Embedded Files
PAGE 3
The majority of the sample correctly identified the transmission modes of HIV/AIDS (85.9%), with the poorest result found for polio (6.4%). For 15 of the 25 infectious diseases, over 50% of respondents could not identify correct modes of transmission. Only modes of transmission for three diseases were noted as having correct percentage rates higher than 80, those being for HIV/AIDS, salmonella and influenza. Disturbingly, a proportion of participants either did not know or incorrectly identified modes of transmission for hepatitis B (20.4%) and C (30.2%). These diseases are widely regarded and documented as high-risk occupational hazards for health care workers performing exposure prone procedures .
The results suggest paramedics in this study had poor knowledge of how infectious diseases are transmitted. Paramedics with poor knowledge of agents causing disease and poor knowledge of how disease is transmitted are hampered in their ability to prevent cross-infection . Patients who present with diagnosed infectious diseases require specific care. Over half the participants incorrectly identified the aetiology for 8 diseases, some of which require the application of specific additional infection control precautions. The understanding of disease aetiology and modes of transmission are vital components in understanding disease epidemiology and form two components of the concept widely recognised in infection control as the ‘Chain of Infection This concept illustrates the manner in which infectious diseases remain endemic in populations, and from time to time lead to epidemics and pandemics. Further, it underpins the rationale for the use of precautions taken for particular infections . In the present study, participants were asked to identify, using a true/false format, the correct components of the ‘Chain of Infection’. Only 46.2% of participants correctly identified the six components of the ‘Chain of Infection’, with 19.4% reporting that they did not know. This result illustrates poor overall knowledge of the basic mechanism of cross infection. McCulloch [7] suggests that it is vital for health care personnel to understand the process of infection, so that they know how they can prevent the transmission of infection. McCulloch suggests that in order to improve infection control practice, all staff require education and involvement in the implementation of infection control policies. To precipitate improvement in knowledge and practice, comprehensive education programs are required. Vital cornerstones of such programs for paramedics should include the management of staff health, occupational exposure, and immunisation. Staff are required to possess a good understanding of the transmission of infection, understand prevention, and analyse their practice to obtain improvement. Importantly, McCulloch suggests infection control skills should be observed and minimum standards maintained, as with any basic clinical procedure, and not merely taught and practised. While the present study is the first of its kind in Australia and provides important baseline data, there are a number of limitations. Surveys were sent to all paramedics but only 55.3% were returned. The participants may not be representative of the larger group. It could be that those staff with poor knowledge did not respond. Although the range of responses provides some confidence in the results, the low levels of knowledge among those who did respond is still of concern. Moreover, the study focused on one particular state-based ambulance service and it is not possible to extrapolate across other jurisdictions.
The risk of exposure to infectious disease for paramedics is high, particularly given the unique environments in which paramedics are required to work. Despite the high-risk environment in which paramedics work, this study found generally poor knowledge of aetiology and transmission of infectious disease and principles of infection among paramedics. The results suggest poor overall knowledge of infectious disease aetiology and transmission by paramedics in this Australian setting and warrant review of infection control practices and education programs in the pre-hospital paramedic setting. Ambulance services and authorities need to address specific and ever-increasing challenges in infection control, by establishing evidence-based practices that value-add to patient care. The study demonstrates a need for further investigation into ambulance infection control knowledge and practices nationally. Importantly, infection control management programs ultimately protect staff and clients from infectious diseases and improve the clinical care and patient care outcomes of the sick and injured.
Google Sites
Report abuse