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公共牙科护理服务中的感染控制措施:来自南非一个省份的调查结果

Infection control practices in public dental care services: findings from one South African Province.

作者信息

Mehtar S, Shisana O, Mosala T, Dunbar R

机构信息

Academic Unit for Infection Control, Tygerberg Hospital, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.

出版信息

J Hosp Infect. 2007 May;66(1):65-70. doi: 10.1016/j.jhin.2007.02.008. Epub 2007 Apr 11.

Abstract

Infection control practices which increase the risk of blood-borne virus transmission with associated dental practice in one South African province were studied. All 24 state dental clinics were observed for adequate provision to carry out good infection prevention and control (IPC) practice, 75 staff including dentists, nurses and dental assistants were interviewed to assess IPC knowledge and 23 dental procedures were observed. Significant findings were the difference between knowledge and practice, despite adequate provisions for safe infection control practice. The lack of protective eye wear during a dental procedure, not washing hands between patients, not disassembling an item prior to disinfection or sterilization, and not using a sterile drill for each patient were identified. A rapid method for detection of occult blood was used as a marker for inadequate IPC practice. Contaminated dental items of equipment just prior to patient use in 25% of equipment tested and 37% of surfaces and surrounding areas in the dental clinics and units were recorded. This study concludes that, despite provision for safe dental practice available in state dental clinics, there was a lack of knowledge application in clinical practice. The risk of blood-borne virus transmission in a population with high human immunodeficiency virus (HIV) prevalence cannot be ignored.

摘要

对南非一个省份中与牙科诊疗相关的、会增加血源病毒传播风险的感染控制措施进行了研究。对该省所有24家公立牙科诊所进行了观察,以评估其是否具备实施良好感染预防与控制(IPC)措施的条件;对包括牙医、护士和牙科助理在内的75名工作人员进行了访谈,以评估他们的IPC知识;并对23项牙科操作进行了观察。显著的发现是,尽管有足够的安全感染控制措施,但知识与实践之间仍存在差异。确定了牙科操作过程中缺乏护目镜、患者之间不洗手、消毒或灭菌前不拆卸物品以及不为每位患者使用无菌钻头等问题。一种检测隐匿性血液的快速方法被用作IPC措施不充分的指标。记录显示,在接受检测的设备中,有25%在即将用于患者之前被污染,在牙科诊所和科室中,有37%的表面和周边区域被污染。本研究得出结论,尽管公立牙科诊所具备安全牙科诊疗的条件,但临床实践中仍缺乏知识应用。在人类免疫缺陷病毒(HIV)感染率较高的人群中,血源病毒传播的风险不容忽视。

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