Hand Hygiene in ambulance
Hand sanitizer dispensers are important in ambulance services.

Widespread support among parademics for improved hygiene practices during COVID

A nation-wide survey in Germany reveals a high level of hygiene awareness and hand hygiene compliance among ambulance service workers during COVID-19 pandemic.

The worldwide COVID-19 pandemic is placing an enormous burden on healthcare systems worldwide. The pandemic is also pushing the emergency services to their limits. One reason is the additional, time-consuming measures that workers need to take, such as disinfecting emergency vehicles. The necessary protective clothing that is also causing additional strain on personnel. 

A study by the occupational medicine team at Otto von Guericke University in Magdeburg underscores the increasing stress in paramedic services as a result of the COVID-19 pandemic. [1] More than 87 percent of respondents in the study stated that their “daily life has become more stressful due to the Corona pandemic.”

That infection prevention measures are essential is evident in the characteristics of the SARS-CoV-2 virus. In addition to the main route of transmission by droplets and aerosols, surface infections can also play a role [2]. In fact, Japanese researchers discovered that this coronavirus has up to four times longer survival time on human skin than influenza A virus, the typical virus of flu season. [3]

As a result, the three W’s—wear your mask, watch your distance, wash your hands—are essential to avoid infections with the coronavirus and also other pathogens.

3 W‘s rules in ambulance services

In addition to the three W‘s rules, the use of personal protective equipment (PPE) is also required to protect against infection in emergency services. Researchers from various hospitals in North Rhine-Westphalia took a closer look at how well these measures were accepted and complied with during the COVID 19 pandemic.

To do this, scientists developed a standardized questionnaire and informed more than 270 paramedic directors about the the survey. After distributing the online link to the various stations, a total of 1,295 emergency services employees responded to the call to participate in the study.

ambulance services and hand hygiene
The ingo-man smart is the ideal hand hygiene dispenser for ambulance services.

The results show that approval of and compliance with 3W‘s rules—including hand hygiene—was widely embraced during the pandemic. With a mean of 4.51 on a 5-point scale (1=disagree, 5=agree completely), acceptance scored slightly higher than compliance with a mean of 4.47.

Hand sanitizer dispensers important in ambulance services

The authors of the study emphasize that despite the positive survey results, hand hygiene must continue to be improved in a targeted manner in order to establish higher infection control standards. This includes improving the hygiene infrastructure—specifically, installing more hand sanitizer dispensers in ambulances and other areas of emergency response.

The fact that hand sanitizer dispensers are not always available and is a frequently cited barrier to why hand sanitization is not performed is noted by an Australian study on hygiene in emergency services. [4] 


Nohl, André, et al. “COVID-19: Akzeptanz und Compliance von persönlicher Schutzausrüstung (PSA) und AHA-L-Regeln (Abstands-und Hygieneregeln) im deutschen Rettungsdienst–eine bundesweite Umfrage.” Notfall+ Rettungsmedizin (2021): 1-8.


[1] Schumann H (2021). Belastungserleben im Rettungsdienst während der Corona-Pandemie-Welle. Stump und Kossendey Verlag.

[2] van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN et al (2020)Aerosol andsurface stabilityof SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 382(16):1564–1567

[3] HiroseR, IkegayaH,NaitoY,WatanabeN,YoshidaT, Bandou R et al (2020) Survival of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) and influenza virus on human skin: importance of handhygiene inCoronavirus disease2019(COVID- 19). Clin Infect Dis

[4] Barr, N. et al. Self-reported behaviors and perceptions of Australian paramedics in relation to hand hygiene and gloving practices in paramedic-led health care. Am J Infect Control, 2017, 45/7,771-778.


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