Is Your Stethoscope Contaminated?
A recent study reminds us of the importance of cleaning our equipment. While healthcare has made a big push on cleaning hands, offering hand sanitizing gels in our hallways for workers and guests, insisting on routine hand washing between patients, and other preventative measures to reduce the transmission of germs, we often forget about the tools we use routinely, like our stethoscopes. We have standards that dictate our hand washing, but not our "ears" and we may be helping bacteria and viruses move around our hospitals.
Workers' clothes, jewelry, shoes and stethoscopes can be a safe harbor for everything that makes us sick. We have known this for some time, but have not really addressed it. We decided long ago that if you want to be in healthcare, your fingernails, for example, should not be too long when you are dealing with patients, because they harbor germs. We pull our hair back (those of you who have it) so our hair is not in the way and the germs in it does not contaminate our working field. Still, the thing that hangs around our neck, the thing we use more than any other piece of equipment in the hospital, has no standard for cleanliness, nor does it get much attention, by many who place it on one patient, then a second, then a third, and so on, pressing against our patients' chests without so much as a wiping off.
Studies by Didier Pittet, director of the Infection Control Program at University of Geneva Hospital, showed that after examining 83 patients, the only "tool" used by a physician that was more contaminated than the stethoscope was the doctor's fingertips. Stethoscope diaphrams were robust with bacteria, including MRSA, in 71 of the after examination samplings.
I have long been an advocate of cleaning my stethoscope after each patient, just like washing hands. It made sense to me, though colleagues would occasionally make fun of my "germophobic" nature. To me, it was not about being a germophobe, but about being clean. We wash hands; we keep our uniforms clean. Why do we spend so little time cleaning the one thing we are putting in contact with every single patient we meet?
In my opinion, the push for a medical standard to clean stethoscopes is a bit much. I just do not think people will follow it, and enforcing it would be a nightmare. I think it is up to each individual therapist "to do no harm" by taking responsibility themselves. If you think of all the germs your "ears" have been exposed to in just one shift, that should convince you to clean your equipment well. Remember that often, that same stethoscope that has been used in the emergency department, ICU, or on the floor, is often the same one you will use on your daughter when she has a chest cold or your father when he is not feeling well. Bringing your work home is admirable, unless that work involves hospital germs. Do not give them a ride to your house, and do not let them leave one hospital bed and travel to another with your assistance. A quick swipe with an alcohol pad can probably take care of most germs, takes less than 10 seconds, and can help you improve your care.
That's just my opinion, Jim Thacker, MBA, MHA, CRT, AE-C