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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
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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
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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