A little perplexed, why don't we clean steths?

[zeppelinpage4]

On rotations. Hand washing/sanitizing stations every few feet, we're encouraged to not wear ties or white coats which can spread infection, told to always wash/sanitize hands between patients, expected to gown and glove up for highly contagious patients on precaution.

But, in our classes M1 and M2, and during our orientation and in the hospital....no one has ever suggested cleaning our stethoscopes. Aren't they contacting patients as much as our hands, and rubbing on things as much as ties?
Are stethoscopes an exception for reasons I'm not aware of? I understand, not every doctor will clean their steths between patients. But, unlike hand hygiene and other things, it's not even encouraged or brought up.

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[cs24]

I have long wondered this as well.

 

[jdh71]

I clean mine all the time.

No one is stopping you.

 

[Perrotfish]

On rotations. Hand washing/sanitizing stations every few feet, we're encouraged to not wear ties or white coats which can spread infection, told to always wash/sanitize hands between patients, expected to gown and glove up for highly contagious patients on precaution.

But, in our classes M1 and M2, and during our orientation and in the hospital....no one has ever suggested cleaning our stethoscopes. Aren't they contacting patients as much as our hands, and rubbing on things as much as ties?
Are stethoscopes an exception for reasons I'm not aware of? I understand, not every doctor will clean their steths between patients. But, unlike hand hygiene and other things, it's not even encouraged or brought up.

Its weird that they don't bring it up. Wash your stethoscope. There are good studies that show that the alcohol glop that you spray on your hands works just as well on the stethoscopes, you don't need to carry around alcohol pads or anything. Think of it as an extension of your hands and wash it every time with the same pump of alcohol you use for your hands. If you need running water for your hands (C-diff) then use a chlorhexadine wipe for the stethoscope.

 

[DoctorLacrosse]

I worked as an ER tech for years, and I can count the number of times I saw someone else cleaning a BP cuff on one hand. there are little things that just boggle my mind in this field. be a trendsetter, clean that stethoscope, save lives.

 

[zeppelinpage4]

I clean mine all the time.

No one is stopping you.

It's not so much that no one is stopping me. I found some wipes and finally cleaned mine today (which is when this thought occurred to me). It's that, there's hundreds of signs telling us to wash our hands and glove and gown, and we're taught to properly do these things from early on in med school. But, there's no protocol for cleaning steths, and I don't recall it ever being suggested by any of my professors or physician preceptors in class or in the hospital. Like, somehow stethescopes got the exception.

Its weird that they don't bring it up. Wash your stethoscope. There are good studies that show that the alcohol glop that you spray on your hands works just as well on the stethoscopes, you don't need to carry around alcohol pads or anything. Think of it as an extension of your hands and wash it every time with the same pump of alcohol you use for your hands. If you need running water for your hands (C-diff) then use a chlorhexadine wipe for the stethoscope.

Thank you Perrotfish! Your post helped a lot. I didn't know most of this. I had tried grabbing small wipe packets when we did standardized patients in M2, but it was getting inconvenient to find and use it every time, especially since I was under a time limit in those situations.
I didn't think the alcohol glop was sufficient, those are way more easily accessible.
Also, solid advice for the running water.
Just useful information like your post would have helped a lot. But many of us aren't even properly informed, which surprises me.

I'll try to keep these in mind. I know I'll often be rushed by superiors, and it may be difficult to clean it every time. But I hope I can at least to try and make it a good habit to clean it when I can. Seems like it would be quite simple for hospitals to make this more convenient for health care workers, or at least offer some guildelines for those interested, like your post did. Just a few signs reminding health care workers to wipe the steths near some of the alcohol dispensers could potentially go a long way.

Edit:
Just stumbled across this. Not sure if it would work, but cool to see other folks are aware of this. https://www.indiegogo.com/projects/zeroscope-stethoscope-barrier-protection-for-patients#/story

 

[Cytarabine]

It's not so much that no one is stopping me. I found some wipes and finally cleaned mine today (which is when this thought occurred to me). It's that, there's hundreds of signs telling us to wash our hands and glove and gown, and we're taught to properly do these things from early on in med school. But, there's no protocol for cleaning steths, and I don't recall it ever being suggested by any of my professors or physician preceptors in class or in the hospital. Like, somehow stethescopes got the exception.


Thank you Perrotfish! Your post helped a lot. I didn't know most of this. I had tried grabbing small wipe packets when we did standardized patients in M2, but it was getting inconvenient to find and use it every time, especially since I was under a time limit in those situations.
I didn't think the alcohol glop was sufficient, those are way more easily accessible.
Also, solid advice for the running water.
Just useful information like your post would have helped a lot. But many of us aren't even properly informed, which surprises me.

I'll try to keep these in mind. I know I'll often be rushed by superiors, and it may be difficult to clean it every time. But I hope I can at least to try and make it a good habit to clean it when I can. Seems like it would be quite simple for hospitals to make this more convenient for health care workers, or at least offer some guildelines for those interested, like your post did. Just a few signs reminding health care workers to wipe the steths near some of the alcohol dispensers could potentially go a long way.

Edit:
Just stumbled across this. Not sure if it would work, but cool to see other folks are aware of this. https://www.indiegogo.com/projects/zeroscope-stethoscope-barrier-protection-for-patients#/story

If your pt is on contact precautions, you can also just stick a glove over your steth

 

[FutureInternist]

I always grab 3 gloves..... hands & steth, screw the alcohol

 

[Smurfette]

We were taught to clean our steths between patients in med school. The hand sanitizers are ubiquitous and easier to find than alcohol wipes, although the wipes are handy to have in your coat pocket anyhow as a student. The glove trick works if the patient is on contact precautions and there wasn't one of the cheapie steths left in the room (my med school hospital and main residency hospital both had steths that were meant to be left in patient rooms if on contact precautions) but it looks a little goofy from the patient perspective since most providers don't explain why they are using the glove.

I also recommend cleaning your ID badge periodically; these tend to brush up against patients, get snagged on things, etc., especially if you use a lanyard.

 

[Crayola227]

I dunno.... the ID docs came and gave us a lecture and said the hand stuff does not do the equivalent job on the steths, they had some evidence to back that up. They were also sure to point out that the stuff in the wipes has to be in contact for some number of minutes, can't remember, like 3 or something. Apparently the specific claims and directions on the sanitizing stuff is there for a reason, it's what the companies that make that stuff can stand behind based on whatever tests they've put it through.

Like once a week I take all my tools that have any kind of waterproof-ness (stethy, tuning fork, clipboard, reference book covers, pens, penlight, etc) and rub them down with the wipes, wait till it dries, then rub again, till I think they've bathed in the stuff for the amount of time the wipes say.

Evidence based! I don't bother with sanitizing stuff that isn't evidence based from our ID docs. Convenient excuse to pass the buck, I don't have time to do the reading they do, so I'll just do what they say. They told me there have a been a lot of studies suggesting that most of the gown/glove stuff we do is bogus for MRSA. Good for c.diff though. So I do wipe down the stethy as I best as I can w/ c diff pts.

I figure I'm taking the initiative to do something I'm not required to do that I don't see many other people doing, going "above and beyond the call of duty" pat myself on the back (I have so few reasons to) and leave it at that. There's a lot of things I'd like to do better in the hospital but I'm a resident so my job is to say "yes sir" do whatever makes the attendings and program happy, keep the patients living, and not go over work hours. I try to sleep sometimes.

 

[mpdoc2]

On rotations. Hand washing/sanitizing stations every few feet, we're encouraged to not wear ties or white coats which can spread infection, told to always wash/sanitize hands between patients, expected to gown and glove up for highly contagious patients on precaution.

But, in our classes M1 and M2, and during our orientation and in the hospital....no one has ever suggested cleaning our stethoscopes. Aren't they contacting patients as much as our hands, and rubbing on things as much as ties?
Are stethoscopes an exception for reasons I'm not aware of? I understand, not every doctor will clean their steths between patients. But, unlike hand hygiene and other things, it's not even encouraged or brought up.

Doctors are dirty 😛

 

[Kaustikos]

I just put mine in an autoclave. Incidentally, I have had to buy more stethoscopes. Am I doing it wrong?

 

[zeppelinpage4]

I just put mine in an autoclave. Incidentally, I have had to buy more stethoscopes. Am I doing it wrong?

I honestly cracked up a bit imagining this.

 

[Promethean]

Wow. My thought was... you don't? Ewww, why not?

They taught us to clean them in nursing school. Maybe it is that nurses are generally more likely to have a pocket full of alcohol wipes. Even with popping into and out of patient rooms, it isn't hard to do while attending to other matters of hygiene. Before wrapping a microbe haven around your neck, giving it a quick wipe down just seems prudent.

Sanitizer/bleach wipes are great for a once or twice a day cleaning, and bleach or soap and water is called for if you have any concerns about C. diff or other tough bugs. Best practice from an infection control standpoint would be to use a dedicated disposable steth for patients in isolation precautions, but that isn't always feasible, especially if you actually want to be able to hear anything. So, bleach wipes are a good way to balance cleanliness with practicality.

 

[mpdoc2]

Wow. My thought was... you don't? Ewww, why not?

Laziness

 

[awared2]

At my school we are always told to wipe our stethoscopes before touching a patient

 

[Kaustikos]

At my school we are always told to wipe our stethoscopes before touching a patient

.....
Yeah, sign me up for guilty in never doing that. Or most people.
Why not dry clean your clothes after every patient, too?

 

[awared2]

.....
Yeah, sign me up for guilty in never doing that. Or most people.
Why not dry clean your clothes after every patient, too?

I didn't say that people do it on rotations, I said in our "school". It's drilled into us during osces just as much as not auscultating over a shirt.

 

[Kaustikos]

I didn't say that people do it on rotations, I said in our "school". It's drilled into us during osces just as much as not auscultating over a shirt.

I know.
I'm just saying how funny it would be if we literally followed that for every patient day in and out. I'm sure our stethoscopes would deteriorate from the excess cleaning. Lol

 

[CaliforniaDreamer]

My hospital had a disposable for each patient.

 

[CubsFan314]

I had once asked this question of one of our infection control docs. Her response was that the vast majority of transmission in the hospital happen because of healthcare worker hands. Although things like stethescopes, ties, etc. have been shown to get colonized with hospital bugs, no one has proven that they are important fomites for actual transmission (although certainly possible). In the end, she wasn't going to take on stethescopes or ties, etc. until the hand hygiene adherence was above 90% (which saddened me that it wasn't). Apparently it's not just our hospital that has this struggle.

 

[Psai]

I had once asked this question of one of our infection control docs. Her response was that the vast majority of transmission in the hospital happen because of healthcare worker hands. Although things like stethescopes, ties, etc. have been shown to get colonized with hospital bugs, no one has proven that they are important fomites for actual transmission (although certainly possible). In the end, she wasn't going to take on stethescopes or ties, etc. until the hand hygiene adherence was above 90% (which saddened me that it wasn't). Apparently it's not just our hospital that has this struggle.

have you ever seen how the rooms get cleaned?
people are all up in arms about doctors
in the ORs they are obsessed with covering ears with the lunch lady hats because apparently the ear skin will slough off and contaminate the surgical field. completely bizarre

 

[OnePunchBiopsy]

I always use alcohol wipes or hand sanitizer on my stethoscope. Hasn't ruined the diaphragm yet. If it does i would rather buy a new diaphragm than carry MRSA in my pocket.