Research Protocol Nov 23, 2021 Show
Page Contents
I. Background and Objectives for the Technical BriefStandard infection prevention and control (IPC) measures for emergency medical service (EMS) workers include hand hygiene, glove-wearing, and disinfection of equipment. Compliance with these measures has been less than optimal. In Nevada, EMS workers wore gloves during 56% of activations, washed hands in 27% of activations, and disinfected equipment 31% of the time.1 In Maine, one study suggested that half of ambulances tested positive for methicillin resistant S. aureus.2 A second study showed that 57% of reusable ambulance equipment tested positive for blood.3 Another study reported that current decontamination practices may not reduce viral load on ambulance surfaces.4 Furthermore, adherence to IPC standards involve structural determinants, such as budget shortages, and individual determinants, such as knowledge, attitudes, and skills. The COVID-19 pandemic has highlighted the importance of IPC practices. The resulting decisional dilemmas relate to addressing reasons for decreased adherence to IPC standards by EMS workers (including 911 telecommunicators) and implementing effective IPC at the individual and system level. The Office of Emergency Medical Services at the U.S. Department of Transportation requested this technical brief for the purpose of summarizing the evidence on: exposures to and incidence/prevalence/severity of infectious diseases in the EMS/911 workforce; and interventions for preventing, recognizing, and controlling occupationally-acquired infectious diseases in the EMS/911 workforce. This brief should be useful to policy makers, researchers, and managers in the EMS field in making decisions about how to minimize the risk of infectious diseases in the EMS/911 workforce. Although the nature of the evidence may not be amenable to a full systematic review, the technical brief should help to identify future research needs by identifying research questions that have not been addressed in the literature. II. Guiding Questions
For Guiding Question 1, we will define occupationally-acquired exposures to infectious diseases as contact exposure (intact skin), respiratory exposure (inhaled and aerosolized), and blood-borne exposure (needlesticks, blood to non-intact skin, etc.). Organisms of interest included but are not limited to severe acute respiratory syndrome coronavirus 2 (SARS-COV2), influenza, tuberculosis, human immunodeficiency virus (HIV), and Hepatitis B and C. We will consider the 911 workforce to be the 911 telecommunicators who are fielding the calls. The EMS workforce will include the responding health care personnel in field settings. We developed a conceptual framework to guide work on the technical brief (Figure 1). Figure 1. Conceptual framework for infection prevention and control in EMS/911 workforce (IPC = infection prevention and control; KQ = key question; PPE = personal protective equipment) III. Methods1. Data Collection:
Table 1. Inclusion and exclusion criteria
* Organisms of interest included but are not limited to SARS-COV2, influenza, tuberculosis, HIV, and Hepatitis B and C. 2. Data Organization and Presentation:
IV. References
V. Definition of TermsEMS = emergency medical service VI. Summary of Protocol AmendmentsIn the event of protocol amendments, the date of each amendment will be accompanied by a description of the change and the rationale. VII. Key InformantsWithin the Technical Brief process, Key Informants serve as a resource to offer insight into the clinical context of the technology/intervention, how it works, how it is currently used or might be used, and which features may be important from a patient of policy standpoint. They may include clinical experts, patients, manufacturers, researchers, payers, or other perspectives, depending on the technology/intervention in question. Differing viewpoints are expected, and all statements are crosschecked against available literature and statements from other Key Informants. Information gained from Key Informant interviews is identified as such in the report. Key Informants do not do analysis of any kind nor contribute to the writing of the report and will not review the report, except as given the opportunity to do so through the public review mechanism. Key Informants must disclose any financial conflicts of interest greater than $5,000 and any other relevant business or professional conflicts of interest. Because of their unique clinical or content expertise, individuals are invited to serve as Key Informants and those who present with potential conflicts may be retained. The TOO and the EPC work to balance, manage, or mitigate any potential conflicts of interest identified. VIII. Peer ReviewersPeer reviewers are invited to provide written comments on the draft report based on their clinical, content, or methodologic expertise. Peer review comments on the draft report are considered by the EPC in preparation of the final report. Peer reviewers do not participate in writing or editing of the final report or other products. The synthesis of the scientific literature presented in the final report does not necessarily represent the views of individual reviewers. The dispositions of the peer review comments are documented and may be published three months after the publication of the Evidence report. Potential Reviewers must disclose any financial conflicts of interest greater than $5,000 and any other relevant business or professional conflicts of interest. Invited Peer Reviewers may not have any financial conflict of interest greater than $5,000. Peer reviewers who disclose potential business or professional conflicts of interest may submit comments on draft reports through the public comment mechanism. IX. EPC Team DisclosuresEPC core team members must disclose any financial conflicts of interest greater than $1,000 and any other relevant business or professional conflicts of interest. Related financial conflicts of interest that cumulatively total greater than $1,000 will usually disqualify EPC core team investigators. X. Role of the FunderThis project was funded under Contract No. xxx-xxx from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. The AHRQ Task Order Officer reviewed contract deliverables for adherence to contract requirements and quality. The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. Project TimelineEMS/911 Workforce Infection ControlSep 15, 2021 Topic Initiated Nov 23, 2021 Research Protocol You Might Also Like
Page last reviewed November 2021 Page originally created November 2021 Internet Citation: Research Protocol: Emergency Medical Service/911 Workforce Infection Control and Prevention
Issues. Content last reviewed November 2021. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. What is the most effective way to control the spread of infectious disease?Washing hands properly is one of the most important and effective ways of stopping the spread of infections and illnesses. Wash your hands thoroughly using water and plain soap. Wash for at least 20 seconds and dry them completely.
What is the single best technique that the EMT can use to prevent the spread of infection?Hand hygiene (e.g., handwashing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others.
What is the easiest and most effective way to prevent the spread of infection?Take action and practice hand hygiene often. Use soap and water or an alcoholbased hand rub to clean your hands. It only takes 15 seconds to practice hand hygiene.
What is the most and effective ways to prevent the spread of infection and transmission of microorganism?Wash your hands before eating, or touching your eyes, nose or mouth. Wash your hands after touching anyone who is sneezing, coughing or blowing their nose. Don't share things like towels, lipstick, toys, or anything else that might be contaminated with respiratory germs.
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