Maintaining asepsis in paramedicine: a Delphi study

Background: The body’s natural defences are breached during invasive procedures conducted during paramedic clinical care. Despite the complexity of these procedures, asepsis is a clinical goal for all invasive procedures. In doing so, it is critical that ‘key-parts’ and ‘key-sites’ are protected to decrease the risk of transmitting healthcare-associated infections (HAIs). Although a national framework in Australia for the prevention of HAIs exists, this advice needs adapting to the field of paramedicine to account for variation in practice setting and clinical practice. This project aimed to reach consensus among experts regarding how to maintain asepsis in paramedic practice. Methods: A modified Delphi process was used with four iterative online rounds. Participants were sought nationally using a snowball (bias) technique and included professionals within healthcare who met the inclusion criteria of extensive experience in one or more of three areas: Paramedicine, infection prevention and control (IPC) and evidence-based policy development. Results: Eleven experts in the field of IPC and paramedicine contributed to a consensus project regarding how to maintain asepsis in paramedic practice. Conclusion: This project provides a consensus statement that will allow operational procedures to be reviewed, techniques specific to paramedic practice to be developed and implemented, and scientific research to be conducted.