422 Surveying Maternal Experiences and Perceptions in Female Emergency Physicians

Abstract

Potentially pathogenic and life-threatening infections such as pseudomonas aeruginosa, VRE, and C. difficile have also been isolated from various studies. Knowing that stethoscopes are vectors of such infections, we aimed to assess the stethoscope cleaning methodology used by health care providers before and after evaluating their patients in a fast-paced level 1 trauma center in Houston, Texas. Methods: Patient-provider interactions were anonymously observed in the Emergency Center, Surgical ICU, and Labor and Delivery rooms. We assessed methods and duration of stethoscope disinfection as well as hand hygiene practices among providers before and after patient encounters. Data was objectively collected and summary statistic analysis was completed. To assess the difference in categorical variables, Wilcoxon-rank sum test and p-values were analyzed using Stata 12.0. Results: A total of 400 interactions were observed. Stethoscope hygiene was only observed in 2% of patient encounters before the patient exam and 16.3% after the patient exam. Of the sanitized stethoscopes, 93.15% were cleaned using a sani-cloth wipe, with the remainder being cleaned using an alcohol pad. Cleaning duration lasted <15 seconds in 90.4% of cases and >15 seconds for the remainder. Hands were sanitized 36 times (9%) before and 80 times (20%) after. Gloves were used in 329 encounters (82.3%). Cleaning of stethoscopes was not practiced for any trauma patients before patient exams. However, 51% of the time, stethoscopes were cleaned after evaluation of trauma patients (p-value <0.05). For patients who were in the isolation unit, stethoscope cleaning was not observed in any of the encounters as there was a dedicated stethoscope provided in the patient room. Conclusions: In a fast-paced and higher acuity setting, hand hygiene is commonly obtained by using gloves. In the ED, ICU, and Labor and Delivery units, only 2% of stethoscopes are cleaned before use. Except trauma resuscitations, after patient contact no stethoscope cleaning occurred in more than 20% of in ED, ICU, or Labor and Delivery patient encounters.