Stethoscope Care Practices of Nurses in Sulu Provincial Hospital, Sulu, Philippines

Main Article Content

Charisma S. Ututalum
Custer C. Deocaris
Krysha Macapendeg

Keywords

Stethoscope Care, Practices, Disinfection, Compliance

Abstract

Background: Regular disinfection practices of the stethoscope, although regarded as a non-critical medical device, is emphasized as a practical and straightforward way of reducing healthcare-associated infections (HCAIs). However, in a resource-poor setting, strict compliance may be hindered by the nurses’ lack of knowledge of its care and sense of ownership.
Purpose: This study explored the compliance of stethoscope disinfection by nurses as well as assessed associated factors affecting practice in a resource-constrained setting in Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), Philippines.
Methods: A cross-sectional descriptive study involving thirty-six nurses in various units of the Sulu Provincial Hospital using a Nurses’ Stethoscope Usage Questionnaire was done.
Results: The majority of the nurses were found compliant with their stethoscopes' regular disinfection, with more than 50% being conscious in swabbing the instrument with alcohol. Compared to the younger nurses (age < 30 years), there appeared to be a greater tendency for older respondents (age > 30 years) to clean their stethoscope diaphragm before (p=0.010) and after use (p=0.030) than the other parts, i.e., earpiece, bell, and ear tube. The same trend was evident for nurses who have more extended professional practice (> 3 years) than those who had been working in the hospital for less than three years (p=0.030). None of the nurses surveyed owned the stethoscopes they use in the clinic, and such had an influenced on how thorough the instrument was being disinfected or cleaned. Better stethoscope disinfection compliance was also attributable to adequate knowledge of stethoscope parts and use.
Conclusions and Implications for Practice: While the results of this study were broadly consistent with the role of knowledge and education program on stethoscope disinfection behavior, a key finding to further improve compliance is by addressing the ownership issues of stethoscopes. This intervention can provide nurses with a stronger sense of personal responsibility towards stethoscope care and hygiene.

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References

1. WHO. Prevention of hospital-acquired infections: a practical guide: Geneva, Switzerland: World Health Organization; 2002.
2. Allegranzi B., Nejad SB., Combescure C., et al. (2011). Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. The Lancet. 377(9761) : 228-241.
3. WHO. The burden of health care-associated infection worldwide: a summary. World Health Organization, Geneva, Switzerland https://www whoint/gpsc/country_work/summary_20100430_en pdf. 2010.
4. Ilyas, F., Burbridge, B. and Babyn, P. (2019) . Health Care–Associated Infections and the Radiology Department. MDCM Journal of Medical Imaging and Radiation Sciences (50)4 : 596606. https://doi.org/10.1016/j.jmir.2019.07.011
5. Ahmedkhan , H., Kanwalbaig, F., Mehboob ,R. (2019). Nosocomial Infections: Epidemiology, Prevention, Control and Surveillance Asian Pacific Journal of Tropical Biomedicine 7(5) : 478-482. https://doi.org/10.1016/j.apjtb.2017.01.019
6. Bansal, A., Sarath, R., Bhan, B., Gupta, K., and Puwar, S. (2018). To assess the Stethoscope Cleaning Practices, Microbial Load and Efficacy of Cleaning Stethoscopes with Alcohol-Based Disinfectant in a Tertiary Care Hospital. Journal of Infection Prevention. ( 20) 1 : 46-50. https://doi.org/10.1177/1757177418802353
7. Alzahrani, A., Albensari, R., Farahat , F., Alamri , A., (2018). 9 Bacterial contamination and stethoscope disinfection practices: a cross-sectional survey among residents at king abdulaziz medical city, western region of saudi arabia, BMJ Journal 8 (1) http://dx.doi.org/10.1136/bmjoq-2019-PSF.9 8. Sahiledengle B. (2019). Stethoscope disinfection is rarely done in Ethiopia: What are the associated factors? PLOS One. 14(6): https://doi.org/10.1371/journal.pone.0208365
9. Horiuchi, Y, Wettersten, N, Vasudevan, R, et al. (2018). Stethoscope as a Vector for Infectious Disease. Curr Emerg Hosp Med Rep 6, 120–125 https://doi.org/10.1007/s40138-018-0167-4
10. Datta, P, Kaur, M, Rawat, S. Gupta, V., & Chander, J. (2018). Stethoscope, "the friendly foe" - A study to evaluate bacterial contamination of stethoscopes and disinfection practices. Journal of infection in developing countries, 12(10), 887–893. https://doi.org/10.3855/jidc.10128
11. Huang, R., Mehta, S., Weed, D., Price, CS. (2017) . Methicillin-Resistant Staphylococcus aureus Survival on Hospital Fomites. Infection Control & Hospital Epidemiology. 27(11):1267-1269. https://doi.org/10.1086/507965
12. Jain A, Shah H, Jain A, Sharma M. (2013). Disinfection of stethoscopes: Gap between knowledge and practice in an Indian tertiary care hospital. Annals of Tropical Medicine and Public Health. 6(2):236-239.
13. Shaw F, Cooper S.( 2014). Stethoscope hygiene: a best practice review of the literature.Australian nursing & midwifery journal.21(8):28-31.
14. Suarez, M.S.S., Oducado, R.M.F., Josue, E.L.C., Gayoso, T.L.C., Ocate, C.A.L., & Lujan, J.J.A. (2019). Infection control practice on vital signs equipment: A survey among senior nursing students in Iloilo City, Philippines, Asia Pacific Journal of Multidisciplinary Research, 7(2), 56-62.
15. World Medical Association declaration of Helsinki. Recommendations guiding physicians in biomedical research involving human subjects. Jama. Mar 19 1997;277(11):925-926.
16. Zehra, D., Iqbal, M., Safdar, A., Jamil, H., Inam, S., & Zahid, M. A. (2019). Awareness Among Healthcare Professionals Regarding Contaminated Stethoscopes as a Source of Nosocomial Infections. Cureus, 11(10), e5968. https://doi.org/10.7759/cureus.5968
17. Pratiksha Srivastava, Atosh Tripathi, Priti Agrawal, Dilshad Arif, Satendra Pratap Singh and Anil Kumar. (2019). The Role of Stethoscopes in the Transmission of Hospital Infections.Int.J.Curr.Microbiol.App.Sci. 8(1): 2472-2478 : https://doi.org/10.20546/ijcmas.2019.801.261
18. Leontsini, F., Papapetropoulos, A., and Vantarakis, A. (2013) Stethoscopes as vectors of multi-resistant coagulase negative staphylococci in a tertiary hospital. International Journal of Medical Science and Public Health, 2 (2), 324-329. https:// doi.org/:10.5455/ijmsph.2013.2.338-34
19. Ahmed, J., Malik, F., Memon, Z. A., Bin Arif, T., Ali, A., Nasim, S., Ahmad, J., & Khan, M. A. (2020). Compliance and Knowledge of Healthcare Workers Regarding Hand Hygiene and Use of Disinfectants: A Study Based in Karachi. Cureus, 12(2), e7036. https://doi.org/10.7759/cureus.7036
20. Holleck, J. L., Merchant, N., Lin, S., & Gupta, S. (2017). Can education influence stethoscope hygiene?. American journal of infection control, 45(7), 811–812. https://doi.org/10.1016/j.ajic.2017.02.004
21. Naghdi H, Azizzadeh Forouzi M, Dehghan M. (2019). Iranian Nurses' Knowledge of Neutropenia and Their Practice for Infection Prevention in Patients with Cancer. Journal of cancer education. Nov 23 2019. https://doi.org/10.1007/s13187-019-01663-7
22. Omiye, J. A., Afolaranmi, O. J., Ghazal, I. D., Yahya, M. B., Oduwale, M. O., Adeyeye, O. H., Emenyonu, U. K., Nwaduru, C. E., Badmos, B. B., Adekanmbi, O. A., & Oladokun, R. O. (2019). Hand Hygiene Practice Among Health Care Workers in a Tertiary Hospital in Sub-Saharan Africa (Handy Study). West African journal of medicine, 36(2), 116–121.
23. Kampf G, Todt D, Pfaender S, Steinmann E. (2020). Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection. 104(3):246-251. 104(3): 246–251. https://doi.org/ 10.1016/j.jhin.2020.01.022 24. Fenelon F, O'Flaherty (2015) The stethoscope and healthcare-associated infection: A snake in the grass or innocent bystander? Journal of Hospital Infection 91(1) https://doi.org/ 10.1016/j.jhin.2015.04.010
25. Fenelon F; Holcroft L. (2015). Contamination of stethoscopes with MRSA and current disinfection practices The Journal of hospital infection 71(4):376-8https://doi.org/10.1016/j.jhin.2008.11.009
26. Venkatesan, K, Chander, S. Victor, K., (2019). Stethoscopes: a potential source of hospital acquired infection International Journal of Advances in Medicine 6(4):1322. https://doi.org/10.18203/2349-3933.ijam20193294