Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-20T15:28:41.072Z Has data issue: false hasContentIssue false

Emergency Medical Services Providers’ Experiences and Attitudes Toward Infection Prevention and Control Measures in Saudi Arabia: a Qualitative Study

Published online by Cambridge University Press:  04 November 2019

Anas A. Khan*
Affiliation:
King Saud University, Emergency Medicine, Riyadh, Saudi Arabia Global Center for Mass Gathering Medicine, Ministry of Health, Saudi Arabia
*
Correspondence and reprint requests to Anas A. Khan, King Saud University, Emergency Medicine, P.O. Box 7805, Riyadh, 11472, Saudi Arabia (e-mail: [email protected]).

Abstract

Objectives:

This study explores the experiences and practices of emergency medical services (EMS) providers, as well as the motivations that underpin perceptions toward standard infection prevention and control (IPC). The current literature suggests that EMS providers have a low compliance level with preventive measures, with misperceptions about risks and self-justification of personal skills reported.

Methods:

The study used qualitative methods and conducted 2 distinct focus group discussions and 20 in-depth interviews with both prehospital and inter-facility EMS providers. Data were thematically analyzed using the Framework approach.

Results:

The participants considered respiratory infections the most significant nosocomial risks. Lack of full disclosure of medical history to EMS providers was considered a significant threat. Beliefs about low effectiveness and harmful effects of the influenza vaccine, as well as low perceptions of influenza risks, were common. While apparent misperceptions contributed largely to the inappropriate use of preventive measures, the reliance on intuition and individual experiences was attributed to the inaccessibility of appropriate guidelines, and lack of formal IPC training programs.

Conclusions:

There is need to address EMS doubts and fears, improve IPC practices and awareness by institutionalizing IPC training programs, and ensure the design and accessibility of simplified and well-tailored IPC guidelines for EMS providers.

Type
Original Research
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

WHO. World Health Organization: Report on the Burden of Endemic Health Care-Associated Infection Worldwide. 2011. https://apps.who.int/iris/bitstream/handle/10665/80135/9789241501507_eng.pdf?sequence=1. Accessed October 20, 2019.Google Scholar
Allegranzi, B, Bagheri Nejad, S, Combescure, C, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011;377(9761):228241.CrossRefGoogle ScholarPubMed
Ministry of Helath Command and Control Center. National Public Health Events, 2019 - Epi-week 12. 2019 [cited March 24, 2019]; https://www.moh.gov.sa/en/CCC/Pages/default.aspx. Accessed October 20, 2019.Google Scholar
Zumla, A, Hui, D. Infection control and MERS-CoV in health-care workers. Lancet. 2014;383(9932):18691871.CrossRefGoogle ScholarPubMed
Rabaan, A, Alhani, H, Bazzi, A, et al. Questionnaire-based analysis of infection prevention and control in healthcare facilities in Saudi Arabia in regards to Middle East Respiratory Syndrome. J Infect Public Health. 2017;10(5):548563.Google ScholarPubMed
Thomas, B, O’Meara, P, Spelten, E. Everyday dangers–the impact infectious disease has on the health of paramedics: a scoping review. Prehosp Disaster Med. 2017;32(2):217223.CrossRefGoogle ScholarPubMed
WHO. World Health Organization: Standard precautions in health care. 2007; https://www.who.int/csr/resources/publications/standardprecautions/en/. Accessed October 20, 2019.Google Scholar
CDC. US Center for Disease Control: Standard Precautions for All Patient Care. 2016 [cited March 24, 2019]; https://www.cdc.gov/infectioncontrol/basics/standard-precautions.html. Accessed October 20, 2019.Google Scholar
Bledsoe, B, Sweeney, R, Berkeley, R, et al. EMS provider compliance with infection control recommendations is suboptimal. Prehosp Emerg Care. 2014;18(2):290294.CrossRefGoogle ScholarPubMed
Parmeggiani, C, Abbate, R, Marinelli, P, et al. Healthcare workers and health care-associated infections: knowledge, attitudes, and behavior in emergency departments in Italy. BMC Infect Dis. 2010;10(1):35.CrossRefGoogle ScholarPubMed
Martel, J, Bui-Xuan, E, Carreau, A, et al. Respiratory hygiene in emergency departments: compliance, beliefs, and perceptions. Am J Infect Control. 2013;41(1):1418.CrossRefGoogle Scholar
Bouchoucha, SL, Moore, KA. Infection prevention and control: who is the judge, you or the guidelines? J Infect Prev. 2018 19(3):131137.CrossRefGoogle ScholarPubMed
Ritchie, J, Lewis, J. Qualitative Research Practice: A Guide for Social Science Students and Researchers. Newbury Park, CA: SAGE Publications; 2003.Google Scholar
Green, J, Thorogood, N. Qualitative Methods for Health Research. Newbury Park, CA: Sage; 2013.Google Scholar
Welsh, E. Dealing with data: using NVivo in the qualitative data analysis process. 2002. http://www.qualitative-research.net/index.php/fqs/article/view/865. Accessed October 20, 2019.Google Scholar
Staniforth, R. Why do health workers decline flu vaccination? Nurs Times 2014;110(49):1617.Google ScholarPubMed
Pollock, K, McDonald, E, Smith-Palmer, A, et al. Tuberculosis in healthcare workers, Scotland. Scott Med J. 2017;62(3):101103.CrossRefGoogle ScholarPubMed
Elkholy, A, Grant, R, Assiri, A, et al. MERS-CoV infection among healthcare workers and risk factors for death: retrospective analysis of all laboratory-confirmed cases reported to WHO from 2012 to 2 June 2018. J Infect Public Health. 2019. doi: 10.1016/j.jiph.2019.04.011 CrossRefGoogle Scholar
Petek, D, Kamnik-Jug, K. Motivators and barriers to vaccination of health professionals against seasonal influenza in primary healthcare. BMC Health Serv Res. 2018;18(1):853.Google ScholarPubMed
Khan, A, Al Johani, M. Level of willingness to report to work during a pandemic among the emergency department health care professionals. Asain J Med Sci. 2014;5:5862.Google Scholar
Gramegna, A, Dellafiore, S, Contarini, M, et al. Knowledge and attitudes on influenza vaccination among Italian physicians specialized in respiratory infections: an Italian Respiratory Society (SIP/IRS) web-based survey. J Prev Med Hyg. 2018;59(2):E128E131.Google ScholarPubMed
Sundaram, N, Ducketta, K, Yung, C, et al. “I wouldn’t really believe statistics” - challenges with influenza vaccine acceptance among healthcare workers in Singapore. Vaccine. 2018;36(15):19962004.CrossRefGoogle Scholar
Boey, L, Bral, C, Roelants, M, et al. Attitudes, believes, determinants and organisational barriers behind the low seasonal influenza vaccination uptake in healthcare workers - a cross-sectional survey. Vaccine. 2018;36(23):33513358.CrossRefGoogle ScholarPubMed
World Health Organization. Report on the burden of endemic health care-associated infection worldwide. 2011. https://apps.who.int/iris/bitstream/handle/10665/80135/9789241501507_eng.pdf;jsessionid=17E30313A42C966802CAE28742425124?sequence=1. Accessed October 20, 2019.Google Scholar