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ORIGINAL ARTICLE
Year : 2017  |  Volume : 15  |  Issue : 1  |  Page : 4-7

Effectiveness of Training Program Related to Infection Control and Waste Management Practices in a Private Dental College, Pune − A Quasi-Experimental Study


Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India

Date of Web Publication14-Mar-2017

Correspondence Address:
Nitin Gupta
Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_118_16

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  Abstract 

Introduction: Healthcare workers, in general, are susceptible to contracting with infectious diseases. Thus, appropriate infection control practices are of prime importance in academic institutions, wherein under-graduate students form a major part of the oral healthcare team right from the 3rd year of the curriculum. This fact underlines the need to provide extensive training to prevent healthcare-related infections to the patient and themselves. Aim: To assess the effectiveness of training related to infection control and waste management practices among under-graduate students in a private dental institution. Materials and Methods: The present study conducted among 3rd year under-graduate dental students in Pune, 2015 assessed their knowledge, attitude, and practices related to infection control and waste management followed by an intervention in the form of training. A quasi-experimental design (before and after comparison) was employed. Complete enumeration was performed. Results: Out of the 88 students, 46 (52.27%) had good knowledge at baseline, which improved to 72 (81.81%) after the training; 80 (90.90%) had good attitude, which improved to 88 (100%); and 67 (76.13%) had good practice, which improved to 88 (100%). At the baseline, the results showed that the mean knowledge score was 3.45 ± 1.03, the mean attitude score was 2.90 ± 0.28, and the mean practice score was 7.3 ± 0.76. After the training, the results showed that the mean knowledge score was 4.5 ± 0.25, the mean attitude score was 3, and the mean practice score was 8.1 ± 0.5. Conclusion: The training was effective in improving the over-all score of the participants related to the knowledge, attitude, and practice regarding infection control and waste management. Thus, we propose to train the students on various aspects of infection control and waste management and introduce an on-going training program in the curriculum.

Keywords: Dental, infection control, students, training, waste management


How to cite this article:
Ladia S, Gupta N. Effectiveness of Training Program Related to Infection Control and Waste Management Practices in a Private Dental College, Pune − A Quasi-Experimental Study. J Indian Assoc Public Health Dent 2017;15:4-7

How to cite this URL:
Ladia S, Gupta N. Effectiveness of Training Program Related to Infection Control and Waste Management Practices in a Private Dental College, Pune − A Quasi-Experimental Study. J Indian Assoc Public Health Dent [serial online] 2017 [cited 2017 Oct 22];15:4-7. Available from: http://www.jiaphd.org/text.asp?2017/15/1/4/201927


  Introduction Top


Healthcare workers, in general, are susceptible to contracting with infectious diseases while providing patient care if they do not use proper infection control procedures. Direct or indirect contact, droplets, aerosols, or contaminated instruments and equipment can lead to transmission of many infections,[1] wherein hepatitis B virus (HBV), tuberculosis, and human immunodeficiency virus can be the most important ones.[2]

Thus, appropriate infection control practices are of prime importance in any healthcare facility to assure safety of both the patients and the dental healthcare personnel. In academic institutions, the under-graduate students form a major part of the oral healthcare team right from the 3rd year of the curriculum. But the curriculum does not incorporate any specific program to train the students in this field.[3] This fact underlines the need to provide an extensive training to prevent the healthcare-related infections to the patients and to the professionals themselves that has been confirmed by two recent systematic reviews in this field.[4],[5] There is a paucity of literature related to cross-infection control and biomedical waste management among Indian dentists.[6] Thus, this study was undertaken to assess the effectiveness of training related to infection control and waste management among under-graduate students in a private dental institution. Objectives of the study were to assess the knowledge, attitude, and practices related to infection control and waste management of 3rd year Bachelor of Dental Surgery (BDS) students before and after their training process.


  Materials and Methods Top


The study was conducted in a private dental college, Pune, between June 2015 and July 2015 among 3rd year under-graduate dental students. A quasi-experimental design (before and after comparison) was utilized to assess their knowledge, attitude, and practices related to infection control and waste management followed by an intervention in the form of training. Ethical clearance was obtained from the institutional ethical committee. Written informed consent was obtained from the participants. Permission to undertake the study was obtained from the dean of the institution.

All 3rd year BDS students studying in the college were included (N = 88, complete enumeration). This study group was chosen because they come in contact with the patients for the first time during 3rd year of the BDS curriculum. Thus, they should have adequate background information related to these topics so as to prevent any cross-infection.

Questionnaire has been modified from a study among the dental students.[7] The tool was validated before the commencement of the study. Face validity and content validity were assessed. The questionnaire consisted of 17 items, which consisted of questions related to knowledge (5), attitude (3), and practice (9). Close-ended type with multiple choice questions were provided. Each correct answer was scored one and wrong answer was scored zero. The participants were proportioned by grading the scores into good, fair, and poor. For knowledge, the scores 1 and 2 were ranked poor, 3 was ranked fair, and 4 and 5 were ranked as good. For attitude, the score 1 was ranked poor, 2 was ranked fair, and 3 was ranked good. For practice, the scores of 1–3 were ranked poor, 4–6 were ranked fair, and 7–9 were ranked good. The ranking was decided on the basis of the number of questions under each domain and divided into three categories.

The intervention consisted of lectures and demonstration related to various aspects of infection control and waste management, which were delivered by the teaching faculties in the Department of Public Health Dentistry. The lectures included information on various types of wastes and their disposal techniques, methods of sterilization, infection control procedures, etc. Single-handed scoop technique and gloving technique were demonstrated.

A postintervention survey was undertaken after 2 months to assess the change in the knowledge, attitude, and practices related to infection control and waste management.

Descriptive and analytical statistics were calculated using the Statistical Package for the Social Sciences version 20 software. Mean and standard deviation (SD) were calculated for each domain. Paired t test was used to assess the difference among the knowledge, attitude, and practice scores before and after the training. The proportion of participants was compared before and after the intervention using the chi-square test. Correlation was assessed among knowledge, attitude, and practice using Pearson’s correlation coefficient.


  Results Top


Out of the 88 students, 46 (52.27%) had good knowledge at baseline, which improved to 72 (81.81%) after the training; 80 (90.90%) had good attitude, which improved to 88 (100%); and 67 (76.13%) had good practice, which improved to 88 (100%) [Table 1].
Table 1: Proportion of participants with grading of scores at baseline and after training

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At the baseline, the results showed that the mean knowledge score was 3.45 ± 1.03; the mean attitude score was 2.90 ± 0.28; and the mean practice score was 7.3 ± 0.76. After the training, the results showed that the mean knowledge score was 4.5 ± 0.25, the mean attitude score was 3, and the mean practice score was 8.1 ± 0.5.

HBV was considered the greatest occupational healthcare worker risk for the blood-borne infection. Most of the participants were not aware of the one-handed scoop technique. 40% of the participants were not aware of the correct autoclave functioning temperature and pressure. After the training, all participants answered questions related to autoclave correctly (temperature − 121°C, 15 lbs pressure). They were aware of one-handed scoop technique as a work practice control.

There was a statistically significant difference between the mean knowledge and practice scores at baseline and after training (P ≤ 0.001). There was a statistically significant difference between the proportion of people with good knowledge and practice at baseline and after training (P ≤ 0.001) [Table 2]. A positive correlation was found between knowledge and practice [Table 3].
Table 2: Statistical analysis of baseline and after training scores

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Table 3: Correlation among knowledge, attitude, and practice using the Pearson’s correlation co-efficient

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  Discussion Top


Literature pertaining to knowledge, attitude, and practices related to infection control and waste management among dental students and professionals reinstates the need for training. This study was undertaken to assess the effectiveness of training among dental students.

At the baseline

The mean ± SD scores of knowledge, attitude, and practice were 3.45 ± 1.03, 2.90 ± 0.28, and 7.3 ± 0.76 with a maximum score of 5, 3, and 9, respectively. A study by Agrawal et al.[7] among dental students in Central India showed that the mean ± SD scores of knowledge, attitude, and practice scores were 3.75 (1.01), 3.40 (0.75), and 3.35 (1.04) with a maximum score of 6, 4, and 5, respectively.

Another study conducted by Santra et al.[8] among dental professionals in Bareilly showed that the mean ± SD scores of knowledge, attitude, and practice toward standard isolation precautions were 6.71 ± 0.99, 34.99 ± 4.47, and 4.97 ± 2.17 with the maximum scores of 9, 45, and 9, respectively.

The mean ± SD scores of knowledge, attitude, and practice scores were 4.35 ± 1.63, 4.69 ± 1.97, 4.43 ± 0.78, respectively, with maximum scores of 9, 5, and 10 in a study conducted by Sanjeev et al.[9] among dental healthcare personnel in Kothamangalam.

Out of the 88 students, 46 (52.27%) had good knowledge, 26 (29.54%) had fair knowledge, 16 (18.18%) had poor knowledge, 80 (90.90%) had good attitude, 8 (9.09%) had fair attitude, 67 (76.13%) had good practice, and 21 (23.86%) had fair practice.

A study conducted by Arora et al.[10] involving dentists in Chattisgarh reported that only 48% of the dental students were aware of waste management guidelines.

A study conducted by Akbulut et al.[11] among dental in Turkey indicated that 77% of the dental students had adequate knowledge.

Recent studies in India concluded that there was a lack of knowledge, attitude, and practices of biomedical waste management and infection control among dental healthcare personnel.[12],[13],[14],[15]

HBV was considered the greatest occupational healthcare worker risk for the blood-borne infection, which is similar to a study conducted by Zagade and Pratinidhi[16] among bio-medical waste handlers in Chennai.

Most of the participants were not aware of the one-handed scoop technique. 40% of the participants were not aware of the correct autoclave functioning temperature and pressure.

In the present study, after the training

The mean ± SD scores of knowledge, attitude, and practice score increased to 4.5 ± 0.25, 3, and 8.1 ± 0.5, respectively, and in that, 72 (81.81%) had good knowledge, 16 (18.18%) had fair knowledge, 88 (100%) had good attitude, and 88 (100%) had good practice.

Participants answered questions related to autoclave correctly (temperature − 121°C, 15 lbs pressure). They were aware of one-handed scoop technique as a work practice control.

A study by Basarkar among hospital staff in Maharashtra observed that there was a highly significant improvement among knowledge and practice scores after educational intervention. The mean pre-training knowledge score was 9.3 ± 3.9, which improved to 20.0 ± 2.4. The mean pre-training practice score was 7.8 ± 3.8, which improved to 21.6 ± 3.8. Initially, there were 110 (58.8%) workers in the poor category, who all improved after educational intervention. Majority of them were 148 (79.1%) in excellent category of knowledge after training. Initially, there were 157 (83.9%) in the poor category of score, and 83 (44.3%) were in the excellent category of practices after educational intervention.[17]In other studies, a significant statistical difference (pre-training and post-training) was found among those who have received training in biomedical waste management, which is evident from the raised level of knowledge and awareness about biomedical waste management.[18],[19],[20]

A survey conducted by Kaushal[19] among intensive care unit nurses in Delhi revealed that there was a significant improvement in the skill levels of the sample respondents after undergoing the training program.

Various studies in India have shown a significant statistical difference (pre-training and post-training) among those who have received training in biomedical waste management, which is evident from the raised level of knowledge and awareness about biomedical waste management.[18],[19],[20],[21] Various authors from Sudan, Saudi Arabia, and Yemen have emphasized on the need for training programs with an implementation of an annual audit and education within the dental healthcare centers.[22],[23],[24]

A statistically significant correlation was found between knowledge and practice in the present study. A study undertaken in central India by Singh et al.[25] among dental students found a significant correlation between attitude and practice scores. Possible limitations of our study could be the duration (2 months) and skewed gender representation, which could have affected the results. Further research with a stronger study design and a longer follow-up period is mandated.


  Conclusion Top


We conclude that training had a profound effect on the knowledge, attitude, and practice of students related to infection control and waste management. Thus, we recommend an on-going training program to the institute for students in the college.

Acknowledgements

We thank Dr. K. Pushpanjali, HOD, Department of Public Health Dentistry, Faculty of Dental Sciences, MSRUAS.

Financial support and sponsorship

This study was approved and funded by Indian Council of Medical Research under Short Term Studentship project: 2014–15 (Ref. ID: 2015-03462).

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3]



 

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