Hostname: page-component-669899f699-7xsfk Total loading time: 0 Render date: 2025-04-26T17:05:54.175Z Has data issue: false hasContentIssue false
  • English
  • Français

Current Evidence for Infection Prevention and Control Interventions in Emergency Medical Services: A Scoping Review

Published online by Cambridge University Press:  29 March 2023

J. Lee Jenkins ,
Edbert B. Hsu ,
Allen Zhang ,
Lisa M. Wilson Open the ORCID record for Lisa M. Wilson [Opens in a new window] ,
Anna Russell  and
Eric B. Bass
J. Lee Jenkins
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Edbert B. Hsu
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Allen Zhang
Affiliation:
Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
Lisa M. Wilson*
Affiliation:
Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
Anna Russell
Affiliation:
Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
Eric B. Bass
Affiliation:
Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
*
Correspondence: Lisa Wilson, Johns Hopkins University 1830 E. Monument, Room 8066 Baltimore, Maryland 21205 USA E-mail: LisaWilson@jhmi.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

The aim of this review was to summarize current evidence from the United States on the effectiveness of practices and interventions for preventing, recognizing, and controlling occupationally acquired infectious diseases in Emergency Medical Service (EMS) clinicians.

Report and Methods:

PubMed, Embase, CINAHL, and SCOPUS were searched from January 1, 2006 through March 15, 2022 for studies in the United States that involved EMS clinicians and firefighters, reported on one or more workplace practices or interventions that prevented or controlled infectious diseases, and included outcome measures. Eleven (11) observational studies reported on infection prevention and control (IPC) practices providing evidence that hand hygiene, standard precautions, mandatory vaccine policies, and on-site vaccine clinics are effective. Less frequent handwashing (survey-weight adjusted odds ratio [OR] 4.20; 95% confidence interval [CI], 1.02 to 17.27) and less frequent hand hygiene after glove use (survey-weight adjusted OR 10.51; 95% CI, 2.54 to 43.45) were positively correlated with nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA). Lack of personal protective equipment (PPE) or PPE breach were correlated with higher severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity (unadjusted risk ratio [RR] 4.2; 95% CI, 1.03 to 17.22). Workers were more likely to be vaccinated against influenza if their employer offered the vaccine (unadjusted OR 3.3; 95% CI, 1.3 to 8.3). Active, targeted education modules for H1N1 influenza were effective at increasing vaccination rates and the success of on-site vaccine clinics.

Conclusions:

Evidence from the United States exists on the effectiveness of IPC practices in EMS clinicians, including hand hygiene, standard precautions, mandatory vaccine policies, and vaccine clinics. More research is needed on the effectiveness of PPE and vaccine acceptance.

Keywords

Emergency Medical Servicesinfection controloccupational exposure
Type
Research Report
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 3 , June 2023 , pp. 371 - 377
Check for updates
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Bucher, J, Donovan, C, Ohman-Strickland, P, et al. Hand washing practices among Emergency Medical Services providers. West J Emerg Med. 2015;16(5):727–735.CrossRefGoogle ScholarPubMed
Richey, TW, Fowler, RL, Swienton, RE, et al. Review of Emergency Medical Services vulnerability to high consequence infectious disease in the United States. Front Public Health. 2021;9:748373.CrossRefGoogle ScholarPubMed
Jenkins, JL, Hsu, EB, Russell, A, et al. Infection Prevention and Control for the Emergency Medical Services and 911 Workforce. Prepared by the Johns Hopkins University Evidence-based Practice Center under Contract No. 75Q80120D00003. AHRQ Publication No. 22(23)-EHC039. Rockville, Maryland USA: Agency for Healthcare Research and Quality; November 2022. DOI: https://doi.org/10.23970/AHRQEPCTB42.CrossRefGoogle Scholar
Agency for Healthcare Research and Quality (AHRQ). Rockville, Maryland USA. effectivehealthcare.ahrq.gov. Accessed March 10, 2022.Google Scholar
Methods Guide for Effectiveness and Comparative Effectiveness Reviews. https://effectivehealthcare.ahrq.gov. Accessed March 10, 2022.Google Scholar
Pandemic All Hazards Preparedness Act. Public Law 109-417. 120 Stat. 2831. 2006.Google Scholar
Thomas, BH, Ciliska, D, Dobbins, M, et al. A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews Evid Based Nurs. 2004;1(3):176–184.CrossRefGoogle ScholarPubMed
Brown, A, Schwarcz, L, Counts, CR, et al. Risk for acquiring coronavirus disease illness among Emergency Medical Service personnel exposed to aerosol-generating procedures. Emerg Infect Dis. 2021;27(9):2340–2348.CrossRefGoogle ScholarPubMed
Glaser, MS, Chui, S, Webber, MP, et al. Predictors of acceptance of H1N1 influenza vaccination by FDNY firefighters and EMS workers. Vaccine. 2011;29(34):5675–5680.10.1016/j.vaccine.2011.06.008CrossRefGoogle ScholarPubMed
Grant, M, Harrison, R, Nuñez, A, et al. Seroprevalence of SARS-CoV-2 among firefighters/paramedics in San Francisco, CA. J Occup Environ Med. 2021;63(11):e807–e812.CrossRefGoogle Scholar
Gregory, ME, Powell, JR, MacEwan, SR, et al. COVID-19 vaccinations in EMS professionals: prevalence and predictors. Prehosp Emerg Care. 2022;26(5):632–640.10.1080/10903127.2021.1993391CrossRefGoogle ScholarPubMed
Halbrook, M, Gadoth, A, Martin-Blais, R, et al. Longitudinal assessment of coronavirus disease 2019 vaccine acceptance and uptake among frontline medical workers in Los Angeles, California. Clin Infect Dis. 2022;74(7):1166–1173.CrossRefGoogle ScholarPubMed
Harris, SA, Nicolai, LA. Occupational exposures in emergency medical service providers and knowledge of and compliance with universal precautions. Am J Infect Control. 2010;38(2):86–94.CrossRefGoogle ScholarPubMed
Hubble, MW, Zontek, TL, Richards, ME. Predictors of influenza vaccination among emergency medical services personnel. Prehosp Emerg Care. 2011;15(2):175–183.CrossRefGoogle ScholarPubMed
Miramonti, C, Rinkle, JA, Iden, S, et al. The prevalence of methicillin-resistant staphylococcus aureus among out-of-hospital care providers and emergency medical technician students. Prehosp Emerg Care. 2013;17(1):73–77.10.3109/10903127.2012.717169CrossRefGoogle ScholarPubMed
Newberry, JA, Gautreau, M, Staats, K, et al. SARS-CoV-2 IgG seropositivity and acute asymptomatic infection rate among firefighter first responders in an early outbreak county in California. Prehosp Emerg Care. 2021. Epub ahead of print.CrossRefGoogle Scholar
Orellana, RC, Hoet, AE, Bell, C, et al. Methicillin-resistant staphylococcus aureus in Ohio EMS providers: a statewide cross-sectional study. Prehosp Emerg Care. 2016;20(2):184–190.10.3109/10903127.2015.1076098CrossRefGoogle ScholarPubMed
Rebmann, T, Wright, KS, Anthony, J, et al. Seasonal and H1N1 influenza vaccine compliance and intent to be vaccinated among emergency medical services personnel. Am J Infect Control. 2012;40(7):632–636.CrossRefGoogle ScholarPubMed
Standard Precautions for All Patient Care. Centers for Disease Control and Prevention; 2016. https://www.cdc.gov/infectioncontrol/basics/standard-precautions.html. Accessed March 10, 2022.Google Scholar
Supplementary material: File

Jenkins et al. supplementary material

Tables 1-4 Appendix

Download Jenkins et al. supplementary material(File)
File 22.1 KB