Healy C M, Kearns H P O, Coulter W A, Stevenson M, Burke F J T
Department of Oral Surgery, Oral Medicine and Oral Pathology, Dublin Dental School and Hospital, Lincoln Place, Dublin 2, Ireland.
Int Dent J. 2004 Aug;54(4):182-6. doi: 10.1111/j.1875-595x.2004.tb00278.x.
To assess by postal questionnaire, cross-infection control methods, especially sterilisation procedures, of 700 general dental practitioners in the Republic of Ireland, and to biologically monitor steam pressure sterilisers or autoclaves in their practices.
Methods of instrument cleaning and sterilisation, autoclave efficacy.
A response rate of 40% with all, except one practitioner, using steam sterilisation. 49% also reported the use of chemical sterilisation with a quarter of these using glutaraldehyde. However, instrument soaking time varied greatly from 2.5 minutes to 74 hours. Methods of instrument cleaning prior to autoclaving were as follows: scrubbing by hand 41.5%, ultrasonic cleaning 7.0%, combination of both 50%. 52.9% of the respondents did not autoclave their dental handpieces and only 44.7% disinfected impressions before sending them to the laboratory. The autoclaves of thirty practitioners (11.3%) did not pass the initial biological test. Following counselling about possible causes of failure, four autoclaves (1.5%) failed a repeat biological test. However, seven practitioners did not return the repeat biological test.
Some aspects of recommended cross-infection control procedures are well adhered to, e.g. instrument cleaning, but further education is required in certain key areas, in particular the use of chemical sterilisation, dental handpiece autoclaving and impression disinfection. There is also a need to increase awareness of the importance of routine autoclave servicing and calibration, along with validation and monitoring.
通过邮寄问卷的方式评估爱尔兰共和国700名普通牙科医生的交叉感染控制方法,尤其是灭菌程序,并对他们诊所中的蒸汽压力灭菌器或高压灭菌器进行生物监测。
器械清洁和灭菌方法、高压灭菌器效能。
回复率为40%,除一名医生外,所有医生均使用蒸汽灭菌。49%的医生还报告使用化学灭菌,其中四分之一使用戊二醛。然而,器械浸泡时间差异很大,从2.5分钟到74小时不等。高压灭菌前器械的清洁方法如下:手工擦洗占41.5%,超声清洁占7.0%,两者结合占50%。52.9%的受访者不对牙科手机进行高压灭菌,只有44.7%的人在将印模送往实验室前进行消毒。30名医生(11.3%)的高压灭菌器初次生物测试未通过。在就可能的失败原因进行咨询后,4台高压灭菌器(1.5%)重复生物测试未通过。然而,7名医生未返回重复生物测试结果。
推荐的交叉感染控制程序的某些方面得到了很好的遵守,如器械清洁,但在某些关键领域还需要进一步教育,特别是化学灭菌、牙科手机高压灭菌和印模消毒的使用。还需要提高对常规高压灭菌器维护和校准以及验证和监测重要性的认识。