Aseptic Disposable Stethoscope Barrier

Health care-associated infections (HAIs) occur in ∼1.7 million patients annually, and 100,000 die, at a cost of $147 billion.1Marchetti A. Rossiter R. Economic burden healthcare-associated infection US acute care hospitals: societal perspective.J Med Econ. 2013; 16: 1399-1404Crossref PubMed Scopus (61) Google Scholar Overall, 85% stethoscopes (the physician’s third hand) are contaminated with the identical pathogens as found on hands.2Longtin Y. Contamination physicians’ hands after physical examination.Mayo Clin Proc. 2014; 89: 291-299Abstract Full Text PDF (76) Although hand hygiene is emphasized, cleaning between occurs few 10% encounters.3Boulée D. Kalra S. Haddock Johnson T.D. Peacock W.F. Contemporary stethoscope practices: what we haven't learned 150 years.Am J Infect Control. 2019; 7: 238-242Abstract (11) Unfortunately, Centers for Disease Control Prevention (CDC) guidelines rely outdated strategies, instructing providers to clean their own stethoscopes, an intervention that has repeatedly been dismal failure. methods decrease stethoscope-mediated transmission include single-use disposable aseptic diaphragm barriers placed high-fidelity stethoscopes4Vasudevan Shin J.H. Chopyk J. et al.Aseptic allow contact diaphragms.Mayo Proc Innov Qual Outcomes. 2020; 4: 21-30Abstract (Figure) or auscultation stethoscope. How these strategies affect stethoscope’s auscultory function not previously described. Our purpose was evaluate impact barrier preferences vs We performed institutional review board-exempt prospective evaluation assessing sound effects (DiskCover, AseptiScope Inc, San Diego, California) diaphragm. Using Littmann 3200 recording (3M, Maplewood, Minnesota) simulation mannequin (iSTAN, CAE, Sarasota, Florida), 28 physicians auscultations prespecified locations, 15 seconds respiratory wheezes, normal heart sounds, systolic murmurs, diastolic murmurs. Physicians were blinded barriers' presence received sounds random order. Digital audio files analyzed amplitude differences (Logic Pro X, Apple Inc., Cupertino, California), without barrier. reported subjective sound-quality differences. Unblinded then used (Proscope 665, ADC Hauppauge, New York) barriers, accuracy recorded. To compare among groups, Wilcoxon rank sum test used, McNemar’s diagnostic accuracy. Of 800 matched observations, DiskCover there no (P=1.0), this consistent all sounds. Diagnostic 110 using Littman/DiskCover 100%. However, Proscope had error rate 10.9% (12 110), misinterpretation 9 murmurs occurring during diastole 3 identified systole. In evaluation, 95% preference personal Ultimately, advantages significant when it considered dirty, bacteria cultured from them routinely carries pathogens.5Zachary K.C. Bayne P.S. Morrison V.J. Ford D.S. Silver L.C. Hooper D.C. gowns, gloves, vancomycin-resistant enterococci.Infect Hosp Epidemiol. 2001; 22: 560-564Crossref (107) findings acoustically invisible does alter must be costs only cents compared several dollars selection restricted those published infection-control efficacy. As other demonstration performance, our acoustic results limited