Stethoscope disinfection is rarely done in Ethiopia: What are the associated factors?

IntroductionThe stethoscope, which is non-critical medical devices and a symbol of healthcare, is likely to be contaminated by pathogenic microorganisms and can play a contributory role in the transmission of hospital-acquired infection. And regular cleaning of the diaphragm of the stethoscope with a suitable disinfectant is decisive. However, in the resource-constrained setting like many healthcare facilities in Ethiopia healthcare provider’s stethoscope disinfection practice and its associated factors have not been well studied so far. Therefore, this study sought to determine stethoscope disinfection practice and associated factors among the healthcare providers in Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was carried out between April and May 2016. For this study, 576 healthcare providers (physicians, health officers, nurses, midwives, and anesthesiologist) were included from 21 healthcare facilities in Addis Ababa. A pre-tested structured questionnaire was used for data collection. Descriptive statistics were computed. Bivariate and multivariable logistic regression analyses were used to identify factors that were significantly associated with stethoscope disinfection after every use.ResultsA total of 546 healthcare providers participated in this study, for a response rate of 94.7%. Two-fifths, 39.7% (95%CI: 35.9, 44.0%) of healthcare providers disinfecting their stethoscope after every use. And a significant number of participants 34.6% (95%CI: 30.8, 38.5%) never disinfect their stethoscope. Three out of four (76.0%) healthcare providers believe that stethoscope contamination can contribute to the transmission of infections. Safe infection prevention practice (AOR = 3.79, 95%CI: 2.45–5.84), awareness on infection prevention guideline (AOR = 1.93; 95%CI: 1.31, 2.82), and favorable attitude towards infection prevention (AOR = 1.73, 95%CI: 1.02, 2.93) were significantly associated with stethoscope disinfection after every use. The study also found that the odds of stethoscope disinfection were likely to be reduced by 79% among physicians than nurses (AOR = 0.21; 95%CI: 0.09, 0.49).ConclusionsOnly a small proportion of healthcare providers disinfect their stethoscopes after every use. Factors such as safe infection prevention practice, awareness on infection prevention guidelines, and favorable attitude towards infection prevention were the independent predictors of stethoscopes disinfection after every use. Hence, promotion of stethoscope hygiene along with an educational program to enhance disinfection compliance in healthcare facilities may have a positive effect.

【引言】听诊器作为非关键性医疗器械与医疗保健行业的标志性器具，易被病原微生物污染，且可能在医院获得性感染的传播中起到促进作用。采用合适消毒剂定期清洁听诊器膜片，对防控感染至关重要。然而，在埃塞俄比亚众多医疗保健机构这类资源受限的场景中，医护人员的听诊器消毒实践及其相关影响因素迄今尚未得到充分研究。因此，本研究旨在探明埃塞俄比亚亚的斯亚贝巴地区医护人员的听诊器消毒现状及其相关影响因素。

【研究方法】本研究于2016年4月至5月开展了一项基于医疗机构的横断面调查。研究从亚的斯亚贝巴的21家医疗保健机构中招募了576名医护人员，涵盖医师、卫生员、护士、助产士与麻醉医师。数据收集采用经过预试验的结构化问卷。研究计算了描述性统计量，并通过单因素及多因素logistic回归分析，识别出与每次使用后均进行听诊器消毒显著相关的影响因素。

【研究结果】本研究共纳入546名医护人员，应答率为94.7%。其中仅39.7%（95%CI: 35.9, 44.0%）的医护人员会在每次使用听诊器后进行消毒，另有34.6%（95%CI: 30.8, 38.5%）的参与者从未对听诊器进行消毒。四分之三（76.0%）的医护人员认为听诊器污染会促进感染传播。与每次使用后均消毒听诊器显著相关的因素包括：规范的感染预防操作（调整后优势比（Adjusted Odds Ratio, AOR）=3.79, 95%CI: 2.45–5.84）、对感染预防指南的知晓水平（AOR=1.93; 95%CI: 1.31, 2.82）以及对感染预防持积极态度（AOR=1.73, 95%CI: 1.02, 2.93）。本研究同时发现，医师群体每次使用后消毒听诊器的概率较护士群体降低79%（AOR=0.21; 95%CI: 0.09, 0.49）。

【结论】仅有少数医护人员会在每次使用听诊器后进行消毒。规范的感染预防操作、对感染预防指南的知晓水平以及对感染预防的积极态度，是医护人员每次使用后均消毒听诊器的独立预测因素。因此，在医疗保健机构中推广听诊器卫生规范，并开展教育项目以提升消毒依从性，或可产生积极的防控效果。