Pennsylvania dental hygienists' knowledge, attitudes, and infection control practices in relation to AIDS and AIDS patients.

PURPOSE: Limited documentation is found on dental hygienists' attitudes toward acquired immunodeficiency syndrome (AIDS) patients and their knowledge and practice of clinical infection control to prevent disease transmission to themselves and their patients. The purpose of this paper was to survey practicing Pennsylvania dental hygienists to document 1) their infection control practices; 2) their attitudes towards AIDS patients; and 3) their knowledge of clinical infection control practices.

METHODS: A self-administered survey questionnaire, with fixed-alternative responses, was mailed in January 1991 to a random sample (N = 300) of licensed, practicing Pennsylvania dental hygienists. The questionnaire comprised eight multiple-choice questions for demographic purposes and 89 Likert-type questions eliciting information in five areas: AIDS-related knowledge, attitudes toward AIDS patients, knowledge of recommended Centers for Disease Control and Prevention (CDC) infection control measures, individual infection control measures, and individual laboratory infection control measures. Means and modes for individual questions and for specific categories were determined and analyzed utilizing Spearman rho correlation coefficients (p < .05). Mean scores were also tabulated for actual operator/laboratory infection control practices for both a routine patient and an AIDS patient. Those scores were analyzed utilizing the Wilcoxen signed-ranks test.

RESULTS: Two hundred twenty questionnaires were returned for a 73.3% initial response rate. One hundred fifty-four of those returned were usable, for a 64% response rate. Results indicated that 94.2% of surveyed dental hygienists had comprehensive knowledge about AIDS and 92% had comprehensive knowledge of CDC-recommended infection control procedures. Eighty-five percent of respondents possessed a moderate or high feeling of worry concerning treatment of AIDS patients. The majority of surveyed dental hygienists routinely practiced the use of glasses, masks, and gloves; the use of disposable items; and surface disinfection of light handles, instrument bracket trays, and patient chair switches. Knowledge of recommended infection control procedures for dentistry was found to be associated (r = .22) with adherence to recommended infection control practices. Accurate knowledge about AIDS showed a weak (r = -.088) and nonsignificant relationship with dental hygienists' attitudes toward AIDS patients. Use of recommended infection control practices was found to be associated (r = -.20) with less fear concerning the treatment of AIDS patients. In addition, dental hygienists' infection control practices varied according to their perception of patient HIV status.

CONCLUSIONS: Since Pennsylvania dental hygienists, within the limitations of this study, appear not to follow CDC guidelines on proper and responsible operatory/laboratory aseptic techniques stringently, and to differentiate infection control procedures based on perceived patient HIV status, recommendations are that 1) the Commonwealth of Pennsylvania should mandate that all Pennsylvania-licensed dental hygienists take at least one state-approved course on operatory/laboratory infection control every two years to qualify for relicensure; 2) all dental and dental hygiene education institutions and professional organizations should place more emphasis on strict adherence to the various agency recommended clinical guidelines for infection control; and 3) all dental hygienists should continually strive to update their own knowledge of current infection control practices.