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Keshauna Millner
Senior Nursing Student

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Uploaded by Keshauna Millner on 2017-05-01.

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Sentara College of Health Sciences. (2017). Celebrating 125 years [Image]. Retrieved from http://125.sentara.edu/#/

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                   - Literature Review -

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                   - Literature Review -

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All literature confirms the adoption of nurses utilizing the practice of stethoscope hygiene
About that healthcare icon dangling around your neck: Do we have some cleaning to do?
Summary:

WHO reveals high levels of stethoscope diaphragm  contamination second to practitioner fingertips

Recommendation to simultaneously clean stethoscopes and hands

Time saving disinfection methods: Alcohol wipes or gel, ethanol agents increased compliance and decreased contamination

Sticker reminders and available cleansing agents increased compliance

Stethoscope disinfection campaign in a Nigerian teaching hospital: Results of a before-and-after-study
Summary:

Stethoscope hygiene viewed as low priority

Pre-intervention: 78.5% stethoscope contamination rate

Pathogens found: E. coli, K. pneumonia, S. aureus resistant to most antibiotics

Pre-intervention: 39.2% of nurses perform stethoscope hygiene post assessment

Post-intervention: 20.2% stethoscope contamination rate

Providing education and accessible disinfectants increased compliance

Stethoscope hygiene: A best practice review of literature
Summary:

Research reveals stethoscopes as high risk vectors

Pathogens found: MRSA, E.coli and C. Difficile

MRSA viable for 7 months

E. Coli viable for 16 months

C. difficile viable for 5 months

Alcohol or ethanol based agents removes 94% of contamination

Tackling time constraints, nurses' attitudes, and using reminders increased compliance

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                                                                            - Reflection -

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                                                                            - Reflection -

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Two curricular concepts learned during education at SCOHS that pertain to HAI reduction with stethoscope hygiene

1. Standard precaution needs (fundamentals)

2. Nursing practice based on evidence-based practice (research/OB)

How has upholding standard precautions prepared me to assume a leadership role transitioning to professional practice?

Importance of maintenance

Avoid HAI transmission

Abide by code of ethics to keep patients safe

How has adopting the framework of evidence based practice (EBP) nursing prepared me to assume a leadership role transitioning to professional practice?

Nursing practice derived from EBP (research and OB/Peds)

Lifelong learning

Responsibility to protect patient health (ANA, 2015)

Developing personal stethoscope hygiene process in absence of agency protocol when caring for patients based on literature

Translating EBP changes into practice with collaboration, communication and teaching

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                                 - Analysis 3 -                                                                                                                                    Stethoscope hygiene challenges or barriers faced by nurses                                    

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                                 - Analysis 3 -                                                                                                                                    Stethoscope hygiene challenges or barriers faced by nurses                                    

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What  challenges or barriers  are present that effect nurse involvement in decreasing HAIs with stethoscope hygiene?

Nurses' attitudes/resistance

Absence of reminders

Disinfectant inaccessibility

Recommendation vs. requirement

Ethics

Why is there limited nursing participation with stethoscope hygiene?

Absence of protocol

Perception

Lack of awareness

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                                - Analysis 2 -                                                                                                                                 Importance of the Nurses' role in decreasing HAIs with stethoscope hygiene

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                                - Analysis 2 -                                                                                                                                 Importance of the Nurses' role in decreasing HAIs with stethoscope hygiene

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Why is the nurses role in decreasing HAIs with stethoscope hygiene important?

Front line patient care

Facilitate patients' return to optimal health

Decrease incidence of HAIs

Avoidance of negative effects of HAIs

How can nurses' help with battling HAIs with stethoscope hygiene?

Patient advocacy

Uphold patient safety commitments

Compliance

How will nurses' involvement with stethoscope hygiene help decrease HAIs ?

Decreased transmission rates

Patient education

Patient empowerment

Compliance encouragement

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                                - Analysis 1 -                                                                         Nurses' current roles with stethoscope hygiene to stop HAIs

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                                - Analysis 1 -                                                                         Nurses' current roles with stethoscope hygiene to stop HAIs

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What is happening with stethoscope hygiene?

No cleaning between patients

Personal stethoscopes prohibited while caring for patients on contact precautions resulting in stethoscope sharing within patient room

Stethoscope hygiene usually occurs once daily

How does noncompliance exacerbate the issue?

Increased HAIs

Longer hospital stays

Increased healthcare costs

Superbugs

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                                 - Issue -                                    Lack of stethoscope hygiene in patient care

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                                 - Issue -                                    Lack of stethoscope hygiene in patient care

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Stethoscopes are vectors allowing transmission of HAIs if not properly disinfected between patient use

Who is affected: All patients seeking healthcare

How: Stethoscopes are used daily by all healthcare professionals when providing patient care increasing susceptibility and HAI transmission rates

Where: Any healthcare setting

When: During the auscultation portion of assessment

Why:  Stethoscopedisinfection inconsistencies due to absent protocol

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Increasing Awareness for the Disinfection of Stethoscopes

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Two Juniors, Jordan Lyerly and Justin Alexander, passed a resolution at the 2016 NSNA National Convention in Orlando, Florida, on creating more awareness for the disinfection of stethoscopes between patients.

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CBS stethoscope video on USA Today article

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CBS stethoscope video on USA Today article

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Coverage 16 sec. to 29 sec.

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Headlines at 8:30: Stethoscopes are covered in germs, study says

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"CBS This Morning" takes a look at some of the day's headlines from around the globe.

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                       - Recommendations -

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                       - Recommendations -

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Improving nurses' stethoscope hygiene participation Development of stethoscope hygiene protocol with a maintenance campaign

Literature affirms need

Expand CDC and WHO recommendations

Protocol formation

Three team approach

Before and after studies show decreased contamination levels

Requirement increases compliance and accountability

Maintenance campaign leads to sustained compliance

Time saving disinfection methods

Time constraints most common reported barrier

Decreasing time needed for disinfection increases compliance

Combination hygiene methods

Decreased resistance to change

Increased knowledge

Nursing education

Education helps with adoption into practice

Patient education and empowerment

Nurses' encourage patients to hold care providers accountable