Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-17T22:21:02.886Z Has data issue: false hasContentIssue false
  • English
  • Français

Improving Stethoscope Disinfection at a Children's Hospital

Part of: BARRY FARR AWARD RECIPIENTS

Published online by Cambridge University Press:  02 January 2015

Justin Zaghi ,
Jing Zhou ,
Dionne A. Graham ,
Gail Potter-Bynoe  and
Thomas J. Sandora
Justin Zaghi
Affiliation:
Harvard Medical School, Boston, Massachusetts
Jing Zhou
Affiliation:
Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts
Dionne A. Graham
Affiliation:
Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts
Gail Potter-Bynoe
Affiliation:
Infection Prevention and Control, Boston Children's Hospital, Boston, Massachusetts
Thomas J. Sandora*
Affiliation:
Infection Prevention and Control, Boston Children's Hospital, Boston, Massachusetts Division of Infectious Diseases, Department of Medicine and Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts
*
Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 (thomas.sandora@childrens.harvard.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

Stethoscopes are contaminated with pathogenic bacteria and pose a risk for transmission of infections, but few clinicians disinfect their stethoscope after every use. We sought to improve stethoscope disinfection rates among pediatric healthcare providers by providing access to disinfection materials and visual reminders to disinfect stethoscopes.

Design.

Prospective intervention study.

Setting.

Inpatient units and emergency department of a major pediatric hospital.

Participants.

Physicians and nurses with high anticipated stethoscope use.

Methods.

Baskets filled with alcohol prep pads and a sticker reminding providers to regularly disinfect stethoscopes were installed outside of patient rooms. Healthcare providers' stethoscope disinfection behaviors were directly observed before and after the intervention. Multivariable logistic regression models were created to identify independent predictors of stethoscope disinfection.

Results.

Two hundred twenty-six observations were made in the preintervention period and 261 in the postintervention period (83% were of physicians). Stethoscope disinfection compliance increased significantly from a baseline of 34% to 59% postintervention (P < .001). In adjusted analyses, the postintervention period was associated with improved disinfection among both physicians (odds ratio [OR], 2.3 [95% confidence interval (CI), 1.4-3.5]) and nurses (OR, 14.3 [95% CI, 4.6-44.6]). Additional factors independently associated with disinfection included subspecialty unit (vs general pediatrics; OR, 0.5 [95% CI, 0.3-0.8]) and contact precautions (OR, 2.3 [95% CI, 1.2-4.1]).

Conclusions.

Providing stethoscope disinfection supplies and visible reminders outside of patient rooms significantly increased stethoscope disinfection rates among physicians and nurses at a children's hospital. This simple intervention could be replicated at other healthcare facilities. Future research should assess the impact on patient infections.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 11 , November 2013 , pp. 1189 - 1193
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Schroeder, A, Schroeder, MA, D'Amico, F. What's growing on your stethoscope? (and what you can do about it). J Fam Pract 2009;58:404–409.Google Scholar
2.Williams, C, Davis, DL. Methicillin-resistant Staphylococcus aureus fomite survival. Clin Lab Sci 2009;22:34–38.Google ScholarPubMed
3.Cohen, HA, Amir, J, Matalon, A, Mayan, R, Beni, S, Barzilai, A. Stethoscopes and otoscopes: a potential vector of infection? Fam Pract 1997;14:446–149.CrossRefGoogle ScholarPubMed
4.Youngster, I, Berkovitch, M, Heyman, E, Lazarovitch, Z, Goldman, M. The stethoscope as a vector of infectious diseases in the paediatric division. Acta Paediatr 2008;97:1253–1255.Google Scholar
5.Guinto, CH, Bottone, EJ, Raffalli, JT, Montecalvo, MA, Wormser, GR. Evaluation of dedicated stethoscopes as a potential source of nosocomial pathogens. Am J Infect Control 2002;30:499–502.Google Scholar
6.Lange, CG, Morrissey, AB, Donskey, CJ. Point-prevalence of contamination of healthcare workers' stethoscopes with vancomy-cin-resistant enterococci at two teaching hospitals in Cleveland, Ohio. Infect Control Hosp Epidemiol 2000;21:756.Google Scholar
7.Zachary, KC, Bayne, PS, Morrison, VJ, Ford, DS, Silver, LC, Hooper, DC. Contamination of gowns, gloves, and stethoscopes with vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 2001;22:560–564.CrossRefGoogle ScholarPubMed
8.Alleyne, SA, Hussain, AM, Clokie, M, Jenkins, DR. Stethoscopes: potential vectors of Clostridium difficile. J Hosp Infect 2009;73: 187–189.Google Scholar
9.Vajravelu, RK, Guerrero, DM, Jury, LA, Donskey, CJ. Evaluation of stethoscopes as vectors of Clostridium difficile and methicillin-resistant Staphylococcus aureus. Evaluation 2012;33:96–98.Google Scholar
10.Jones, JS, Hoerle, D, Riekse, R. Stethoscopes: a potential vector of infection? Ann Emerg Med 1995;26:296–299.Google Scholar
11.Bernard, L, Kereveur, A, Durand, D, et al. Bacterial contamination of hospital physicians' stethoscopes. Infect Control Hosp Epidemiol 1999;20:626–628.Google Scholar
12.Muniz, J, Sethi, RK, Zaghi, J, Ziniel, SI, Sandora, TJ. Predictors of stethoscope disinfection among pediatric health care providers. Am J Infect Control 2012;40:922–925.Google Scholar
13.Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG. Research Electronic Data Capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377–381.Google Scholar
14.Rutala, WA, Weber, DJ; Healthcare Infection Control Practices Advisory Committee. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Atlanta: Centers for Disease Control and Prevention, 2008. http://www.cdc.gov/hicpac/pdf /guidelines/Disinfection_Nov_2008.pdf. Accessed September 22, 2011.Google Scholar
15.Gupta, A, Delia-Latta, P, Todd, B, et al. Outbreak of extended-spectrum betaβ-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. Infect Control Hosp Epidemiol 2004;25:210–215.CrossRefGoogle Scholar
16.Crespo, MP, Woodford, N, Sinclair, A, et al. Outbreak of carba-penem-resistant Pseudomonas aeruginosa producing VIM-8, a novel metallo-betaβ-lactamase, in a tertiary care center in Cali, Colombia. J Clin Microbiol 2004;42:5094–5101.Google Scholar