Systematic review of adherence to infection control guidelines in dentistry (original) (raw)

2001, Journal of Dentistry

To determine the knowledge and attitudes of dental health care workers (DHCWs) towards infection control procedures, to examine DHCWs' practice in respect of infection control, and to determine whether a relationship exists between knowledge, attitudes and behaviour. Searching MEDLINE, EMBASE, the Science Citation Index and Social Sciences Citation Index (via BIDS), the Cochrane Library, NHS EED, SIGLE and the British Dental Association library were searched for reports in any language. Papers published between 1980 and 1999 were included. In addition, three journals were handsearched, abstracts were retrieved from professional meetings and conferences, and a panel of key researchers in the field were contacted. Sensitive search strategies were also developed from keywords and abstracts of papers identified through the review team's previous work. The search terms were not specified. Study selection Study designs of evaluations included in the review Randomised controlled trials, clinical controlled trials,controlled before-and-after studies, interrupted time series studies, observational studies, surveys and reports of infection control procedure uptake were included. Specific interventions included in the review The included studies described a standard of practice which implicitly met the definition of an infection control guideline in dental practice. Participants included in the review The participants were DHCWs including: dentists, dental nurses ordental surgery assistants, dental hygienists, dental therapists, dental students and dental laboratory workers. Outcomes assessed in the review The outcome measures were:glove use, mask use, use of protective eyewear and the changing of these items between patients; the wearing of protective clothing; the sterilisation of instruments and handpieces between patients; the disinfection of surfaces; hepatitis B vaccination of clinical staff; the use of disposable items and waste disposal; the training of staff in the principles of infection control; the knowledge of the dental team regarding blood borne infections; the willingness to treat HIV-infected patients; and an infection control policy in place, an accident book for the recording of occupational injuries in place, and post-exposure protocol for each practice. Both the observed and selfreport measures of these outcomes were considered. How were decisions on the relevance of primary studies made? All studies which met the predefined criteria were included in the review. Two reviewers independently selected the studies to be included, and any disagreements were resolved by discussion with all review team members. Assessment of study quality Validity was assessed using a checklist based on the standard checklist produced by the NHS Centre for Reviews and Dissemination. Two researchers independently performed the quality assessment, and any discrepancies were resolved by discussion. Data extraction The data extraction was performed by one reviewer and checked by a second.