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    The impact of an ambulance vehicle preparation service on the presence of bacteria: a service evaluation

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    Author
    Mackenzie, Mo
    Pilbery, Richard
    Keyword
    Emergency Medical Services
    Infection Control
    Ambulances
    Paramedic Practice
    Adenosine Triphosphate
    Equipment and Supplies
    Journal title
    British Paramedic Journal
    
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    Show full item record
    URI
    http://hdl.handle.net/20.500.12417/638
    DOI
    10.29045/14784726.2019.03.3.4.27
    Abstract
    Introduction: Around 300,000 patients a year in England acquire a healthcare-associated infection (HAI) while being cared for by the NHS. The contribution from NHS Ambulance Services is not known, but previous studies have identified the presence of pathogenic bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus, including resistant strains in some cases, inside ambulances. To improve ambulance cleanliness, Yorkshire Ambulance Service NHS Trust (YAS) piloted an Ambulance Vehicle Preparation Service (AVPS) at two ambulance stations, where staff were tasked with ensuring every ambulance at these stations was cleaned every 24 hours. Methods: Adenosine triphosphate (ATP) bioluminescence testing was conducted on 16 ambulances at the two pilot AVPS stations and on 18 ambulances at four ‘business as usual’ (BAU) ambulance stations using a Hygiena SystemSURE luminometer. Swabs were obtained from 10 pre-selected locations inside each ambulance. Results: Between November 2016 and August 2018, a total of 690 swabs were obtained and recorded from 34 ambulances. Overall, median relative light unit (RLU) values for both groups were < 100, with only the BAU group having an upper quartile value > 100. However, when stratified by swabbing area, three areas had a median RLU of > 100 in the BAU group: suction unit handle, steering wheel and airway seat shelf. In addition, the upper quartile RLU values for the grab rail above the stretcher and the passenger seat in the BAU group were also > 100. No swab areas had a median RLU > 100 in the AVPS group. Conclusion: A dedicated AVPS results in better cleaning of ambulance vehicles than the existing cleaning system utilising operational crews. The areas most likely to be contaminated are the suction unit handle, steering wheel, airway seat shelf and grab rails. The position of equipment and the materials that equipment are constructed from should have infection prevention and control (IPC) as a consideration. Abstract published with permission.
    ae974a485f413a2113503eed53cd6c53
    10.29045/14784726.2019.03.3.4.27
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    Publications - Yorkshire Ambulance Service

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