1156. Observation of Stethoscope Sanitation Practices in an Emergency Department Setting

BACKGROUND: Nosocomial infections pose significant risk to patients and hygienic standards may be easily overlooked, especially in fast-paced emergency department settings. Studies have shown that stethoscopes can harbor pathogens, which can be transferred to patients when proper sanitary measures are not taken. Survey-based studies have mostly assessed stethoscope hygiene, but they may not accurately represent cleaning practice. This study aimed to accurately assess cleaning practice through observation of stethoscope cleaning and hand hygiene among medical providers in an emergency department setting. METHODS: Four hundred twenty-six provider–patient encounters were observed in the emergency department of the VA San Diego Healthcare System. The frequency and methods of stethoscope and hand hygiene practices were anonymously observed and recorded. Stethoscope hygiene was recorded during and after each encounter if cleaning took place for at least 15 seconds. Hand hygiene data were also gathered before and after each encounter. Data analysis was performed to determine the frequency of these practices. RESULTS: Of 426 encounters, 115 involved the use of a personal stethoscope. In 15 of 115 encounters (13.0%), the provider placed a glove over the stethoscope before patient contact. Following patient interaction, 13 of 115 encounters (11.3%) involved stethoscope hygiene with an alcohol swab. Stethoscope hygiene with water and hand towel before patient interaction was observed in 5 of 115 encounters (4.3%). Hand sanitizer use or hand washing was observed in 213 of 426 encounters (50.0%) before patient interaction. Gloves were also used prior to patient interaction in 206 of 426 (48.4%) encounters, some overlapping with those who used hand sanitizer or washed their hands. Hand sanitizer or hand washing was used in 332 of 426 encounters (77.9%) after patient interaction. CONCLUSION: Only 11.3% of encounters involving the use of a personal stethoscope had stethoscope sanitation with an alcohol swab. In 4.3% post-encounters, there was an attempt to clean stethoscopes with water and towel. Rates of appropriate hand hygiene were also lower than expected. Stethoscope and hand hygiene standards need to be raised to reduce infection risk and further studies need to be conducted to set guidelines for adequate stethoscope sanitation. DISCLOSURES: All authors: No reported disclosures.