Background: Paramedics provide health care in a mobile primary emergency setting in which episodes of service are unpredictable in time, nature, and place.1 This presents a challenge for the implementation of recommended environmental hygiene practices in the paramedic workplace. Although guidelines for the routine and deep cleaning of ambulances and the associated medical equipment have been published,2 several international studies found that recommended cleaning measures were not being implemented effectively by emergency medical service (EMS) workers.3, 4, 5, 6, 7

The Australian paramedic workforce has access to advice on recommended environmental hygiene practices through national guidelines and standards,8 and operating procedures disseminated by state and territory ambulance authorities.1 However, it is not clear whether paramedics are compliant with these recommended practices. The aim of this study was to explore the self-reported behaviors and perceptions of Australian paramedics in relation to their environmental hygiene practices in paramedic-led health care.

Methods: The Survey of Paramedics on Infection Control (SoPIC) was an online, self-administered questionnaire used to survey Australian paramedics about their self-reported behaviors and perceptions regarding infection control practices (IPCs).9 The survey used open and closed questions and was made available for 1 month in 2013 (July 8-August 8). To provide a national perspective, members of Paramedics Australasia (PA) were targeted because the PA is the lead professional organization for paramedics employed in the delivery of prehospital emergency primary health care in Australia. In 2013, there were 12,500 full-time equivalent paramedics in Australia, and PA had 2,449 paramedic members.

This brief report outlines the SoPIC findings in relation to environmental hygiene practices of the survey participants. For the survey, competency-based training (CBT) was defined as education and assessment based on the competency standards set by an industry to ensure that all the outcomes required have been achieved.10 Routine cleaning was defined as the regular cleaning and disinfection of frequently touched areas inside ambulances,8 and deep cleaning was defined as a more thorough clean and disinfection of internal compartments and shared medical equipment inside ambulances.2 Textual data were analyzed using thematic analysis with a combination of a priori codes and inductive codes to capture emerging themes. National IPC guidelines8 were used as the lens to compare textual data associated with how the survey participants managed small and large (>10 cm diameter) blood and body substance spills, and cleaned shared medical equipment. A 5-step coding frame for text-based comments was developed, with details provided in the footnotes of Table 1. Nontext data (categorical, ordinal, and Likert scales) were summarized using descriptive statistics. Ethical clearance was obtained from the University of the Sunshine Coast Human Research Ethics Committee (S/10/252).