Hübner Nils-Olaf, Handrup Stephan, Meyer Georg, Kramer Axel
Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Germany.
GMS Krankenhhyg Interdiszip. 2012;7(1):Doc14. doi: 10.3205/dgkh000198. Epub 2012 Apr 4.
To assess trends in hygiene management in dental practices in comparison to an earlier survey in 2002/2003 and to point out key aspects for future efforts.
The infection prevention management of all dental practices in Greifswald (n=35) was determined by a questionnaire in a personal interview in 2008/2009.
26% of the dentists did not use sufficient personal protective equipment during the general examination of the patient. In conservative and prosthetic dentistry, 15% still did not use adequate measures and 9% did not even in surgical interventions. Vaccination coverage was clearly too low, as only 35% of dentists were vaccinated against influenza and coverage with other vaccinations was also quite low. 11% of the dentists did not perform a documented anamnesis and in 29% of the dental practices no appointment system for risk patients existed.There were significant deficiencies in the reprocessing of medical devices and in the equipment needed for reprocessing. The opportunity to participate in further training in this field was rejected by 23% of the dentists.In 10 dental practices, the colony count in the dental unit water-conducting system was five times higher than the limit. A contamination with P. aeruginosa was discovered in 4 practices. All units were renovated.
Overall, both the hygiene management and hygiene equipment in the practices have improved considerably compared to the previous survey in 2002/2003. This demonstrates the positive effect of the KRINKO guidelines from 2006. However, the survey again showed relevant deficiences in the hygiene management of dental practices, which agrees with a Germany-wide online survey from 2009.
While the study revealed persistent deficiencies in hygiene management, especially in reprocessing, it confirms that the KRINKO guidelines for dental practices from 2006 led to significant improvements in hygiene management. Doubts about the impact of the guidelines are not backed by evidence.
与2002/2003年的早期调查相比,评估牙科诊所卫生管理的趋势,并指出未来工作的关键方面。
2008/2009年通过个人访谈中的问卷对格赖夫斯瓦尔德所有牙科诊所(n = 35)的感染预防管理情况进行了调查。
26%的牙医在对患者进行一般检查时未使用足够的个人防护设备。在保守牙科和修复牙科中,15%的人仍未采取适当措施,在外科手术中甚至有9%的人也未采取。疫苗接种率明显过低,只有35%的牙医接种了流感疫苗,其他疫苗的接种率也相当低。11%的牙医未进行有记录的问诊,29%的牙科诊所没有针对高危患者的预约系统。医疗器械的再处理以及再处理所需的设备存在重大缺陷。23%的牙医拒绝参加该领域的进一步培训。在10家牙科诊所中,牙科设备导水系统中的菌落数比限值高五倍。在4家诊所中发现了铜绿假单胞菌污染。所有设备都进行了翻新。
总体而言,与2002/2003年的上次调查相比,诊所的卫生管理和卫生设备都有了显著改善。这证明了2006年KRINKO指南的积极作用。然而,调查再次显示牙科诊所的卫生管理存在相关缺陷,这与2009年德国范围内的在线调查结果一致。
虽然该研究揭示了卫生管理方面持续存在的缺陷,尤其是在再处理方面,但它证实了2006年牙科诊所的KRINKO指南在卫生管理方面带来了显著改善。对该指南影响的怀疑没有证据支持。