How clean is your stethoscope?

Sharon Klim1, Brittany Scott-Rimington2, Professor Anne-Maree Kelly1

1Western Health, Footscray, Australia, 2University of Melbourne, Parkville, Australia

Background: It has long been known that healthcare facilities themselves contribute to disease. While a lot of research has been conducted on the in-hospital transmission of infectious organisms between humans, few studies have explored stethoscopes as a fomite for healthcare-associated infection.  Indeed a 2014 study showed that, following a physical examination, stethoscope diaphragms have a greater bacterial load than physician’s hands.

Objectives:  This project aimed to determine the rate of contamination of stethoscope diaphragms used in ED through microbiological culture and to measure the effectiveness of a multimodal educational campaign on improving staff stethoscope cleaning behaviours in ED.

Methods:  This was a two-part project that was conducted in the ED of Sunshine and Footscray Hospitals. For the first part of the study, thirty randomly chosen stethoscopes in use by clinicians in ED were swabbed and sent for bacterial culture. For the second part of the study, using observation we measured compliance with stethoscope cleaning before and after an educational intervention comprising presentations at staff meetings and a poster campaign.

Results: Seventy percent of cultures grew bacteria (21/30, 95% CI 52-83%), most of which were mixed skin flora.  There were 118 observations in each data period.  Stethoscope cleaning rates improved from 0% (95% CI 0-3%) to 25% (95% CI 18-33%).

Conclusion: Few stethoscopes were free of bacteria, although highly pathogenic bacteria were uncommon. Implementation of a multimodal educational package resulted in a modest change in staff behaviour.  Further research is needed to explore barriers to stethoscope cleaning and sustain and improve stethoscope cleaning rates.


Sharon is a research nurse and coordinator for the Joseph Epstein Centre for Emergency Medicine Research at Western Health.

She is also a Clinical Nurse Specialist with the Emergency Department at Footscray Hospital in Melbourne.  Her area of interest is clinical handover and leadership.