Education, Training, and Competencies
Oral Presentation
.jpg "Stacy Hartmann, MPH, CHES photo")
Stacy Hartmann, MPH, CHES
Epidemiology Analyst
Los Angeles County Department of Public Health
Los Angeles, California
Nothing to disclose
Christina Eclarino, RN, MSN, PHN
Public Health Nurse
Los Angeles County Department of Public Health
Los Angeles, California
Nothing to disclose
Angela Vassallo, MPH, MS, CIC, FAPIC
Infection Prevention Expert
Health Services Advisory Group, Inc.
Los Angeles, California
Infection control (IC) in the pre-hospital care setting by EMS providers is important to protect themselves and patients receiving emergency care and being transported between healthcare facilities. From 2016-17, LAC Department of Public Health (DPH) collaborated with LAC Emergency Medical Services Agency (EMSA) to assess and improve IC among EMS providers.
DPH/EMSA adapted tools from the Centers for Disease Control and Prevention designed for healthcare facilities to assess EMS IC policies and practices. Large and small EMS agencies/companies were assessed to ensure a representative sample. Policies were reviewed, and observations made by DPH/EMSA nurses during ride alongs in >2 ambulances per provider.
Fourteen providers were assessed. Eleven had a designated infection control officer (DICO). Thirteen had written IC policies; 12 reviewed and updated them annually. All required IC training for new staff, but only 59% assessed skills post-training and 31% audited across four IC topics. Twelve had written policies for cleaning/disinfection. Twelve had a policy for influenza vaccination; however, the median vaccination rate was only 55% (range 1-99%). Observations showed handwashing occurred before patient contact for 7% of assessments, glove use in 100% and hand hygiene after removing gloves in 79%. Staff cleaned the ambulance after each patient encounter; cleaning high touch surfaces in 79% and replaced cleaners/disinfectants when appropriate in 89%.
EMS providers are an important part of the healthcare system as they transport patients in and out of hospitals and other healthcare facilities. Overall, findings were encouraging, but ensuring up-to-date policies for all areas of IC, monitoring competencies, and observing practices to assess adherence may improve IC. In 2018, LAC hosted an IC train-the-trainer course for DICOs to bring proper IC practices back to their agencies/companies. LAC DPH and EMSA will continue to work with EMS providers to improve IC policies and practices.