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Authors:Dr.Krishna Prasad,Dr.ChethanHegde,Dr.Manan Buch.

Abstract :
Health professionals in their day to day life deal with patients and they get exposed to many infectious materials.  High standards of infection control and safety (IC & S) practice are necessary in improving patient safety and reducing occupational exposure to blood borne diseases. Sterilization and disinfection are essential for ensuring that medical and surgical instruments do not transmit infectious pathogens to patients.
This article describes the results of survey conducted to assess awareness of sterilization and disinfection among post-graduate students of various health science colleges of south coastal Karnataka.

INTRODUCTION:
Health professional from various health sciences like medical, dental, nursing, and allied sciences come across various patients with various diseases in their routine practice. They are always at a higher risk of acquiring infections caused by pathogenic organisms. To avoid that it is very important to maintain proper sterilization and disinfection of the instruments as well as the working area. Occupational Safety and Health Administration (OSHA) has given guidelines and they have divided materials and instruments under three main categories that is critical, semi-critical and non- critical. Based on that all the instruments and materials should be divided into different categories and appropriate steps should be taken to achieve proper infection control. Health professionals should have a thorough knowledge of various methods of sterilization and infection control and disposal method of different types of bio-medical waste.
The purpose of this epidemiological survey wasto assess awareness of sterilization and disinfection among the postgraduate students of various health science colleges in south coastal region of Karnataka.

MATERIALS AND METHODS:
The study sample consisted of 200 subjects, with 100 males and 100 females. Participants selected were postgraduates of health science colleges including medical, dental, nursing and allied sciences in south coastal region of Karnataka between the age group of 22-30 years. An informed consent was taken from each participant before conducting the survey. The information was collected with the help of special prepared questionnaire, which consisted 20 questions in relation to sterilization and disinfection protocols and the awareness for the same among the postgraduate health science students.

RESULTS:
Questionnaire forms from each participants were collected and results were analysed based on number of correct answers given. Results were subdivided in four categories:

  • Excellent (more than 15 correct answers)
  • Good (less than 15 more than 10 correct answers)
  • Average (less than 10 more than 5 correct answers)
  • Poor (less than 5 correct answers)
  • Awareness about sterilization:
       
    Graph 1: Awareness among male postgraduate students about sterilization Graph 2: Awareness among Female postgraduate students about sterilization
         
    Graph 3: isolation methods followed by postgraduate students Graph 4: Vaccination received by postgraduate students Graph 5: Awareness about protocols in HIV infection cases
    DISCUSSION:
    Due to the nature of their profession, health professionals should not forget the risk of treating patients with probability of infectious diseases. Health professionals and patients may be exposed to pathogenic microorganisms localized in oral cavity and respiratory tract including cytomegalovirus (CMV), HBV, HCV, herpes simplex virus (HSV) type 1 and 2, HIV, Mycobacterium tuberculosis, staphylococci, streptococci and other viruses and bacteria.1
     These microorganisms could be transmitted to the health care professionals by direct contact with a patient's saliva, blood, skin, and oral secretions, or by indirect contact through injuries caused by sharp contaminated instruments, or by droplet infection from aerosols or spatter. 1,2,3.
    There are two reasons why dental health care workers must wear operating gloves: to prevent transmission of infection from the operator's hands to the patients, and to prevent contact of blood and saliva with the operator's hands.4
    In present study out of total 200 postgraduate health science students 95% knew that
    sterilization destroys all microbes including spores.87% students wash their hands before and after patient examination with antiseptic solution.70% students follow proper isolation methods in their all clinical procedures and 99% students are aware of sterilization method used in their department for instrument sterilization.76% students have taken vaccination against hepatitis and 80% students take all protective measures like mouth masks, and gloves ,protective eye wares to protect them from injury.
     But they have very poor knowledge about color coding of hospital waste disposal. Only 57% students knew the color coding for disposal of blood contaminated cotton and gloves and 60% were aware of proper method of sharp waste disposal. It was found that majority of students do not sterilize their hand pieces on regular basis and only 65% students were aware of proper method of sterilization of hand pieces. 80 %students were aware of formaldehyde fumigation which is done to fumigate clinical areas, wards and operation theatres. 68% students knew the correct protocol in situation of direct blood contact with HIV patients. 67% students were aware of probability of HIV transmission after a needle injury.
    This epidemiological survey reveals that post graduate students in colleges of south coastal Karnataka have good knowledge of sterilization and disinfection. They are also well aware of isolation methods and various methods used to practice sterilization in clinical procedures. But it was found that they do not follow these procedures meticulously. In spite of having all the instruments necessary, regular sterilization of instruments is neglected. Another outcome of this survey was that students have very limited knowledge regarding biomedical waste management and colour coding for different types of waste generated. Knowledge about HIV infection control and management of medically compromised patients is also very poor.
                     To overcome these problems strict sterilization protocols should be followed and arrangements should be made to enrich their knowledge in areas like management of biomedical waste and management of medically compromised patients.

    CONCLUSION:
    1. Overall results shows that postgraduate health science students have good knowledge of sterilization and they are aware of various method used.
    2. Female students have slightly more awareness as compared to male students.
    3. Improvement in subjects like hospital waste management and management of medically compromised patients is required.

    REFERENCES:
    1. Bolyard EA, Tablan OC, Williams WW, Pearson ML, Shapiro CN, Deitchman SD. Guideline for infection control in health care personnel, 1998. Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1998;26:289-354.        
    2. Centers for Disease Control and Prevention. Recommended infection-control practices for dentistry. MMWR Morbid Mortal Wkly Rep. 1993;42:1-12.
    3.Verrusio AC, Neidle EA, Nash KD, Silverman S Jr, Horowitz AM, Wagner KS. The dentist and infectious diseases: a national survey of attitudes and behavior. J Am Dent Assoc. 1989;118:553-62.
    4. Wood PR. A practical gloving and handwashing regimen for dental practice (letter). Br Dent J. 1992;172:367-8.    

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