A Study on Actual Conditions for Prevention of Infections by Dental Hygienists

치과위생사의 감염 예방 실태 조사

This study aimed to provide basic information on dental hygienists' practicing the prevention of infections by figuring out their actual conditions in dental clinics. The subjects of the study were the dental hygienists who participated in the continuing medical education of Incheon & Gyeonggi-do association and Seoul city association in October and November 2005 and the self-administered surveys were used for the prevention of infections. The results were as below. 1. In terms of education experiences of infection prevention, those who answered "there were" were 72 persons (42.9%) and those who followed the educational route for infection prevention were "through the in-house education from the hospital" and they were 42 persons (58%), which were highest. 2. In terms of the injury experiences, those who answered "there were" were 147 persons (87.5%) and the number of annual injury out of 147 persons with injury experiences was 7.7 time. For the tools that were damaged, 125 persons (75%) damaged the "explorer," which was highest. 3. For the experiences of being infected with contagious diseases, those who answered "there were" were 6 persons (3.6%) and there were four persons for "hepatitis B", one person for "rubella" and one person for "TB." 4. The questions with high practice scores were as in the following: "2. I wash my hands after conducting medical examinations (1.86 points)," "7. I always close the lid of a shot of Novocain after doing local anesthesia (1.86 points)" and "20. I separate and collect the wastes and give them to those who treat accumulated materials (1.85 points)". Meanwhile, the questions with low practice scores were as below: "16. I change my medical gowns (doctor wears) once a day (0.24 point)" and "I wash my medical gowns every time after examining patients with contagious diseases (0.52 points)." 5. The question with high knowledge was as below: "1. The contagion during the dental treatment is determined by source of infection, infection methods, infection routes and the host that is prone to infection (0.95 point)" and the question with the lowest knowledge was "5. HBV(hepatitis B) is destroyed after adding 95oC of heat for more than 5 minutes (0.27 points)." 6. The question with the highest organization-related factors was "I am always ready to use a mask, gloves, etc. if necessary" (0.89 points)" and the question with the lowest score was "There is a guideline that I can refer when I am exposed to dangerous situations related to the contagion in my workplace (0.33 point)." 7. In terms of the equipment conditions of protectors in medical environments, 168 persons for (disposable) mask (100%), 167 persons for disposable gloves (Latex) (99.4%), which meant that most of them were equipped with them. On the contrary, 108 persons (64.3%) are equipped with the protectors for frontal faces, which is the lowest and 165 persons (98.2%) said that they had autoclave in their disinfecting and sterilizing devices.

이 연구는 치과 진료실에서 치과위생사의 감염예방 실태를 파악하여 치과위생사가 감염예방을 실천하는데 기초 자료로 제공하고자 한다. 연구 대상은 2005년 10월과 11월에 인천경기도회와 서울시회 보수교육에 참여한 치과위생사로 하였으며, 감염 예방에 관한 설문조사를 자기기입방식으로 시행하였다. 그 결과는 다음과 같다. 1. 감염예방 교육경험은 "있다"로 응답한 자가 72명(42.9%)이었고, "없다"고 응답한 자가 96명(57.1%)이었고 감염예방 교육경로를 보면 "근무병원 자체 교육을 통해서"가 42명(58%)으로 가장 많았다. 2. 손상 경험은 "있다"로 응답한 자가 147명(87.5%)이었고 "없다"로 응답한 자가 21명(12.5%)이었으며, 손상 경험이 있는 대상자 147명의 전체 연 평균 손상 횟수는 7.7회였다. 손상을 입힌 기구 명으로는 "explorer"가 125(75%)명으로 가장 많았다. 3. 감염성 질환에 감염된 경험은 "있다"로 응답한 자가 6명(3.6%)이었는데 질환으로는 "B형 간염"이 4명으로 가장 많았고, "풍진" 1명, "결핵" 1명이었다. 4. 실천 점수가 높은 문항은 "2. 나는 진료 후에 손을 씻는다(1.86점)", "7. 나는 국소 마취 후 마취주사바늘 뚜껑을 덮는다(1.86점)", "20. 나는 폐기물을 분리수거하여 적출물처리업자에게 위탁 한다(1.85점)"이었으며, 실천 점수가 낮은 문항은 "16. 나는 진료복을 하루에 한번 갈아입는다(0.24점)"와 "감염성 환자 진료 후에는 진료복을 매번 세탁 한다(0.52점)"이었다. 5. 지식도가 가장 높은 문항은 "1. 치과 진료를 하는 동안에 전염은 감염원, 전염방법, 전염경로, 감염되기 쉬운 숙주에 의해 좌우 된다(0.95점)" 이었으며 지식도가 가장 낮은 문항은 "5. HBV(B형간염)는 95oC에서 5분 이상 가열해야 파괴 된다(0.27점)"이였다. 6. 조직관련 요인 점수가 가장 높은 문항은 "나는 필요한 경우 마스크, 장갑 등의 보호 장구가 항상 이용 가능하다(0.89점)"이었으며 가장 점수가 낮은 문항은 으로 "내가 일하는 곳에는 감염과 관련된 위험한 상황에 노출되었을 때 참고할 수 있는 지침서가 있다(0.33점)" 이었다. 7. 진료환경에서 세면대와 진료실의 거리는 "1미터 미만"이 116명(69.0%), 소독실과 진료실의 거리는 "2미터 미만"이 77명(45.8%)으로 가장 많았으며 보호 장구 구비 현황은 마스크(일회용) 168명(100%), 일회용 장갑(라텍스) 167명(99.4%)으로 대부분 구비되어 있었다. 반면 안면 보호대는 응답자수가 108(64.3%)명으로 가장 적었다. 소독, 멸균기에서는 autoclave가 있다고 응답한 자가 165명(98.2%)이었다.