Asepsis in paramedic practice – time for a national approach

Dr Nigel Barr1

1University of the Sunshine Coast, Sippy Downs, QLD, Australia


In May 2018 the inaugural Asepsis and Hand Hygiene Workshop was hosted by the NSW Ambulance Service. An outcome of this symposium was the call for a paramedicine specific approach to maintaining asepsis. This presentation has four aims: provide an overview of compliance issues with aseptic technique during Australian paramedic practice; outline the warrant for a national approach; recommend the development of an asepsis framework using Hazard Analysis Critical Control Points (HACCP); and call for dissemination strategies based on implementation science.

Compliance of Australian paramedics with aseptic techniques was explored through a national online survey and semi-structured focus groups. Thematic analysis was used to explore the unstructured textual survey data. Inferential and descriptive statistical methods were used to explore the non-textual data (categorical, ordinal and Likert scales). Ethical clearance was obtained from the University of the Sunshine Coast (S/10/252 and S/14/719).

Australian paramedics consider aseptic technique to be important, significant noncompliance with recommendations and a reluctance to officially report breaches was found. Several barriers preventing paramedics from undertaking recommended aseptic techniques were found, including: poor hand hygiene and gloving practices, low rates of competency based training, operational pressure, attitudes, and limited access to appropriate products.

A HACCP approach is suited to developing the necessary framework and techniques to improve paramedic aseptic procedures. Such a framework will have significant operational and educational implications and its development would benefit from a broad national approach. Additionally, consideration must be given to implementation science theories for effective behaviour change.


Dr Nigel Barr has extensive experience in healthcare, emergency medical services and education sectors. Nigel was formerly an intensive care paramedic in several ambulance jurisdictions, and a Senior Operations Officer (Clinical and Education Services) for Rural Ambulance Victoria. His roles have encompassed the provision of intensive care paramedicine, clinical governance, professional leadership, teaching and research.

Nigel has completed a PhD exploring infection prevention and control in paramedic-led healthcare. He has a considerable research publication history and is a member of the Australian and New Zealand College of Paramedicine (ANZCP) research committee.

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