Could the Risk of Stethoscopes Cross-Infection be the ‘Push’ for Redesign?


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Adele Graham King
Medical Devices Developer,
Free Lance Writer & Blogger

In the clinical environment we are often asked and encouraged to demand that clinical staff members wash their hands, and indeed many medics and nurses wear badges that say ‘Please ask me to wash my hands’. 

Hand washing is something that is instilled into us from a very young age in nursery and kindergarten to ensure good personal hygiene, and it is widely accepted that bacteria passed from hands are the most common cause of hospital bourn cross-infection, but it could all be pointless if the medical devices we are using just pass the bugs back.

The University of Geneva recently conducted a research study of bacteria found on stethoscopes during routine use in examination of patients. The study, published in Mayo Clinic Proceedings compared the amount and type of bacteria found on the diaphragm (circular metal end piece) of the stethoscope, and the tube connecting the ear pieces, with the bacteria found on four separate sites of the doctors hands after patient examination. 

While the fingertips of the clinician were found to be the site of highest bacterial presence, the diaphragm of the stethoscope was found to have more bacteria present than any of the other site on the hand and the tube picked up substantial amounts of bacteria too. The researchers also tested specifically for MRSA (meticillin-resistant staphylococcus aureus) and found similar amounts of the bacteria on both the doctors’ hands and the stethoscopes.

Bearing in mind that with each patient examination the surface of the stethoscope touches a ‘sick’ person's 
skin the transfer of bacteria cannot be a surprise, but the design of such devices doesn’t currently facilitate effective decontamination during use, and sterilization doesn’t take place on a patient by patient basis. 

In fact digital stethoscopes that carry electronics within the end ‘piece’ which has patient contact have even more limitations with regards to cleanliness. Many stethoscopes have over moulded edges or separate parts that are removable but rarely removed. There are many sites for bacteria to ingress and multiply on these devices that are probably the most commonly used item in a clinicans’ bag. But they could realistically be the root cause of many cross-infections. Not proven – but food for thought. The design of the stethoscope has remained similar for many years, using old technology with mediocre modification in aesthetics and some developments in sound transfer, but could the cross-infection risk be the stimulus for the redesign and technological advancement of an old ‘dog’? Be interesting to see.

Adele is a keen 'blogger' specialising in creating discussions in emerging drug, medical device and packaging technologies and pharmaceutical industry evolution.

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