DS 01 - Point-of-Care Stethoscope Disinfection Improves Hand Hygiene Compliance

Background: Hospital acquired infections (HAIs) can be contracted from a variety of sources, including contaminated devices such as stethoscopes, and unwashed hands of caregivers. In order to lower HAI risk, we investigated use of a point-of-care stethoscope disinfection device (SDD) in both an urgent care clinic setting (UCC), and an academic medical center emergency department (ED). We hypothesized that presence of the wall mounted SDD would reinforce infection control behaviors, and hand hygiene (HH) compliance in particular.

Methods: Experienced research nurses were used to observe HH compliance the day before, and after installation of the SDDs. Devices were placed outside exam rooms next to hand gel dispensers. Caregivers were considered compliant with Center for Disease Control and Prevention recommendations if hand sanitizer was applied before or after patient interaction. Use of the SDD itself was also recorded. Chi square analyses were performed.

Results: A total of 168 patient room entries were logged during the pre-installation observation periods - 38 in the UCC, and 130 in the ED. After SDD placement, 199 patient room entries were recorded - 74 in the UCC, and 125 in the ED. Overall HH compliance increased from 19% before to 54% after device installation (p < 0.0001). Among those who used the device for stethoscope disinfection, HH compliance was 94%, as opposed to 46% in those who did not (p < 0.0001).

Conclusions: Installation of an SDD in two distinct medical settings improved HH compliance. Use of the device itself resulted in further optimization of HH rates, likely from the mutually reinforcing nature of infection control behaviors. While the novelty of the SDD and the effect of observation may have influenced our findings, we speculate that the device’s visual presence in proximity to hand gel dispensers will serve as an enduring stimulus to HH guideline conformity.