The Case for Patient-Specific Stethoscopes

[adventure_rn, MSN, NP]

I've been reading comments on a "Resident Stole my Stethoscope" forum, and it has gotten me thinking...

In many Neonatal ICUs around the country, it is standard for each patient to have a dedicated stethoscope. They remain at the bedside for the duration of the patient's stay, and are disinfected upon discharge like any other piece of equipment. My unit uses basic Littmann neonatal scopes, which are relatively cost-effective for the hospital and still very functional for providers.

This process makes sense for many reasons:

1. Most importantly, this process reduces infection risk between patients. It doesn't depend on providers diligently cleaning the entire scope from room to room (which, let's be honest, doesn't always happen).

2. This allows patients on isolation to have a functional high-quality stethoscope, rather than those dinky disposables that look like Fisher Price toys. (Again, how often have you seen an irritated provider slip their scope out over their isolation gear when they got fed up with the disposable scope?)

3. We never really have a problem with the scopes walking away since every patient has a scope. There is no reason for anyone to put a scope around their neck or in their pocket; it goes straight from the hook at the bedside to the ears, and then back to the hook. There is no incentive for anybody to "borrow" a scope since we have faith that there will always be one at the patient's bedside.

4. As a piece of equipment required to perform patient care, it makes sense that the hospital should be responsible for providing the piece of equipment, not the staff. It seems unfair to burden staff with the expense of providing stethoscopes when they are so likely to be accidentally taken.

A few adult units at my hospital have begun trialing this process. I'm curious to hear whether or not you all think that this could be a viable system in the adult world.

[Double Dunker]

Not just providers refuse to use the disposable ones. I'll often use my own scope in an isolation room and then bleach it when I walk out. This is only a viable option if we get REAL stethoscopes.

[KatieMI, BSN, MSN, RN]

No way unless some special considerations are on board.

Stetoscope for me is like what pointe shoes are for a ballerina. They are personal. Every one has minor quirks, earplugs properly "deformed" to fit my ears from long use, etc. It got to be "mine" for best results. And, sorry, but disposable cheapies belong to trash cans.

I doubt that any hospital would be rich enough to provide something worthy like Littmann Cardio in every room, accounting for that there will be folks helping themselves. NICU may be a special place, but otherwise it is not going to happen, and no provider will like to be forced to abandon his or her own working instrument.