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“Imperative to put in place control guidelines and educate clinicians on the outcomes of not ensuring safety”
New Delhi, December 19, 2018:
Recent research has indicated that stethoscopes used in an intensive care unit (ICU) are loaded with bacteria, including those that may be associated with hospital-acquired infections (HAIs). Moreover, standard cleaning methods do not eliminate the problems. Practitioner stethoscopes are contaminated by a plethora of bacteria, including organisms that may be associated with nosocomial infections.
The researchers found that all stethoscopes used in the ICU were significantly contaminated with a variety of pathogens. The highest bacterial contamination levels were found on practitioner stethoscopes, followed by patient-room stethoscopes. Bacterial contamination levels on clean stethoscopes and background controls were indistinguishable from each other.
Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Given that the stethoscope is seen universally as a healing instrument, both patients and healthcare workers may not take it as a transmitter of bloodborne pathogens or a vector of infection. However, the truth is far from this. Some of these pathogens include Staphylococcus aureus, Pseudomonas aeruginosa, Clostridium difficile, and vancomycin-resistant enterococci. These are responsible for many diseases such as pneumonia, urinary tract infections (UTIs), and skin infections, some of which can be life threatening. Patients and at times, even hospital staff, fail to follow certain basic hygiene protocols which can go a long way in preventing these infections. This is further exacerbated by the fact that there is no specific documentation of HAI incidence in India, at least in the major cities.”
Studies have also concluded that the diaphragm of the stethoscope is more contaminated than other regions of the hand, including the skin around the base of the thumb and little finger, or the back of the hand.
Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “In light of all this, it becomes imperative to educate clinicians on the importance of stethoscope hygiene. They should conduct a cleanliness check between each patient encounter. Cleaning hands and ensuring other forms of hygiene is also an important part of avoiding HAIs.”
Some tips from HCFI
Stethoscopes can be cleaned using a combination of 90% ethanol, isopropyl alcohol (IPA), and chlorhexidine. This will help in reducing the bacterial contamination of diaphragm of stethoscope.
- If your stethoscope needs to be disinfected, wipe with a 70% isopropyl alcohol solution.
- Do not use hand sanitizer as a cleaning agent as there are additives that may damage parts of the stethoscope.
- Do not immerse your stethoscope in any liquid, or subject it to any sterilization process.
- Keep your stethoscope away from extreme heat, cold, solvents and oils.
- Tunable diaphragms can be removed from the chest piece and their surfaces wiped with alcohol or soapy water. Dry all parts thoroughly before reassembly.
- Ear tips can be removed from the ear tubes for thorough cleaning. For safety, snap ear tips firmly back onto the ribbed ends of the ear tubes.
