The Third Hand
Just like a clinician’s hands, stethoscopes can, and DO, harbor dangerous contaminants and organisms. Unlike our two hands, there is no easy, rapid, or effective way to clean our "third hand."
DIAPHRAGMS AND FINGERTIPS, EQUALLY POTENT VECTORS FOR PATHOGENS1
The stethoscope diaphragm carries the same volume and diversity of pathogens as the Hand1
“Transmission of pathogens…by stethoscopes could undermine the benefits of hand hygiene programs”2
CONTAMINATION OF STETHOSCOPES AND PHYSICIANS’ HANDS AFTER A PHYSICAL EXAMINATION1
study: 489 sample surfaces
Conclusion: Stethoscope contamination is "substantial after a single physical examination and comparable to contamination" of the physician’s hand.
THE CLINICIAN’S THIRD HAND: CONTAMINATED STETHOSCOPES ARE COMMON AND POSE A SIGNIFICANT SAFETY RISK
STETHOSCOPE CLEANING
STANDARD OF CARE
1-minute with alcohol wipe
Seldom performed
Ineffective against resistant pathogens
Surfaces often remain contaminated
CLINICIANS RARELY CLEAN THEIR STETHOSCOPES
Less than 4% of stethoscopes are cleaned between patients per CDC guidelines3
WITH CDC GUIDELINES
PATHOGENS FREQUENTLY PERSIST AFTER CLEANING
Stethoscope contamination is reduced but not eliminated after cleaning4
PRE-AND POST-PRACTITIONER CLEANING
SHARED (DISPOSABLE) STETHOSCOPES REDUCE SOUND QUALITY AND MAY CONTAMINATE STAFF AND PATIENTS5
"Practitioner and patient room stethoscopes are colonized with nosocomial pathogens, and cleaning reduces but doesn’t always eliminate contamination”6
NEJM Journal Watch, January 7, 2019