A Systematic Review of the Knowledge, Attitudes and Behaviour of the Dental Team and Their Adherence to Infection Control Guidelines

Gordon, Beth L (2000) A Systematic Review of the Knowledge, Attitudes and Behaviour of the Dental Team and Their Adherence to Infection Control Guidelines. Master in Medical Science thesis, University of Glasgow.

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The increased profile of infections arising from blood-borne viruses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) since the 1980s has resulted in an examination of dental surgery infection control procedures. Infection control procedures in dentistry principally protect the patient from microorganisms present on the dentist's hands and on instruments or equipment used on previous patients. A secondary function of some infection control procedures is the protection of the operator from micro-organisms which may be present in the patient's mouth. In these respects, many guidelines have been issued to dental health care workers (DHCWs) concerning, for example, the wearing of gloves, masks, and the autoclaving of handpieces. The purpose of the present review was to investigate the dental team's knowledge, attitudes and behaviour with regard to infection control and relevant guidelines. The present review outlined three objectives: to determine the knowledge and attitudes of GDPs towards infection control procedures; to determine the DHCWs practising behaviour in respect of infection control; to determine whether a relationship exists between knowledge, attitudes and behaviour (e.g. adherence to guidelines). The studies included in this review suggest that the overall rate of adherence to infection control guidelines in the dental profession is less than adequate and therefore needs to be improved. Several measures, such as hepatitis B vaccine acceptance and the sterilisation of hand instruments, are indicative of an increase in compliance with guidelines, but these successes are far outweighed by shortcomings. In particular, post-exposure follow-up, vaccination follow- up and impression disinfection are measures which tend to be overlooked by the dental team and require attention. Gaps are also evident in the dental team's knowledge of infectious diseases and cross-infection control. By improving their knowledge by means of interventions, the attitudes and behaviour of the team may follow suit. Current guidelines are explicit and widely available to the dental team, but the policing of their implementation could be improved. By setting up independent bodies to deal with practice inspections, the rate of guideline compliance could perhaps be increased. To help in this task, researching of the key indicators of guideline adherence would enable a checklist to be developed and to be used by independent practice inspectors to pinpoint non-compliant practices. The level of occupational health support could likewise be improved in practices in relation to hepatitis B vaccination follow-up and follow-up to occupationally acquired injuries, both of which have been highlighted as key problem areas. Furthermore, the role of the dental surgery assistant is central to infection control, however, the rate of adherence within this particular group is inadequate and requires attention. An equalising of standard training and certification, on a global scale, may rectify this situation. A systematic review of the literature has indicated that new methodological techniques need to be introduced for the assessment of the dental team's compliance with infection control guidelines. Inclusion of a greater observational element within study design may help to reduce the socially desired responses resulting from the questionnaire-based and interview survey data currently available and offer more reliable answers to the questions being posed. This points to an urgent need for a properly structured contemporary examination of dental practice infection control world-wide, using optimum methodology. (Abstract shortened by ProQuest.).

Item Type: Thesis (Master in Medical Science)
Qualification Level: Masters
Additional Information: Adviser: Trevor Burke
Keywords: Dentistry
Date of Award: 2000
Depositing User: Enlighten Team
Unique ID: glathesis:2000-74935
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 27 Sep 2019 15:06
Last Modified: 27 Sep 2019 15:06
URI: https://theses.gla.ac.uk/id/eprint/74935

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