Comparing the auscultatory accuracy of health care professionals using three different brands of stethoscopes on a simulator

Abstract

BackgroundIt is considered standard practice to use disposable or patient-dedicated stethoscopes to prevent cross-contamination between patients in contact precautions and others in their vicinity. The literature offers very little information regarding the quality of currently used stethoscopes. This study assessed the fidelity with which acoustics were perceived by a broad range of health care professionals using three brands of stethoscopes.MethodsThis prospective study used a simulation center and volunteer health care professionals to test the sound quality offered by three brands of commonly used stethoscopes. The volunteer’s proficiency in identifying five basic ausculatory sounds (wheezing, stridor, crackles, holosystolic murmur, and hyperdynamic bowel sounds) was tested, as well.ResultsA total of 84 health care professionals (ten attending physicians, 35 resident physicians, and 39 intensive care unit [ICU] nurses) participated in the study. The higher-end stethoscope was more reliable than lower-end stethoscopes in facilitating the diagnosis of the auscultatory sounds, especially stridor and crackles. Our volunteers detected all tested sounds correctly in about 69% of cases. As expected, attending physicians performed the best, followed by resident physicians and subsequently ICU nurses. Neither years of experience nor background noise seemed to affect performance. Postgraduate training continues to offer very little to improve our trainees’ auscultation skills.ConclusionThe results of this study indicate that using low-end stethoscopes to care for patients in contact precautions could compromise identifying important auscultatory findings. Furthermore, there continues to be an opportunity to improve our physicians and ICU nurses’ auscultation skills.

Aseptic Stethoscope Barriers Prevent C difficile Transmission In Vitro

“…Strategies that are commonly used, especially for patients infected with multidrugresistant organisms (MDROs), include the implementation of contact precautions, strict hand washing protocols, and the use of disposable gowns, gloves, and single-patient disposable stethoscopes to decrease the likelihood of transfer to other patients. 19 Although effective for infection control, 20 the singlepatient disposable stethoscope allows only suboptimal auscultation due to poor audio quality, 21 potentially leading health care providers to abandon their use in favor of their own stethoscopes. This not only results in the potential contamination of the provider's stethoscope with an MDRO, but also creates the exact scenario that the disposable stethoscope was implemented to prevent; that is, facilitating the transfer of an MDRO to other hospitalized patients.…”

“…The potential benefits of barriers include reduced transmission of pathogenic and antibioticresistant microbes, as well as the improved quality of auscultation by the use of the physician's clean personal stethoscope rather than that of the single-patient disposable stethoscopes. 21 Alternatively, other stethoscope hygiene solutions have been described. One study evaluated the antimicrobial properties of a copper-alloy metal stethoscope, citing decreased levels of contamination.…”

Persistent Value of the Stethoscope in the Age of COVID-19

“…However, the poor quality of these stethoscopes could either lead to disuse or compromise the identification of important auscultatory findings. 51 Furthermore, contamination of single-patient stethoscopes with multi-drug-resistant bacteria in the intensive care unit has been reported. One study found pathogenic contamination with MRSA on the diaphragm and ear pieces of singleuse stethoscopes.…”

Wireless stethoscope for auscultation of the heart and lungs in critically ill patients: A systematic review

“…One of the physical examinations that must be carried out by nurses in critical patients is by carrying out auscultation of the heart and lungs to find out any abnormalities in these organs (Harcharran, 2022). Abnormal sounds that are usually heard when auscultating the lungs in critical patients, namely wheezes, stridor, crackles while on auscultation of the heart, friction rub and gallop, although not all critical patients have these sounds (Mehmood et al, 2014). Poor auscultation results can affect the accuracy in carrying out care and treatment so that the treatment of patients is not optimal and causes lengthy treatment (Hu et al, 2017).…”