from Emanuelsson et al. 2013
published in Eur J Emerg Med 20(4):281-5
DOI 10.1097/MEJ.0b013e328357938e

Ambulance personnel adherence to hygiene routines: still protecting ourselves but not the patient

Hand hygiene compliance of emergency medical technicians (EMTs) is crucial for patient safety and the qualitiy of patient care

In the observational study emergency medical service (EMS) employees were observed during seven differing hygiene measures by randomly selected EMS employees. Furthermore, a checklist was used to determine whether alcohol-based hand disinfectants, gloves, gowns and eye protection was available in the ambulance and in the emergency backpack. A total of 168 employees participated in the study: 123 nurses and 45 EMTs. 71 observations were carried out in 21 ambulances; 68 of these observations were analysed.
The study showed that only two of the observed employees (3 %) properly adhered to the seven observed hygiene measures. Compliance with hand disinfection was 34 % before and 72 % after touching a patient. Gloves were correctly used in 69 % of the situations, gowns in 91 %. However, short-sleeved uniforms were only used in 28 % of the observations. Correct adherence to the rule not to wear rings, watches or bracelets was observed in 74 % of the situations. Hair was short or tied back in 91 % of the observations.
The checklists showed that hand disinfectants, gloves and gowns were available in all ambulances. Eye protection was available in approx. 90 % of the ambulances. Hand disinfectants were available in almost every fifth backpack, gloves in every second.
The hygiene compliance in EMS varies very much depending on the hygiene measure (only 3 % compliant for all seven hygiene measures). The analysis of the checklists reveals that the access to the respective equipment was limited outside the ambulance, which may have a negative influence on the compliance.