EMS Provider Compliance with Infection Control Recommendations Is Suboptimal

Bledsoe, Bryan E; Sweeney, Richard J.; Berkeley, Ross P.; Cole, K.; Forred, W.; Johnson, Larry

doi:10.3109/10903127.2013.851311

Cited by 36 publications

(46 citation statements)

References 16 publications

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“…Cleaning in healthcare settings is one of the cornerstones of infection control and prevention [8] and emphasized in the Danish prehospital hygiene guidelines [14]. Nevertheless, we discovered a suboptimal adherence to daily TC, which could be related to various factors, e.g., time pressure, lack of prioritization and/or insufficient education [8, 17].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, we discovered a suboptimal adherence to daily TC, which could be related to various factors, e.g., time pressure, lack of prioritization and/or insufficient education [8, 17]. However, further research is needed to investigate these assumptions.…”

Section: Discussionmentioning

confidence: 99%

“…The ambulances are non-static environments that must be ready for service shortly after delivering the patient to the emergency department, hence offering limited time and equipment to clean and decontaminate [7]. In addition to logistic challenges, studies indicate that implementation of cleaning measures [7, 8] and efficiency of cleaning [9] within the EMS vary. Moreover, pathogens have been found in both the ambulances [6, 7, 10], on uniforms [11, 12] and on the hands of the providers [13], and the spread of microbes within the ambulance environment is a proven reality [9].…”

Section: Introductionmentioning

confidence: 99%

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Prehospital infection control and prevention in Denmark: a cross-sectional study on guideline adherence and microbial contamination of surfaces

Vikke

Giebner

Kolmos

2018

Scand J Trauma Resusc Emerg Med

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BackgroundPrehospital acute care and treatment have become more complex, and while invasive procedures are standard procedures, focus on infection control and prevention is scarce. We aimed to evaluate guideline adherence, microbial contamination, and associated risk factors.MethodsIn a nationwide cross-sectional study, we evaluated guideline adherence to thorough cleaning (TC) once a day, and moderate cleaning (MC) in-between patient courses. Microbial contamination on hand-touch sites (HTS) and provider-related sites (PRS) was assessed by total aerobic colony forming units (CFU) and presence of selected pathogens, using swab and agar imprints. Also, microbial contamination was assessed in relation to potential risk factors.Results80 ambulances and emergency medical service (EMS) providers were enrolled. Adherence to guidelines regarding TC was 35%, but regarding MC it was 100%. In total, 129 (27%) of 480 HTS presented a total CFU > 2.5/cm2 and/or pathogenic growth, indicating hygiene failures. The prevalence of selected pathogens on HTS was: S. aureus 7%; Enterococcus 3% and Enterobacteriaceae 1%. Total CFU on the PRS ranged from 0 to 250/cm2, and the prevalence of pathogens was 18% (S. aureus 15%, Enterococcus 3% and Enterobacteriaceae 0.3%). Methicillin-resistant S. aureus was found in one sample, and Vancomycin-resistant Enterococcus in two. No Enterobacteriaceae with extended-spectrum beta-lactamases were recorded.ConclusionGuideline adherence was suboptimal, and many HTS did not comply fully with proposed standards for cleanliness. Pathogens were demonstrated on both HTS and PRS, indicating that the EMS may be a source of infection in hospitalized patients. Moreover, cleaning effort and time appears associated with microbial contamination, but a comprehensive investigation of risk factors is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prehospital infection control and prevention in Denmark: a cross-sectional study on guideline adherence and microbial contamination of surfaces

Vikke

Giebner

Kolmos

2018

Scand J Trauma Resusc Emerg Med

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“…Considerando as três classificações de Spaulding que determina o nível de desinfecção ou esterilização para os equipamentos reprocessáveis, alguns autores têm sugerido incluir a superfície ambiental como uma quarta classificação no controle de infecção (102) .…”

Section: Discussionunclassified

“…No entanto, há pouca informação disponível sobre a conformidade desses profissionais em relação à adesão às medidas de precauções padrão, especialmente às relacionadas à higiene de mãos (102) .…”

Section: Discussionunclassified

Higienização das viaturas móveis de atendimento pré-hospitalar:intervenção educativa

Suzuki¹

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Discussions on prevention and control of infection Related to Health Care (IRHC) should be unrestricted and expanded to other health care facilities. The literature on infection control is traditionally based on the practice of hospital context, and there is a gap when it comes to prehospital care. In addition to health care professionals, other professionals make up the team, firefighters, police officers and others who have not taken their training specific content to provide them with knowledge about prevention and control of infections in situations with potential risk of contamination by biological fluids, therefore, education is the weapon against the spread of infectious diseases. Objective: To evaluate the effectiveness of an educational intervention using concept maps and compliance indicators for cleaning of mobile cars of Prehospital care from a capital of the midwestern region of Brazil. Method: quantitative study, quasi-experimental, data collection was from July 2014 to January 2015. The study included 34 firefighters Rescue Battalion Emergency (BSE) of the Fire Brigade of the State of Goiás working in basic and advanced life support vehicles. The study was developed in four phases: Development and content validity of compliance indicator for cleaning of vehicles; Conformity assessment of the cleaning of vehicles before training; Educational Intervention and Conformity assessment of the cleaning of vehicles after intervention. A questionnaire was applied before the intervention and 30 days after. Compliance indicators were validated by an 8 experts judge with Content Validity Index (IVC≤ 70%). The evaluation of training effectiveness was taken by McNemar test, being considered p ≤ 0.05. The training of professionals was based on the theory of meaningful learning of David Ausubel and the construction of a conceptual map designed by Joseph Novak. The data show that after the course there was a slight improvement in the number of correct questions, being statistically significant (p = 0.021) and that the course brought a homogenization knowledge given to reducing the standard deviation. Results: Of the 71 indicators of compliance, 26 were excluded, totaling 45 indicators.The pre-intervention assessment, only one (2.9%) rescuer knew cleaning definition, four (11.8%) knew the concept of disinfection, 14 (41.2%) knew the importance of sanitize the vehicle and the use of PPE. After intervention a total of three (8.8%) firefighters knew conceptualize cleanliness, five (14.7%), disinfection, on the importance of cleaning and disinfection 16 (47.1%) and of the importance of the use of PPE were 15 (44.1%). The observation of the cleaning procedure improved regarding these parameters drying after washing (p=0,004) and disinfection of the vehicle (p=0,002) Conclusion: The educational intervention using an active methodology and the construction of conceptual maps was not fully effective. The observation of the vehicles cleaning procedures remained the same pattern, except for drying and disinfecting res...

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COVID-19: acceptance and compliance of PPE (personal protective equipment) and rules for hygiene and reducing contacts in German emergency medical services—a nationwide survey

Nohl

Afflerbach

Lurz

et al. 2021

Notfall Rettungsmed

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verfügbar. QR-Code scannen & Beitrag online lesen Zusammenfassung Hintergrund: Die COVID-19-Pandemie (coronavirus disease-2019) hat auch den deutschen Rettungsdienst deutlich belastet und gefordert. Die persönliche Schutzausrüstung (PSA) und die AHA-L-Regel (Abstand halten, Hygiene beachten, Maske tragen, regelmäßig lüften) spielen hierbei eine wichtige Rolle, um eine Verbreitung der COVID-19-Infektionen zu reduzieren. Ziel: Mit dieser Studie möchten wir die Akzeptanz und Compliance von PSA und Schutzmaßnahmen beim Rettungsdienstpersonal in Deutschland in Pandemiezeiten evaluieren. Methode: Über 270 ÄLRD wurden angeschrieben. Diese wurden gebeten, eine webbasierte Onlineumfrage an die Rettungswachen weiterzuleiten. Die Teilnehmer wurden zu Akzeptanz und Compliance im Alltag, in der Rettungswache, im Einsatz ohne COVID-19, im Einsatz mit COVID-19 befragt. Ergebnisse: Es haben n = 1295 Personen teilgenommen. Die Akzeptanz und Compliance von PSA und Schutzmaßnahmen ist insgesamt hoch. Die geringste Akzeptanz und Compliance findet sich bei den Fragen Akzeptanz (MW = 4,16; ±1,01) und Compliance (MW = 4,26; ±0,89) in der Rettungswache. Fazit: Wir empfehlen gezielte Schulungsmaßnahmen in Bezug auf PSA in Pandemien und die Bereitstellung von entsprechenden Räumlichkeiten zur konfliktlosen Einhaltung der AHA-L-Regeln.

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EMS Provider Compliance with Infection Control Recommendations Is Suboptimal

Cited by 36 publications

References 16 publications

Prehospital infection control and prevention in Denmark: a cross-sectional study on guideline adherence and microbial contamination of surfaces

Prehospital infection control and prevention in Denmark: a cross-sectional study on guideline adherence and microbial contamination of surfaces

Higienização das viaturas móveis de atendimento pré-hospitalar:intervenção educativa

COVID-19: acceptance and compliance of PPE (personal protective equipment) and rules for hygiene and reducing contacts in German emergency medical services—a nationwide survey

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