Improving pre-hospital infection control in the ACT
Mr Lincoln Fowler1, Ms Lisa McLeod1
1ACT Ambulance Service, Fairbairn, Australia
Within the Australian Capital Territory Ambulance Service (ACTAS) the infection control performance of paramedics and monitoring of their practices in the pre-hospital setting is constrained by the lack of appropriate resources, paramedic knowledge and understanding, social pressures, and the care requirements of patient presentations. For the paramedic patient interventions often occur outside of the ambulance in uncontrolled environments. Compliance measuring and monitoring is very difficult owing to the diversity of situations where patient contact occurs. There is also a lack of effective ways to measure whether interventions resulted in infections.
An observational audit of infection control policy, procedures and practices was performed. A suite of Clinical Work Instructions (CWIs) was developed that aligned with the National Safety and Quality Health Service Standards and Australian Guidelines for the Prevention and Control of Infections in Healthcare (2019). The audit included personal protective equipment (PPE), hand hygiene products and cleaning supplies provision and use. A trial of different styles of hand hygiene product was undertaken.
Updated infection control policy and CWIs were well received by paramedics with recognition that vehicle cleaning required additional resources. The audit demonstrated inconsistent retention of PPE, cleaning equipment and hand sanitiser across the fleet. Fleet cleaning was also unequal. Introduction of personal carry hand hygiene products readily accepted.
Paramedics are aware structural issues inhibit their practices. Development of a checklist and an audit tool will allow enhanced auditing. ACTAS is now committed to improving fleet cleaning.
Biography:
Infection control was the inevitable path for Lincoln following his inital attainment of qualifications in microbiology and nursing. Since then he has worked for various health care and aged care services across Australia and overseas in both urban and rural environments. Lately he has taken a new role with ACT Ambulance Service where he hopes to establish infection control practices which will translate into Australia-wide ambulance service accreditation.