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Abundant Opportunities to Improve Infection Control Training and Assessment in Dentistry

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      Background

      Infection control (IC) training and practice in dental facilities is not well studied. The Nebraska Infection Control Assessment and Promotion program (ICAP) offers free consultations to Nebraska healthcare facilities, in which infection preventionists visit the site, interview stakeholders, and provide a complete assessment of the facility's IC program using an adaptation of the Centers for Disease Control's “Basic Expectations of Safe Care” infection prevention checklist. Here, we report the ICAP team's findings during voluntary assessments of dental IC programs.

      Methods

      ICAP solicited invitations into eighteen dental facilities (nine private practice clinics, seven public health clinics, and two other facilities) across Nebraska from 2018-2021. Fourteen assessments were conducted in 2018-2019 and four from April to June 2021; assessments were suspended in the interim due to the COVID-19 pandemic.

      Results

      We found 24% of facilities provided no IC training to employees upon hire and 35% did not provide annual refresher trainings. When facilities did offer training, key subjects were frequently omitted, including safe injection practices (omitted in 60%), protective personal equipment (PPE) selection and use (50%), hand hygiene (44%), and sterilization and disinfection procedures (38%). Few facilities required employees to demonstrate competency in PPE selection (19%), safe infection practices (7%), or hand hygiene or sterilization and disinfection (0% each). Additionally, few facilities performed audits with feedback regarding adherence to proper procedures for sterilization and disinfection (19%), hand hygiene (6%), PPE selection and safe infection practices (0% each). New hire and annual IC training rates were higher in post-pandemic assessments, but other measures had not improved.

      Conclusions

      Most dental facilities offered employees IC trainings, but these were often neither routine nor comprehensive. Important gaps in dental IC programs included failures to assess employee competency regarding IC procedures and failures to engage in audit and feedback processes to ensure adherence to IC measures.