According to new research, educating clinicians about the importance of stethoscope hygiene does not appear to increase the practice, despite infection control guidelines stating that stethoscopes should be disinfected between each patient encounter.

This new study, published in the American Journal of Infection Control, was conducted using a covert observational method at a tertiary care Department of Veterans Affairs hospital. Two attending hospitalists recorded instances of stethoscope hygiene (use of alcohol swabs, alcohol gel, or disinfectant wipes) as well as hand hygiene among medical students, resident physicians, and attending physicians during the first week of a 4-week rotation.

Results showed that over 128 observations, stethoscope hygiene never once occurred. Hand hygiene rates were also lower than expected at 58%.

The researchers subsequently carried out an intervention phase which consisted of an 11-slide PowerPoint presentation concerning the importance of stethoscope hygiene. The presentation emphasized that stethoscope hygiene was expected to be practiced between each patient encounter and that either alcohol swabs or hand sanitizer were acceptable forms. 

Even after the intervention, of 41 subsequent observations, the researchers still noted zero occurrences of stethoscope hygiene. Hand hygiene did increase but only slightly, to 63%.

“Stethoscopes are used repeatedly throughout the day and become contaminated after each patient exposure, so they must be treated as potential vectors of transmission,” said Linda Greene, RN, MPS, CIC, FAPIC, and president of Association for Professionals in Infection Control and Epidemiology. “Failing to disinfect stethoscopes could constitute a serious patient safety issue similar to ignoring hand hygiene.”

Concerning the results, the authors write, “We anticipated low stethoscope hygiene rates, but were surprised that no one performed stethoscope hygiene despite the fact that it is on the checklist for second-year medical students’ final evaluation demonstrating competency in performing a complete history and physical at our institution.”

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