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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)
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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

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