title: Self-reported behaviors and perceptions of Australian paramedics in relation to hand hygiene and gloving practices in paramedic-led health care.
abstract: BACKGROUND
  Noncompliance with recommended hand hygiene and gloving practices by workers in the emergency medical services may contribute to the transmission of health care-associated infections and lead to poor patient outcomes. The aim of this study was to explore the self-reported behaviors and perceptions of Australian paramedics in relation to their hand hygiene and gloving practices in paramedic-led health care.
  
  
  METHODS
  A national online survey (n = 417; 17% response rate) and 2 semistructured focus groups (6 per group) were conducted with members of Paramedics Australasia.
  
  
  RESULTS
  Although most of the study participants perceived hand hygiene and gloving to be important, the findings suggest poor compliance with both practices, particularly during emergency cases. All participants reported wearing gloves throughout a clinical case, changing them either at the completion of patient care or when visibly soiled or broken. Hand hygiene was missed at defined moments during patient care, possibly from the misuse of gloves.
  
  
  CONCLUSIONS
  Paramedic hand hygiene and gloving practices require substantial improvement to lower potential transmission of pathogens and improve patient safety and clinical care. Further research is recommended to explore how to alleviate the barriers to performing in-field hand hygiene and the misuse of gloves during paramedic-led health care.
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia. Electronic address: nbarr@usc.edu.au.
authors.forename: Nigel
authors.initials: N
authors.lastname: Barr
authors.affiliation: School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Holmes
authors.affiliation: School of Medicine and Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Roiko
authors.affiliation: School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Dunn
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia.
authors.forename: Bill
authors.initials: B
authors.lastname: Lord
mesh_terms: D000293:Adolescent; D000328:Adult; D000488:Allied Health Personnel; D001291:Attitude of Health Personnel; D001315:Australia; D005260:Female; D005932:Gloves, Surgical / Q000706:statistics & numerical data*; D063373:Hand Hygiene / Q000379:methods*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007407:Interviews as Topic; D008297:Male; D055815:Young Adult
keywords: Allied health personnel; Hand hygiene; Infection prevention and control; Paramedic