning material  7  and second cleaning material  8  may be formed from a single piece of compressible cleaning material of cotton, foam or other suitable cleaning material adapted for scrubbing. This single piece may be cut completely or partially cut to achieve a similar effect as two separate pieces of cleaning material. 
       FIG. 2  illustrates an assembled cap  10 . The first and second cleaning materials  7  and  8  in the inner cavity  20  are at least partially saturated with a cleaning agent, such as isopropyl alcohol, or a mix of cleaning agents. The foil seal  1  is then attached to housing  4  at sealing surface  2  by glue, solvent, thermal bonding, etc. A bottom portion  6  is attached to housing  4  at point  5  by glue, welding, solvent, threads or other attachment mechanism or process. With the foil seal  1  and the bottom portion  6  attached to housing  4 , the inner cavity  20  is hermetically sealed. The housing  4 , bottom portion  6 , and first and second cleaning materials  7 ,  8  are respectively made of a material or cleaning materials that are compatible with the cleaning agent. For instance, if isopropyl alcohol is used for at least part of the cleaning agent, the housing  4  and bottom portion  6  can be constructed of a plastic such as polyethylene. The housing  4  and bottom portion  6  can be formed of a unitary piece of material, as explained further below. 
       FIG. 3  illustrates a medical implement  30  moving toward housing  4 , in a direction A, which should be recognized as a reference only, and that the housing  4  can likewise be moved toward the medical implement  30 . The foil seal  1  is removed from housing  4 . In alternative embodiments, the foil seal  1  can be a foil pouch or other sterilized material that would inhibit evaporation of the cleaning agent. A distal end surface  12  of the medical implement  30  is eventually contacted with the upper surface  50  of the second cleaning material  8 . 
     As the medical implement  30  continues in direction A, it axially compresses second cleaning material  8  continuing to clean surface  12  with surface  50 . This movement also begins to radially compress the first cleaning material  7  and to conform the first cleaning material  7  with, and begin scrubbing, threads  11 . The cleaning materials  7  and  8  contain the cleaning agent so as to perform a thorough cleaning of the area about the threads  11  and the surface  12 . As threads  11  of the medical implement  30  continue to be rotationally inserted into the threads  3  of the housing, the distal end surface  12  is automatically scrubbed by surface  50  of the second cleaning material  8  and cleaned by cleaning agent held therein, and at least a portion of the side and threads  11  of the medical implement  30  are automatically scrubbed by radial compression of the first cleaning material  7  and cleaned by a cleaning agent held therein.  FIG. 4  illustrates the disinfecting cap  10  with a fully inserted medical implement  30 . 
     The cap  10  can be removed immediately from the medical implement  30  after use, or be kept in place. If the cap  10  is removed the medical implement  30  surfaces  11  and  12  will be clean and ready for use upon the drying of the cleaning agent. If the cap  10  is kept secured to medical implement  30 , the cleaning agent in cap  10  will evaporate over time thereby destroying any microorganisms on the surfaces  12  and  11  of medical implement  30 . The cap  10  then maintains the surfaces  11  and  12  of medical implement  30  in a clean and ready-to-access state by eliminating any forms of touch contamination. 
       FIGS. 5-10  illustrate an alternate embodiment of a cleaning device  100 .  FIG. 5  is a perspective view of the cleaning device  100  formed of a cap  102  with a seal  104  that is connected to and covers the opening of the cap  102 . The cap  102  can have a number of gripping ridges or projecting members for ease of use.  FIG. 6  is a cross-sectional view of the cleaning device  100 . The cap  102  forms an inner cavity with one opening that is large enough to receive a site of a medical implement. The seal  104  is affixed to the opening and is preferably entirely removable. In other embodiments, the seal  104  is permanently affixed, and is simply punctured by insertion of a site of a medical implement. 
     The cap  102  houses a threaded ring  106  proximate to the opening. The threaded ring  106  includes one or more threads  105  and is adapted to receive the site of the medical implement to be disinfected, and thus defines the size and shape of the opening. This embodiment is advantageous because it creates a single circumferential seal point, seal  104  to the opening of cap  102 . 
     In some embodiments, the cap  102  and threaded ring  106  are formed of a unitary piece of material or cleaning material. In other embodiments, the threaded ring  106  fits into a groove  109  that is formed in the inside edge surface of the cap  102  near the opening. In this latter configuration, the groove  109  maintains the position of threaded ring  106  near the open end of the cap where the threaded ring top surface may be flush with or slightly recessed from the cap open end walls, and the threaded ring  106  may also include or create with the cap wall a small vent aperture or opening to allow evaporation of a cleaning agent in the cap  102 . The threaded ring  106  can be mechanically kept from rotating with internal ribs or protrusions in cap  102  or groove  109 . Threaded ring  106  may be held in place within grove  109  and cap  102  by glue, welding, snap-fit, solvent bonding or any other mechanism or composition known to those of requisite skill. 
     The cleaning device  100  further includes a first cleaning material  107  that holds the cleaning agent, such as isopropyl alcohol, and a second cleaning material  108  that also holds or is at least partially saturated by the cleaning agent. In preferred exemplary embodiments, the first cleaning material  107  is formed as a hollow cylinder or ring positioned between the threaded ring  106  and the top inside surface of the cap  102 , and is adapted for radial compression against a site that is inserted into the cap  102  or over which the cap  102  is placed. In some embodiments, the second cleaning material  108  is formed as a solid cylinder and positioned within the hollow space of the first cleaning material  107 , and is adapted for axial compression against a leading edge of the site that is inserted into the cap  102  or over which the cap  102  is placed. In other embodiments, cleaning materials  107  and  108  can be made of a single piece of material and cut or formed so as to achieve the same result as described above. The cleaning agent is provided to the cleaning materials  107 ,  108  prior to the opening being covered with the seal  104 . 
       FIG. 7  is a bottom perspective view and  FIG. 8  is a cross-sectional view of the cleaning device  100  with the seal  104  removed, showing the cap  102 , threaded ring  106  that sits within the cap  102 , and the second cleaning material  108  inside the cap  102 . The second cleaning material  108  can extend to and slightly beyond the opening of the cap  102 .  FIG. 8  further shows the first cleaning material  107  that circumscribes the second cleaning material  108  and being positioned between the threaded ring  106  and the top inner surface of the cap  102 .  FIG. 11  illustrates an example of the threaded ring  106  and its threads  105 . An attribute of this embodiment of the threaded ring  106  shown in  FIG. 11  is that there are only two opposing threads that travel 180 degrees before terminating. This enables the molding of threaded ring  106  without the use of a screw to create the thread feature in an injection molding tool. The threaded ring  106  can also be produced with an injection molding tool utilizing a screw. 
       FIG. 9  illustrates the cleaning device  100  about to make contact with a site  120  of a medical implement. As discussed above, the site  120  can be a luer port, a, a needle free valve, an injection port of a vessel, or other medical implement that needs to be cleaned prior to use with a patient. In some embodiments, the site  120  can include a set of threads  122  that correspond to the threads  105  in the threaded ring  106  of the cleaning device  100 . The cleaning materials  107  and  108  are preloaded with a cleaning agent, before removal of the seal and contact by the site  120 . Accordingly, as shown in  FIG. 10 , the site  120  makes contact with the cap  102  by a screwing motion relative to the cap  102 . The second cleaning material  108  is compressed axially and swabs against the leading edge of the site  120 , while the first cleaning material  107  is compressed radially and swabs against sides of the site  120 . 
       FIG. 11  illustrates the molded thread ring  106  with two opposing threads  105  that traverse opposing 180 degree portions of the ring. This design enables the thread ring  106  to be molded without the use of a screw that is typically used to create threaded parts in a molding process. Thus the threaded ring  106  can be manufacture very inexpensively. The threaded ring  106  can also clean some of the threads when the cap is placed into position, and may or may not cover all the threads. In some embodiments, the threaded ring  106  can be molded from the cleaning material, or the cleaning material is formed only of the threaded ring  106 . In such embodiments, the cleaning may only occur on threads of the site and in an axial direction. 
       FIG. 12  shows an alternative embodiment of a cleaning device  130  having a cap  132  that is filled with a cleaning material. The cap  132  has side walls  134  and a top  136  that define an inner cavity with an opening  132 . The cleaning material includes at least a first cleaning material  138 , such as cotton or foam, that delivers a cleaning agent. The cleaning material can include a second cleaning material  140  to hold more cleaning agent. In some embodiments, the second cleaning material  140  can be circumscribed by the first cleaning material  138 . Alternatively, the first cleaning material  138  can completely envelope the second cleaning material  140 , each providing their own compressibility and capacity to hold a cleaning agent. Still, in other embodiments, the first and second cleaning materials  138 ,  140  can be formed of a single piece of material. The cleaning material(s) are filled at least partially with a cleaning agent, prior to sealing of the opening  132  with a seal and closure of the inner cavity. 
       FIG. 13  shows an alternate embodiment of a cleaning device  150 . In this embodiment, the cleaning device  150  includes a housing  152  that is formed as a threaded cap. The inner surface of the housing  152  is covered, at least in part, by a cleaning layer  154  that is bonded to the inner surface of the housing  152 . The cleaning layer  154  can be a cleaning material such as cotton, foam, or other porous and pliable material that suitably holds and/or delivers a cleaning agent such as isopropyl alcohol. The cleaning layer  154  is sized and positioned inside the housing  152  so as to be able to swab the top and a portion of the sides of a part of a medical implement that is inserted therein, or over which the housing  152  is placed. Accordingly, the cleaning layer  154  can have any thickness or compressibility. 
       FIG. 14  shows yet another alternative embodiment of a cleaning device  160 , illustrating an outer view of a rounded housing  162  for an expanded inner chamber to hold more cleaning agents or cleaning materials that hold such agents. Holes  164  in the housing  162  can promote evaporation of the cleaning agent, particularly when the housing covers a site of a medical implement to be disinfected. The location of the vent holes is variable and the vent holes can also be sealed with a filter type membrane that permits the drying of the cleaning agents but does not allow entry of microorganisms or fluid. 
     The use of the various implementations and embodiments above entails the following: the healthcare worker would, with gloved hands, open the foil package and place this cap over the site of a medical implement to be cleaned. Upon placement the alcohol soaked cleaning material wipes all of the port&#39;s surfaces. This wipe could be accomplished by either a turning motion (if threads are used) or by simply pushing the cap onto the port. In this way the cap eliminates errors in the practice of swabbing due to poor training or excessive workloads. The cap would then remain secured in place by threads, mechanical tension provided by the foam, cotton, etc., snaps or some other mechanism. A cap in place on a medical implement is a positive indication that a desired site of the medical implement is clean. A vibrant color may be used to allow instant visualization of a cap&#39;s presence from a door or hallway. ICP&#39;s can review compliance by merely observing sites to see whether or not a cap is in place. The cap could remain in place for periods of up to three days or more. For extended periods the alcohol will likely evaporate, which assures that the site is clean. With the cap in place, it continues to keep the site clean even after the alcohol has evaporated. 
     Although a few embodiments have been described in detail above, other modifications are possible. For instance, any of the embodiments described above may be sized and scaled for a particular medical implement, such as a stethoscope. Other embodiments may be within the scope of the following claims.