Do You Know Where Your Stethoscope Has Been?

“It’s too time-consuming.” “It gets in the way of patient care.” “Who’s going to pay for it?” “Oh no, not another change!”

These were all of the protests issued when gloves were implemented as a critical part of patient universal care for infection control. However, when it comes to patient safety and infection control, barrier protection trumps relying on handwashing compliance every time. Ultimately, implementation is more reliable in protecting both the patient and the healthcare worker from vectors of infection and helps drive down the cost of hospital-acquired infections (HAIs).

For 24 years as a nurse, I have been privileged to work with some of the best doctors, nurses and healthcare workers around. Let’s face it, the very nature of this profession draws the helpful and giving hearts who want to make the world a better place. But one thing I consistently observe is that in our fervor to serve our patients and quickly attend to their needs, we rarely have the time to stop and clean our stethoscopes with alcohol in between patients. This is not an insult to my co-workers; it is the reality and perhaps, the best kept secret of our profession.

It is also why I had to create a real-life solution to protect both the patient and healthcare worker everyday from the harms of the dirty stethoscope. As a mother of nine, I also had thoughts of protecting my own children.

Over the years, I have watched stethoscopes go from patient to patient all day long and then from day to day without ever being cleaned. According to reports that frequently name the stethoscope as a leading vector of infection, the problem is nationwide. For example, Bottom Line Health (Spring 2005) reported that out of 150 physician stethoscopes tested, 133 were found to harbor staph bacteria. This makes it clear that cleaning with alcohol, while effective, is not being done. And as recently as September 2007, Consumer Reports on Health recognized the stethoscope as a threat, recommending patients ask their doctors to wash their hands and clean their stethoscopes before an examination.

Until recently, the stethoscope has been overlooked largely because it is seen universally as a healing instrument. Therefore, patients and healthcare workers don’t think about it as a transmitter of bloodborne pathogens or as a vector of infection. It is only through heightened awareness of the dangers related to HAIs and scares related to methicillin-resistant Staphylococcus aureus (MRSA) that many are beginning to recognize the importance of prevention through barrier protection for each patient.

So, where was that stethoscope before it touched your patient? Consider these scenarios:

• How many times have you been listening for bowel sounds near a seeping colostomy or close to the pubic hair line before being called over to help with a patient where you need to listen to their heart or lungs near an open surgical wound?
• Have you ever touched a patient’s skin that has an unexplained rash and then gotten so busy that you move onto the next patient and then the next without any time to clean the stethoscope?
• How much sense does it make to separate sick children from healthy children in pediatric waiting rooms, yet the healthy and sick alike are touched with the same dirty stethoscope? One emergency room doctor revealed to me that he used the same stethoscope for 20 years and never cleaned it once during that time.

Further, as healthcare professionals, we have become desensitized to where that stethoscope has been. How many of you wear your stethoscope around your neck to the cafeteria? Sneeze and cough over it all day long? Toss it into your purse or pocket? We do ourselves a disservice by not protecting the most commonly used — and most personal — medical device that we come into contact with every day. It is not just the flat surface of the bell that can cause problems, when swabbed there is colonization growth found growing on the neck of the stethoscope as well.

The examples are endless, yet the solutions never seemed to address the problem. Leaving one stethoscope in every hospital room is grossly inadequate. This gives the healthcare worker a false sense of security that there is no reason to clean the stethoscope, not to mention that there is now documentation that there are superbugs like MRSA and others being found on the bed rails and tabletops inside patients’ rooms. At children’s hospitals, kids tend to play with stethoscopes and put them in their mouths. There is also the problem with cross contamination of ear infections between healthcare workers. This problem occurs with disposable stethoscopes as well and these, of course, also present auscultation issues.

A stethoscope cover is the only solution in the healthcare setting that stays with the healthcare worker throughout the day and provides a barrier protection for each new patient when you enter the room. It is best described as a glove for the stethoscope. To use the protection system, you clip a small dispenser directly onto the neck of the stethoscope. Twenty disposable sleeves are found inside, which are used one at a time, each for a different patient.

Let’s face it, as healthcare providers we have to deal with changes every week. It isn’t easy. However, based on the initial response that the stethoscope cover is receiving, I feel this is the new weapon in the war against the superbugs. If necessity is the mother of invention, prevention and a stethoscope cover may be the HAI’s worst enemy.

I’ve seen many patients stay in the hospital longer because of an unknown infection. I’ve also sat with families as they mourn the loss of a loved one who never should have died from an infection that cannot be explained to them. While we cannot solve every infection problem inside our hospitals in one clean sweep, I believe that StethoClean can put into place one more layer of protection for both the patient and the healthcare worker that is profoundly absent in infection control today.

Jennifer Giroux, RN, has more than 20 years of experience in nursing. With a background in mother/infant care, infectious disease and pre-surgical nursing and a mother of nine children, Giroux’s firsthand experience on the front lines of professional and family healthcare led her to obtain the U.S. patent for StethoClean in 2003. Working with Microtek Medical, a global leader in barrier infection control solutions for the healthcare environment, the product was launched in late 2007. She is currently a member of the same-day surgery/ pre-surgical department at Bethesda North Hospital of the TriHealth Hospital System in Cincinnati, and encourages medical professionals to request a free sample of StethoClean at www.mystethoclean.com.