한국응급구조학회지 (The Korean Journal of Emergency Medical Services)

  • 제24권1호
  • /
  • Pages.7-24
  • /
  • 2020
  • /
  • 1738-1606(pISSN)
  • /
  • 2384-2091(eISSN)
한국응급구조학회 (The Korea Society of Emergency Medical Services)
권호 표지
DOI QR코드

DOI QR Code

PRECEDE 모형에 기반한 119구급대원의 감염관리 수행 관련 요인 분석

Analysis of the factors related to the infection control practice of 119 emergency medical service providers based on the PRECEDE model

  • 양연수 (연세대학교 보건대학원 국민건강증진연구소) ;
  • 김희진 (연세대학교 보건대학원 국민건강증진연구소) ;
  • 지선하 (연세대학교 보건대학원 국민건강증진연구소) ;
  • 홍석환 (을지대학교 응급구조학과) ;
  • 한상균 (연세대학교 보건대학원)
  • Yang, Yeunsoo (Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University) ;
  • Kimm, Heejin (Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University) ;
  • Jee, Sun Ha (Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University) ;
  • Hong, Seok-Hwan (Department of Emergency Medical Services. Eulji University) ;
  • Han, Sang-Kyun (Graduate School of Public Health, Yonsei University)
  • 투고 : 2020.03.16
  • 심사 : 2020.04.19
  • 발행 : 2020.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Emergency medical service (EMS) personnel are at high risk of spreading infection. In this study, we used the PRECEDE model to identify the knowledge, status, and barriers to infection control among Korean paramedics to provide basic infection control data. Methods: A total of 164 respondents were analyzed for the study. A questionnaire was administered and collected through an online self-response platform. Descriptive analysis, t-test, ANOVA, multiple regression, and logistic regression analyses were performed to determine infection control practices and associated factors using SAS 9.4. To identify the pathways and direct, indirect, total effects based on the PRECEDE model, we used AMOS 26.0. Results: Highly rated self-efficacy (OR 8.82, 95% CI: 3.23-24.09), awareness (OR 6.05, 95% CI: 2.06-17.72), and enabling factors (OR 3.23, 95% CI: 1.18-8.78) led to superior infection control. As a result of the structural model analysis, the highly rated enabling factors and awareness led to superior practice patterns. Conclusion: Practice is related to self-efficacy, awareness, and enabling factors; however, further research is needed to develop strategies for infection control. In particular, institutional arrangements are needed to improve the enabling factors. Improving infection control performance may lead to better infection control and enhanced protection of EMS personnel and patients against infection risks.

키워드

참고문헌

  1. Standard guidelines for emergency response to 119 emergency personnel, National Fire Agency, 2019.
  2. Roline CE, Crumpecker C, Dunn TM. Can methicillin-resistant Staphylococcus aureus be found in an ambulance fleet?. Prehospital Emergency Care 2007;11(2):241-4. https://doi.org/10.1080/10903120701205125
  3. Brown R, Minnon J, Schneider S, Vaughn J. Prevalence of methicillin resistant Staphylococcus aureus in ambulances in southern Maine. Prehospital Emergency Care 2010;14(2):176-81. https://doi.org/10.3109/10903120903564480
  4. Amiry AA, Bissell RA, Maguire BJ, Alves DW. Methicillin-resistant Staphylococcus aureus nasal colonization prevalence among emergency medical services personnel. Prehosp Disaster Med 2013;28(4):1-5. https://doi.org/10.1017/S1049023X13003476
  5. Smith EC, Burkle FM, Archer FL. Fear, familiarity, and the perception of risk: a quantitative analysis of disaster specific concerns of paramedics. Disaster Med Public Health Prep 2011;5(1):46-53. https://doi.org/10.1001/dmp.10-v4n2-hre10008
  6. Kim BK. A study on the development of korean EMS system : focus on 119 EMS of fire department. Unpublished master's thesis, Kangwon National University 2011, Chuncheon, Korea.
  7. Oh HS, Uhm DC. Occupational exposure to infection risk and use of personal protective equipment by emergency medical personnel in the Republic of Korea. Am J Infect Control 2016;44:647-51. https://doi.org/10.1016/j.ajic.2015.12.022
  8. Jang HY, Han MA, Park J, Ryu SY. Associated factors with the performance of infection control among 119 rescue crews. J Korean Soc Emerg Med 2015 1;26(3):232-9.
  9. Park SM, Lee HJ, Choi JH, Kim JH. Infection management for emergency rescue equipment. Korean J Emerg Med Ser 2017;21(1):87-98. https://doi.org/10.14408/KJEMS.2017.21.1.087
  10. Video conference with the head of the city.province headquarters for COVID-19, National Fire Agency 2020. 2
  11. Coronavirus patients transport. http://www.nfa.go.kr/nfa/news/firenews/disasterNews/?boardId=bbs_0000000000000105&mode=view&cntId=29240
  12. Green LW, Kreuter MW. Health promotion planning: an educational and environmental approach. 2003.
  13. Sim KY, Kim JH, Lee HC, Kim CT. Influencing factors of prevention practices against infection exposure among emergency medical technicians in emergency rooms. Korean J Emerg Med Ser 2018;22(1):21-34. https://doi.org/10.14408/KJEMS.2018.22.1.021
  14. Cho EY. Application and testing the PRECEDE model for health promotion of aircrew. Korean J Aerosp Environ Med 2002;12(3):151-70.
  15. Han EO, Kwon DM, Dong KR, Han SM. A model for protective behavior against the harmful effects of radiation based on medical institution classifications. Journal of Radiation Protection and Research 2010;35(4):157-62.
  16. Shaban RZ. Paramedic knowledge of infection control principles and standards in an Australian emergency medical system. Australian Infection Control 2006;11(1):13-4, 16-9. https://doi.org/10.1071/HI06013
  17. Klein KR, Atas JG, Collins J. Testing emergency medical personnel response to patients with suspected infectious disease. Prehosp Disaster Med 2004;19(3):256-65. https://doi.org/10.1017/S1049023x00001850
  18. Hwang JH. Awareness and performance towards the infection prevention standard attention in 119 paramedics and hospital emergency medical technician using IPA. Unpublished master's thesis, Kangwon National University 2014, Samcheok, Korea.
  19. Kim SO, Cho SH. A study on clinical nurses level of perception of importance, performance and satisfaction in the control of nosocomial infection. J Nurs Acad Soc 1997;27(4):765-76. https://doi.org/10.4040/jnas.1997.27.4.765
  20. Martin SD. Nurses' ability and willingness to work during pandemic flu. J Nurs Manag 2011;19(1):98-108. https://doi.org/10.1111/j.1365-2834.2010.01190.x
  21. Speers D. Infectious diseases and the pre-hospital practitioner. J Emerg Prim Health Care 2003;1(Issue 1-2). https://doi.org/10.33151/ajp.1.1.67
  22. Lawrence J, May D, Editors. Infection control in the community. Elsevier Health Sciences 2003.
  23. Le AB, Buehler SA, Maniscalco PM, Lane P, Rupp LE, Ernest E et al. Determining training and education needs pertaining to highly infectious disease preparedness and response: a gap analysis survey of US emergency medical services practitioners. Am J Infect Control 2018;46(3):246-52. https://doi.org/10.1016/j.ajic.2017.09.024
  24. Lateef F, Lim SH, Tan EH. New paradigm for protection: the emergency ambulance services in the time of severe acute respiratory syndrome. Prehospital Emergency Care 2004;8(3):304-7. https://doi.org/10.1016/j.prehos.2003.12.016