Stethoscope disinfection Essay Example
Stethoscope disinfection Essay Example

Stethoscope disinfection Essay Example

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  • Pages: 9 (2349 words)
  • Published: May 7, 2018
  • Type: Essay
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Although the concept behind the solution for intimidated stethoscopes was sensible and practical for healthcare providers, additional background information could have been provided to explain the issue further. The study's abstract was well-structured, including details on methodology, results, and conclusion. The abstract provided enough information to encourage further examination of the article. However, there was only a brief statement referred to as 'background' acknowledging alcohol pads' effectiveness in reducing bacteria on stethoscopes. Unfortunately, they are sparsely available with plenty of waste and infrequent usage. The study aimed to demonstrate how effortless and convenient it is to use alcohol-based foam for cleaning stethoscopes; however, an introduction detailing bacterial contamination on stethoscopes would have better supported research efforts. Although the study design wasn't specified, it meticulously illustrated steps taken to obtain cultured samples.

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The literature review lacked references specific enough as authors insinuated other studies' existence without specifically referencing them under the heading 'an often neglected source of bacteria.' Only one reference from a 2007 unpublished study conducted by a team member was found.

The research conducted a study to determine the effectiveness of rubbing stethoscopes with alcohol pads versus using alcohol-based foam in reducing bacterial counts. The paper included 19 references, but none were cited within the work. To establish cause-effect relationships among variables, the research utilized an experimental subtype of quantitative methodology. The independent variable manipulated was the use of alcohol-based foam, and its effect on bacterial counts on stethoscopes was determined as the dependent variable. Randomly assigning ID numbers to 200 agar plates allowed practitioners to imprint their stethoscope head on one plate before and after cleaning their diaphragm with alcohol-based foam an

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repeating the process on a second agar plate. All plates were incubated at 35 degrees Celsius for 48 hours, while validation of bacterial types was done by a hospital laboratory supervisor with 20 years experience working with cultures who randomly sampled agar plates. Any discrepancies that varied by seven would have necessitated intervention from another investigator; however, no such intervention occurred as there were no discrepancies found. Before commencing this study, a pilot study was performed on control group stethoscopes to estimate bacterial count averages and variances while assessing whether imprinting affected counts.The study utilized various statistical analyses such as linear regression, paired t test, random effects model, and signed rank test to validate its quantitative research findings. The authors reported results using statistical measures like mean, median, 95% confidence interval and P values. Good external and internal validity was ensured through the use of a control study, validation by a hospital laboratory supervisor and diverse participants including doctors, nurses and medical students from different hospital settings. The study's conclusion briefly reiterated its hypothesis that alcohol-based foam can reduce bacterial counts on stethoscopes when combined with hand sanitation but acknowledged limitations such as lack of control over hand washing techniques and possible changes in hand washing procedures due to being part of the study. Further research is recommended. Although the introduction could have provided more background information on bacterial colonization problem considering the limited literature review before the study.The study did not specify when cultures were provided by practitioners, who were recruited from a grand rounds program. If cultures were given later, participants' knowledge of the study may have affected results. The research paper presented

impressive data analysis with statistical support for the hypothesis but lacked detail in its conclusion and addressed limitations. Ethical approval was obtained from the hospital institutional review board without raising concerns according to AAA guidelines; however, informed consent from practitioners was not mentioned. Established ethical guidelines aim to prevent past atrocities committed against individuals during human testing, such as those in Hitler's reign in Germany. The study involved stethoscope culturing before and after applying alcohol-based foam with no patient involvement documented. Although it contained elements consistent with experimental methodology, the research paper did not specify its methodology.

The quantitative research methodology generates and tests hypotheses to prove or disprove them.

Quantitative research methodology is demonstrated in the study of whether alcohol-based foam reduces bacterial contamination on stethoscopes. This binary study involves random allocation of cultures and statistical analysis. It is an experimental subtype, with cause and effect as major attributes. Measurements were taken before and after applying the foam treatment. In contrast, qualitative research collects non-numeric data and studies the group as a whole to develop theories based on data collected, such as phenomenology, which describes how individuals experience a phenomenon. Interviews could be conducted to understand health care workers' perceptions about disinfecting stethoscopes. Neglect of stethoscope disinfection by nurses despite evidence of bacterial colonization leading to healthcare associated infections (HCI) is an issue that requires further exploration in future studies expanding upon evidence of bacterial contamination reduction through disinfection measures and why health workers fail to disinfect their equipment.The statistics are alarming as monoclonal infections were responsible for 99,000 deaths in 2002 and HCI is increasingly complicating hospitalizations. Nurses prioritize hand washing to prevent infection

but often overlook the possibility of bacteria transmission through stethoscopes. Studies reveal that pathogenic bacteria like MRSA can colonize on stethoscopes, especially those used on elderly patients over 65 years old who are at the highest risk. Stethoscope disinfection is a crucial procedure that is often neglected in medical care. Please refer to Attachment 2 for the Matrix.
In the Grecian, Mammalian, and Acquire (2008) study conducted in a tertiary hospital, potential pathogens on stethoscopes and current stethoscope care practices among healthcare providers were examined with an aim to reduce contamination rates of stethoscopes after an educational intervention was implemented. The contamination rate decreased from 68.9% to 27.6%. Non-compliance with stethoscope cleaning recommendations was attributed to high workloads and lack of awareness. In Hyde's (2012) cross-sectional study spanning two teaching hospitals in Pakistan, bacterial colonization was investigated along with its correlation with stethoscope cleaning practices.Out of the 80 medical students and physicians who participated, 37.7% said that they never clean their stethoscope, while 64.4% said that they use an alcohol swab to clean it after coming into contact with body fluids. Although those who were educated about bacterial contamination showed improved cleaning practices, further education is still necessary for disinfecting stethoscopes. Elect et al.'s (2009) article examined the difference between using Ethanol-based cleansers and Spoilsport alcohol pads to decontaminate stethoscopes. The study sample included doctors, nurses, residents, and medical students who cleaned a total of 99 stethoscopes; 49 with Ethanol-based cleanser and 50 with Spoilsport alcohol pads. Before cleaning, all stethoscope cultures had bacteria present but both methods were equally effective in reducing bacterial counts as long as thorough cleaning took place. Factors hindering cleaning included

poor accessibility to supplies and debris disposal along with time constraints. Limiting et al.'s (2014) article aimed to compare the contamination levels between physicians' hands and stethoscopes while exploring cross-contamination likelihood at a Swiss university teaching hospital involving three inpatients during physical examinations where the physician wore a glove on one hand but not on the other while taking cultures from four sections of each hand and two sections of the stethoscope itself.The study found that physicians' fingertips and stethoscopes were highly contaminated after just one examination. Another study focused on the prevalence of non-metallic resistant staphylococcus erasures (MRS) on emergency personnel's stethoscopes pre-hospitalization. 50 swab cultures were taken upon arrival at the emergency department, with 1 in 3 showing colonization with MRS bacteria. Furthermore, 32% of emergency personnel could not recall when they last cleaned their stethoscope. An article titled "What's growing on your stethoscope? And what you can do about it" published by The Journal of Family Practice explores this issue further and discusses how to address stethoscope contamination by developing educational programs and guidelines for proper care, including the use of an alcohol-based foam that was found to be effective in reducing bacterial count during hand and stethoscope disinfection. The purpose behind all these studies is to prevent healthcare infection through scientific data gathering.A study on stethoscope care education resulted in a significant decrease in contamination rates from 78.5% to 20.2%. The findings were published in the Journal of Infection in Developing Countries by Nuke et al. (2014). Non (2010) conducted research on bacterial transmission through healthcare workers' stethoscopes, discovering that 79% of the seven cultured stethoscopes were contaminated with various bacteria

strains such as Staphylococcus urea's, pseudonymous organisms, intercourse fiscals, and Escherichia coli. Higher levels of contamination were found in uncleaned stethoscopes compared to those cleaned with alcohol or soap and water. Furthermore, Whetting et al. (2009) investigated cleaning frequency and bacterial contamination among ICC bedside stethoscopes used by 24 ICC staff and 22 non-CHIC staff visiting physicians, physiotherapists, and medical students. All non-ICC staff had personal stethoscopes while all ICC staff claimed to have cleaned the ICC bedside stethoscopes at least once during their shift.According to a study conducted by Wilkins, R., Restorer, R., Bourne, K., and Darer, N. (2007), only 3 out of the 10 visiting physicians clean their stethoscopes daily or after each use. The study evaluated the contamination level on personal and bedside ICC stethoscopes belonging to doctors and physician assistants in an outpatient setting. It found that 67% of personal stethoscopes and 95% of bedside ICC stethoscopes were contaminated with bacteria. All stethoscopes had varying degrees of minimal, moderate, or severe contamination. Physician stethoscopes were found to have moderate to severe contamination levels without any preference reported for cleaning frequency. Another study by Schroeder, Schroeder, and Dynamic (2009) involved 184 cultures taken from 92 different stethoscopes where nurses comprised 39% of participants. The evidence from this study emphasized the need for practice change among nurses as the impressions before and after using ethyl based foam showed significant reduction in bacterial count in post-wash samples as compared to pre-wash samples examined by a supervisor from the hospital laboratory sample that revealed an average bacterial count of 28.4 compared to just 3.2 after disinfection as reported by Schroeder et al.in 2009."In a second

study, 107 stethoscopes were cultured and it was discovered that approximately 32% of those belonging to nurses had bacterial colonization. Longer durations between disinfection were linked to higher levels of contamination. Stethoscopes that had never been cleaned had the highest amount of colonization, while those disinfected within the last week had the least amount. A correlation was found between bacterial contamination on stethoscopes and how often practitioners washed their hands, as discovered by Nuke et al.in 2010.

A third pilot study interviewed healthcare workers regarding their knowledge, practices, and attitudes regarding stethoscope disinfection. All healthcare workers' stethoscopes were cultured at that time. To address this issue, various trainings and workshops were conducted to provide information on stethoscope care and maintenance. An evaluation was conducted after education, where out of 202 participants (including 163 nurses), none of the doctors disinfected their stethoscopes prior to patient care but 39 reported doing so afterwards (Nuke et al., 2014). According to Nuke et al.(2014), before educational training, 78.5% of nurses were contaminated while only 20.2% were contaminated afterwards.

It is important for research instruments such as questionnaires to be reliable and consistent in order for both researchers and readers to have confidence in results.Questionnaires are utilized in all quantitative studies within this paper, and can have either closed or open questions. However, there is variation among the specific questions used across studies. Some evaluate factors such as stethoscope cleaning frequency and years of practice, while others focus on attitudes and knowledge regarding stethoscope practices. Despite some advantages to using questionnaires - like cost-effectiveness, anonymity, ease of implementation with large groups, and widespread data distribution - there are also disadvantages including bias,

low return rates due to literacy barriers or time constraints, and lack of personalization. Tools may be employed for data collection and study focus. In order to be reviewed here, articles must meet two criteria: providing relevant evidence related to disinfecting stethoscopes for patient safety and demonstrating ethical approval from the Institutional Review Board. All reviewed articles employ similar methodologies that concentrate on bacterial contamination of stethoscopes; differences arise only in researchers' approaches to conducting their studies.The articles cover various topics related to stethoscope contamination, including pre- and post-disinfection colonization of bacteria, comparison of different disinfectant types, cross-contamination prevention, and education programs on proper care and sanitation. The studies analyzed populations consisting of physicians, physician's assistants, nurses, and medical students with similar sizes. Most studies had less than 100 participants and focused on stethoscope contamination after use. Results showed that inadequate disinfection practices lead to contamination or colonization over 67% of the time. Two studies by Schroeder (2009) and Elect (2009) demonstrated that alcohol or ethanol-based cleansers significantly reduced bacterial counts. Compliance with disinfection is crucial as stethoscopes should be cleaned as frequently as hands. Nuke (2014) found that none of the doctors and only 39.2% of the nurses cleaned their stethoscopes before receiving education on proper sanitation methods; however, practitioners reported cleaning their stethoscopes more often after being educated about it, reducing pre-educational contamination rates from 78%. According to multiple studies including Grecian (2008), health professionals – especially nurses – do not disinfect their stethoscopes as often as they should.High pre-educational contamination rates have been reported, with some as high as 68.9%. However, after education on proper disinfection techniques, post-contamination rates significantly decreased. For

example, in Grecian's study, the rate dropped from 68.9% to 27.6%. It is a nurse's responsibility to protect patients from infection and monoclonal infections by properly disinfecting stethoscopes. Lack of knowledge and time are the two main barriers to proper disinfection. Education is the best intervention for this issue, but getting busy nurses to buy-in can be challenging.

Hospitals should periodically collect random cultures of nursing stethoscopes to visually demonstrate the effectiveness of disinfection techniques through pictures of bacterial growth on agar plates. To improve stethoscope disinfection and infection control, hospitals could organize workshops on-site and collect a random sample of stethoscopes after the intervention with results shared among nursing staff. These interventions are essential in reducing patient infections and enhancing outcomes for both patients and hospitals.

Theoretical models provide a framework for research studies by serving as the foundation for parameters within them. Researchers begin their study by developing a theory framework that guides their work based on an idea or question they want to explore.Without a firm basis, research lacks guidance. This is essential to sustain concentration and reliability while operating under constraints of limited time and funding.

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