542. Fight the Fomite: A Dedicated Stethoscope Demonstration Project
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Stethoscopes are frequently contaminated by pathogens, are often not disinfected between use on patients, and have been incriminated as potential fomites in outbreaks. Protective measures, such as covers or coatings, have not proven beneficial. Therefore, a patient-specific stethoscope was introduced for each patient in our hospital.
Methods: Prior to project initiation, a subset of personal stethoscopes was cultured. The Cardiology Section field-tested six stethoscopes and indicated the best performing instrument. A dedicated stethoscope was introduced for each patient and a systematic means to disinfect stethoscopes at the time of patient discharge was instituted. A means to spot-check stethoscope cleaning was introduced. Post introduction, a survey was administered to staff to assess project performance. A microbiologic culture survey was performed on a subset of dedicated stethoscopes.
Results: All personal stethoscopes sampled (N =15) harbored microbes, including a 20% Staphylococcus aureus and a 13% Gram-negative bacilli carriage rate. Approximately 500 3MTM Littman® Lightweight II SE® Stethoscopes were introduced. Two months after introduction, a subset of stethoscopes (N=10) was cultured. All carried small numbers of skin flora. None carried S. aureus or Gram-negative bacilli. Ultraviolet tagged spot checking of stethoscopes (N=15) was performed after terminal cleaning of patient rooms and 66% of the dedicated stethosocopes were adequately cleaned. A post-implementation survey was completed by 276 healthcare workers (33.7% physicians, 55.9% nurses, 10.4% other). 65.3% indicated a preference for the dedicated stethoscopes and 96% indicated the dedicated stethoscope had a positive or neutral effect on workflow. 62.3% indicated that they did not disinfect their own personal stethoscope between each patient use.
Conclusion: A patient dedicated stethoscope resulted in less contamination and a decreased risk of transmission of pathogens to patients. Dedicated stethoscopes were well accepted and a beneficial effect on workflow was documented. Additional improvements are required to ensure adequate disinfection between patients.
Ann Adler, RN1, Paul Fey, PhD2, Mark Rupp, MD, FIDSA2, Valerie Smith, RN1 and  M. E. Rupp,
3M Role(s): Grant Investigator, Scientific Advisor (Review Panel or Advisory Committee), Received: Research Support, Speaker Honorarium.
V. Smith, None..
A. Adler, None..
P. D. Fey, None., (1)Nebraska Medical Center, Omaha, NE, (2)University of Nebraska Medical Center, Omaha, NE