Focus on hand hygiene when using stethoscopes
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November 1, 2017
Healthcare workers know to keep both hands clean. What about ‘the third hand’?
There were special contact precautions imposed on those caring for the patient in room 12. Doctors and nurses were required to don gowns and gloves before entering, as a sign on the door stated. When a physician in the University of Kansas Hospital’s family medicine progressive care unit stepped into room 12 the morning of October 26, 2016, he wore the PPE as required, but he jeopardized the facility’s infection control efforts in a subtler way—by bringing his stethoscope, a foreign object, into the room with him.
A federal inspector spotted the stethoscope dangling around the doctor’s neck when he entered and exited the room, then watched as the doctor began typing on a computer keyboard without using the hand hygiene gel container mounted on the wall just outside the patient’s room. A compliance officer confronted the physician, who then used the hand gel and explained that he hadn’t used his stethoscope inside the room, according to a summary of the inspector’s report obtained and published online by the Association of Health Care Journalists. A manager explained, however, that the stethoscope should not have been taken into an environment with any kind of isolation or contact precautions, regardless of whether it was used.
Do the details of that inspection sound familiar, even mundane? Could you picture this happening in your facility? If so, then you’re likely already aware that poor stethoscope hygiene practices are pervasive. The importance of hand hygiene is one of those topics that infection control specialists tend to spend a great deal of time reinforcing, for good reason; what often gets overlooked is how handheld tools, such as the stethoscope, can transmit pathogens just as easily and often as hands do.
“Stethoscopes are used repeatedly throughout the day and become contaminated after each patient expo-sure, so they must be treated as potential vectors of transmission,” said Linda Greene, RN, MPS, CIC, FAPIC, president of the Association for Professionals in Infection Control and Epidemiology (APIC), in a statement. “Failing to disinfect stethoscopes could constitute a serious patient safety issue similar to ig-noring hand hygiene.”