title: Lack of compliance with basic infection control measures during cardiopulmonary resuscitation--are we ready for another epidemic?
abstract: OBJECTIVE
  Healthcare workers in the emergency department are particularly vulnerable to communicable disease. This study aimed to evaluate compliance with standard precautions by analysis of the incidence and systems sources of such contaminations and by quantifying the use of personal protective equipment.
  
  
  METHODS
  A prospective observational study from 1 November 2005 to 30 April 2006, using analysis of video segments. Videotapes were recorded in two rooms designed for cardiopulmonary resuscitation of out-of-hospital cardiac arrests, and compliance with basic infection control measures by all emergency department crews was monitored.
  
  
  RESULTS
  A total of 44 consecutive performances of cardiopulmonary resuscitation were recorded for time-motion analysis. The percentages of staff wearing personal protective equipment were 90%, 50%, 20% and 75% for masks, eye protection, gowns and gloves, respectively. Compliance ranking scored doctors as high, trainees as moderate and nursing staff as low. Overall contamination rate was 16.9x10(-2) events/person-min. The two leading systems sources for contamination were lack of specific task assignments among rescuers (44%) and inadequate preparation for procedures (42%).
  
  
  CONCLUSIONS
  Among healthcare workers in the emergency setting, the study disclosed suboptimal compliance with basic infection control measures, including use of personal protective equipment and avoiding contamination. By further time-motion analysis of resuscitation sessions, major systems sources and strategies for improvement could be identified.
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Wen-Chu
authors.initials: WC
authors.lastname: Chiang
authors.forename: Hui-Chih
authors.initials: HC
authors.lastname: Wang
authors.forename: Shey-Ying
authors.initials: SY
authors.lastname: Chen
authors.forename: Li-Mei
authors.initials: LM
authors.lastname: Chen
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Yao
authors.forename: Grace Hui-Min
authors.initials: GH
authors.lastname: Wu
authors.forename: Patrick Chow-In
authors.initials: PC
authors.lastname: Ko
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Ming-Tse
authors.initials: MT
authors.lastname: Tsai
authors.forename: Cheng-Chun
authors.initials: CC
authors.lastname: Hsai
authors.forename: Chan-Ping
authors.initials: CP
authors.lastname: Su
authors.forename: Shyr-Chyr
authors.initials: SC
authors.lastname: Chen
authors.forename: Matthew Huei-Ming
authors.initials: MH
authors.lastname: Ma
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D004866:Equipment Contamination; D005260:Female; D019983:Guideline Adherence; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000592:standards*; D008297:Male; D011446:Prospective Studies; D011482:Protective Devices