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Stethoscope Hygiene

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by

Nicola Raeside

on 3 March 2014

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Transcript of Stethoscope Hygiene

Stethoscope Hygiene
Objective
Background
There is no shortage of journal articles regarding stethoscope hygiene. The articles are generally in agreement that the vast majority of stethoscopes are not cleaned on a regular basis and that most harbour various organisms, predominantly staphylococci. This is important as these bacteria are potentially pathogenic and may put patients at risk. These research articles were done all over the world, however there was not any found from Imperial College London or Chelsea and Westminster. Additionally, most of the articles were published during the 1990s. We thus thought it was fitting that a new survey were to be conducted to see if Chelsea and Westminster staff were any better than what was reported in previous journal articles.
To assess how
frequently
stethoscopes were being cleaned by health care practitioners in Chelsea and Westminster Hospital and their
method
of cleaning the stethoscope
Method
Handed out questionnaires asking:

Staff position
: Medical student/Foundation Doctor/SHO/Registrar/Consultant/Nurse/
Other staff

How often do you use your stethoscope?
: 0-5 times a day/5-10 times a day/>10 times a day

How often do you clean your stethoscope?
: Between each patient/Between each infection (side room) patient/Weekly/Monthly/Yearly/Never

How do you clean your stethoscope?
: Alcohol wipe/Alcohol gel/Soap and water/Other (please specify):


Results
34 responses: 7 Med Students, 12 F1/F2, 5 SHO, 0 Consultants, 5 Registrars, 1 Nurse and 4 others.
Although no consultants were surveyed, most don't carry their own stethoscopes.
Only 35% of staff said that they were cleaning their stethoscopes between each patient.
Disgracefully, 12% said they had never washed their stethoscopes before, with 3% saying they only washed theirs yearly, perhaps suggesting that there is a lack of awareness.
By and large, foundation doctors and nurses were the most likely to clean their stethoscopes between each patient.
This suggests that it may be recent changes in the mentality regarding infection control that drive people’s stethoscope hygiene.
How often they cleaned their stethoscope
Bar chart to show the percentage of people in each position who washed there stethoscopes between each patient
Conclusion
A large majority of medical professionals are not cleaning their stethoscopes, despite increased awareness that this is necessary and protects patients. We therefore find that there is an impetus for further education and the tools required to carry this out.

Further research could focus on elucidating the reasons why medical staff does not clean their stethoscopes before and after each patient.

Discussion
In this era of increasing awareness about the threat that microorganisms play, as well as an increased number of immunodeficiency syndromes due to transplants and viruses like HIV, we can’t be too careful about the threat of bacteria. Yet nosocomial infections have become increasingly resistant. While many practitioners are careful about washing their hands before and after patient contact, the same care is not taken for medical devices that touch the patient. Thus, it is entirely plausible that this represents a source of infection by direct contact.

Potential remedies include making alcohol wipes more available and visible; they should be stocked in every consulting room and at each nursing station. Even better would be a box located in each bay in a ward.

Limitations
We were not able to culture the actual stethoscopes, which represents a major limitation in our study. Other limitations include non-random sampling, the potential for dishonesty among respondents, and a relatively small number of respondents.
References
1. Jones JS, Hoerle D, Riekse R. Stethoscopes: A Potential Vector of Infection? Annals of Emergency Medicine 26:3(296-299). September 1995. http://dx.doi.org/10.1016/S0196-0644(95)70075-7
2. Breathnach AS, Jenkins DR, Pedler SJ. Stethoscopes as possible vectors of infection by staphylococci. BMJ 305:15734. 1992.
3. Smith MA, Mathewson JJ, Ulert IA, Scerpella EG, Ericsson CD. Contaminated Stethoscopes Revisited. Arch Intern Med. 1996;156(1):82-84. doi:10.1001/archinte.1996.00440010100013
4. Schaberg DR, Culver DH, Gaynes RP. Major trends in the microbial etiology of nosocomial infection. The American Journal of Medicine 91:3(S72-5). http://dx.doi.org/10.1016/0002-9343(91)90346-Y

Solution
Method of cleaning stethoscope
Those who never washed their stethoscopes were excluded
Previous research has shown that alcohol wipes are the best way to clean a stethoscope
Firm: S1

Ashwin Sivaharan
Nicola Raeside
Stephanie Joppa
Umair Mughal
Full transcript