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McCulloch 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.

REFERENCES

1. Shaban RZ. Paramedic knowledge and reported practice of infection control and infectious disease: Implications for education and practice. [Masters Dissertation]. Brisbane (Australia): Griffith University; 2001

2. Mencl F, Birkle M, Blanda M, Gerson LW. EMT’s knowledge regarding transmission of infectious disease. Pre-hospital Emergency Care 2000;4(1): 57-61.

3. Eutis TC, Wright SW, Wrenn KD, et al. Compliance with recommendations for universal precautions among pre-hospital providers. Annals of Emergency Medicine 1992; 21:1353-9.

4. Cydulka RK, Matthews, JJ, Born M, Moy A, Parker M. Paramedics: knowledge base and attitudes towards AIDS and hepatitis. Journal of Emergency Medicine 1991; 9(37-43).

5. Gellert GA, Maxwell RM, Higgins KV, Barnard R, Page B. AIDS and pre-hospital personnel: knowledge and prevention of occupational exposure. Prehospital Disaster Medicine 1996; 11: 112-116.

6. National Health and Medical Research Council (NHMRC). Infection control in the health care setting: guidelines for the prevention and transmission of infectious disease. Canberra (Australia): Commonwealth Department of Health and Family Services; 1996.

7. McCulloch J. Editor. Infection control: Science, management and practice. London: Whurr Publishers; 2000.

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