EMS providers reported inconsistent sanitation practices, MDR awareness

Issue: November 2014

PHILADELPHIA — Not all emergency medical service providers may be adhering to proper sanitation practices when dealing with multidrug-resistant organisms, according to data presented at IDWeek 2014.

“This is a high impact group of healthcare workers that can make a big difference in terms of protecting themselves and their patients from a lot of these organisms,” Stephen Y. Liang, MD, of the infectious disease division at Washington University School of Medicine, St. Louis, told Infectious Disease News.

Stephen Y. Liang

Liang and colleagues distributed an electronic survey to a stratified random sample of nationally certified emergency medical service (EMS) providers. Surveys were received by 5,293 EMS providers, and were returned by 9.7% (n=516). Of these respondents, 50.1% were Emergency Medical Technician-Basics (EMT-B) and 34.6% were paramedics. The survey included 22 items concerning hand hygiene, glove use and environmental disinfection, along with general knowledge and attitudes regarding MDR organisms.

Glove use during patient care was reported by 84.9% of respondents. Hand hygiene was considered necessary regardless of glove use by 95.3%, but only 16.1% regularly disinfected their hands prior to glove use, with 68.9% doing so after. The commonly stated reasons for not adhering to proper hand hygiene were lack of time, interference with patient care and low perceived risk of exposure to blood or other body fluids.

While 85.9% of respondents said they routinely disinfected their medical equipment and stretcher after each patient, less than 60% disinfected the ambulance compartment during a shift. When compared with paramedics, fewer EMT-Bs were familiar with vancomycin-resistant Enterococcus, Clostridium difficile, or MDR gram-negative bacteria.

Respondents reported being more likely to use gloves (94.6%), perform hand hygiene (91.2%) and disinfect their environment (87.3%) if they knew that a patient had a MDR organism, believing that a lack of communication and documentation were barriers to MDR organism awareness.

“Even among the people who responded, the compliance rate is low, and we expect our non-responders are even lower than the ones that responded,” Liang said. “As far as disinfection, hand hygiene and all of these practices, there’s definitely a lot of room to improve in the EMS community.” — by Dave Muoio

For more information:

Liang S. Abstract 323. Presented at: IDWeek 2014; Oct. 8-12, 2014; Philadelphia.

Disclosure: Liang reported serving as an investigator for and receiving a research grant from Barnes Jewish Hospital Foundation.