Stethoscopes: Friend or fomite?

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Hospital-acquired infections (HAIs) continue to remain at the forefront of the challenges facing healthcare today. According to the CDC, on an average day in U.S. hospitals, 1 in every 25 patients has at least one HAI.1 These infections affect approximately 2 million patients annually, resulting in 99,000 estimated deaths and attributable costs of $6.7 billion.1-4 Although estimates suggest that between 10% and 70% of HAIs are preventable with simple improvements in hygiene, predominantly hand washing, current research leads us to believe that poor hand hygiene isn't the sole means by which infection spreads.4,5 There's compelling evidence from recent studies that many stethoscopes when tested were found to harbor disease-causing bacteria, such as Staphylococcus aureus, including methicillin-resistant strains (MRSA).
Moreover, evidence is accruing that many clinicians fail to properly clean their stethoscopes, often citing both a basic lack of understanding of stethoscope hygiene principles and a general misconception regarding the potential implications for patient safety when proper stethoscope hygiene practices aren't followed. These studies are small and many have been conducted outside of the U.S. healthcare system. A gap persists in our understanding of knowledge, attitudes, and practices of U.S. nursing staff, particularly among ICU nursing staff where stethoscopes are used more frequently than on other units.

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