We have placed a great deal of emphasis on hand hygiene in the healthcare setting over the past few years, but unfortunately little is said about the stethoscope. Found hanging from almost every doctor's neck, the device is used many times in the course of a day, but most physicians seldom wipe it down. Studies have shown it to be contaminated with common pathogens. So I was excited to see an
article in the Boston Globe about Dr. Richard's Ma invention, a disposable plastic cover (shown in the photo). Do you think physicians are any more likely to use the cover than wiping the stethoscope down?
Photo: David Ryan, Boston Globe
We just had a mock JACHO survey and were told that we were in need a policy for staff to disinfect their personal stethoscopes after each patient. I have looked at the limited research on this and conclude that stethoscopes diaphragms are generally colonized with very low numbers of normal skin flora and occassionaly by staph aureus. Cleansing the diaphragm with alcohol gels decreases the presence of staph aureus by about 50%. However, no studies indicate that routine disinfection has any impact on HAI and there is no data that the alcohol gel with emollients can regularly be applied to the stethoscope diaphragm without leading to speedy deterioration of the stethoscope.
ReplyDeleteDoes anybody think routine disinfection of personal sthetoscopes should be a JACHO quality standard?
Gary Kravitz MD, United Hospital, St. Paul, MN