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Table of Contents
ORIGINAL ARTICLE
Year : 2018  |  Volume : 6  |  Issue : 4  |  Page : 73-77

Effectiveness of a training program related to infection control and waste management practices in a dental college: A quasi-experimental study


Department of Public Health Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India

Date of Web Publication14-May-2019

Correspondence Address:
Dr. Mayank Das
Department of Public Health Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_8_19

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  Abstract 

Introduction: Biomedical waste is an important public health concern regarding waste management and diseases related to this issue in developing countries. Aim: This study was undertaken to assess the effectiveness of training related to infection control and waste management among undergraduate students in a dental institution. Materials And Methods: This was a quasi-experimental study carried out in two dental colleges, including 100 final year students of both the colleges. In group A (experimental group) and group B (control group) at the baseline, a questionnaire and a lecture were given. Follow-up and assessment were conducted at 1 and 3 months, and at the end of 6 months. Collected data were analyzed, and independent t test and one-way analysis of variance test were used for the analysis. Result: Knowledge and attitude scores in the experimental group showed a statistically significant increase. Practice scores in the experimental group showed a statistically significant increase in scores from 1 to 3 months and from 3 to 6 months. Conclusion: The training program was found to be effective in improving knowledge, attitude, and practice regarding infection control and waste management among undergraduate dental students.

Keywords: Biomedical waste, dental offices, effectiveness, infection control, quasi-experimental study, waste management practices


How to cite this article:
Das M, Reddy L V, Sinha P. Effectiveness of a training program related to infection control and waste management practices in a dental college: A quasi-experimental study. Int J Oral Care Res 2018;6:73-7

How to cite this URL:
Das M, Reddy L V, Sinha P. Effectiveness of a training program related to infection control and waste management practices in a dental college: A quasi-experimental study. Int J Oral Care Res [serial online] 2018 [cited 2019 Sep 21];6:73-7. Available from: http://www.ijocr.org/text.asp?2018/6/4/73/258116




  Introduction Top


Biomedical waste is any waste that is generated during the diagnosis, treatment, or immunization of human beings or animals, or in research activities pertaining thereto or in the production or testing of biologicals.[1] It is also estimated that 10–25% of the health-care waste generated is hazardous and causes serious health problems.[2] Improper handling of waste not only poses a significant risk of infection due to pathogens but also carries the risk of water, air, and soil pollution thereby adversely affecting the environment and community at large.[3],[4] According to a survey conducted by the Indian Society of Hospital Waste Management, the quantum of waste that is generated in the country is estimated to be around 1–2kg/bed/day in a hospital and 600g/day/bed in a general practitioner’s clinic.[5] Dental offices generate a number of hazardous wastes that can be detrimental to the environment if not properly managed.[6] Segregation and collection of various categories of waste should be carried out at the source in separate containers so that each category is treated in a suitable manner to render it harmless.[7],[8] For waste management to be effective, the waste should be managed at every step, from acquisition to disposal. Good knowledge and attitude toward dental waste management will minimize the risk of disease transmission from the hospital and dental clinic to the community.[9] Poor biomedical management practice constitutes a huge risk to the general public health, patients, and health-care workers and contributes to environmental degradation.[10] Dental practitioners are at an increased risk of exposure to cross contamination with blood-transmitted diseases and in addition with different microbes that colonize the oral cavity and the upper respiratory tract.[11] Successful infection control systems should be planned to break different contaminations to counteracting the diseases.[12] Direct involvement in patient treatment as part of their clinical training puts doctor at risk of exposure to pathogens.[13] The majority of carriers of infectious disease cannot be identified; implementation of standard universal precautions in dental institution is the most effective way of controlling cross infection.[14] Dental education can play an important role in the training of dentists, helping them to adopt adequate knowledge and attitudes related to infection control measures.[15] There is a paucity of literature related to cross infection control and biomedical waste management among Indian dentists.[16] Thus, the purpose of this study was to assess the effectiveness of training related to infection control and waste management among undergraduate students in a dental institution.


  Materials and Methods Top


This quasi-experimental study was carried out in two dental colleges in Lucknow city, Uttar Pradesh, India. Ethical clearance was obtained from the institutional ethical committee. Prior to the study, permission was taken from the dental college principal. The study procedure was explained to all study participants and informed consent was taken. The study was conducted between April 2018 and September 2018. Those who accept to participate and present on the day of examination were included. Those who have already attended any lecture or program regarding waste management and infection control were excluded from the study. Sample size estimation was carried out by using G power software (version 3.0). A minimum sample size of 188 was found to be sufficient for α = 0.05, 80% power of study, and small (0.2) effect size, anticipating a dropout rate of 5% in this follow-up study. Hence, final sample size was considered as 200 (100 per group). A pilot study was conducted on 20 participants to check the feasibility of the study. These subjects were not included in the final study. Inter-examiner reliability was calculated, which was found to be fair as 0.70. The questionnaire was distributed to participants before and after the intervention. The questionnaire consisted of sections such as knowledge-based questions, practice-based questions, and self-assessment questions regarding the topic. Each correct answer was scored 1 and wrong answer was scored 0. Interpretation for scores 1 and 2 will be ranked “poor,” 3 ranked “fair,” and 4 and 5 ranked “good.” In this study, intervention consisted of a lecture and educational health material related to biomedical waste management and infection control. For group A (experimental group), at the baseline, a questionnaire and lecture on the topic were given to the participants. Reinforcement in the form of lecture was given at 1 and 3 months. For group B (control group), at the baseline, a questionnaire and health educational material related to the topic was given. Follow-up and assessment were carried out with the questionnaire at 1 and 3 months, and at the end of 6 months. Collected data were analyzed using SPSS software (version 22). Independent t test and repeated measures analysis of variance test were used for statistical analysis.


  Results Top


The gender-wise distribution of study participants showed that both groups had an equal number of males and females and there were no gender-wise differences. Intragroup comparison of knowledge scores in experimental group showed that there was a statistically significant increase from 1 to 3 months and 3 to 6 months; the control group showed that scores did not increase significantly from 1 to 3 months but were increased significantly from 3 to 6 months. However, intergroup comparison of knowledge scores between experimental and control group showed that at baseline, there was no statistically significant difference but at every follow-up (1, 3, and 6 months), the scores among the experimental group were significantly higher than that among control group [Table 1]. The attitude scores in experimental group showed that there was a statistically significant from 1 to 3 months and 3–6 months and in control group, it did not increase significantly from 1 to 3 months, but it increased significantly from 3 to 6 months. However, attitude scores between experimental and control group showed that at baseline, there was no statistically significant difference but at every follow-up, the scores among the experimental group were significantly higher than that among control group [Table 2]. The practice scores in the experimental group showed that there was a statistically significant increase from 1 to 3 months and from 3 to 6 months and the scores in control group showed that it did not show any significant increase from 1 to 3 months but increased significantly from 3 to 6 months. However, practice scores between experimental and control group showed that at baseline, there was no statistically significant difference but at every follow-up, the scores among experimental group were significantly higher than that among control group [Table 3].
Table 1: Comparison of knowledge scores at baseline, 1 month, 3 months, and 6 months

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Table 2: Comparison of attitude scores at baseline, 1 month, 3 months, and 6 months

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Table 3: Comparison of practice scores at baseline, 1 month, 3 months, and 6 months

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  Discussion Top


Most of the health-care waste generated is hazardous and causes different health problems. Improper handling of it not only poses a significant risk of infection but also carries the risk of environment pollution. Dental offices generate many hazardous wastes, which include sharps, used disposable items, infectious wastes, mercury-containing waste, lead-containing waste, and chemical waste.[6] This study was a quasi-experimental study undertaken to assess the knowledge, attitude, and practice of undergraduate dental students regarding biomedical waste management and infection control. For the analyzing the effectiveness of training program among students before and after intervention, comparison was carried out at a time interval among experimental and control group. In our study, the intragroup comparison of knowledge scores in the experimental group showed a statistically significant increase in knowledge scores from 1 to 3 months and from 3 to 6 months. Also, the intragroup comparison of knowledge scores in the control group showed that knowledge scores did not increase significantly from 1 to 3 months, but it increased significantly from 3 to 6 months. Similarly, in a study conducted by Ladia and Gupta[16] among third year dental students, there was a statistically significant difference between the mean knowledge and practice scores at baseline and after training and a positive correlation was found between knowledge and practice. Intergroup comparison of knowledge scores between both groups showed that at baseline, there was no statistically significant difference in the knowledge scores, but at every follow-up, that is, 1, 3, and 6 months, the knowledge scores among the experimental group were significantly higher than that among control group subjects. Similarly, a study conducted by Akbulut et al.[17] among dental clinical students in Turkey indicated that around maximum number of dental students had adequate knowledge.

A study conducted by Singh et al.[18] among dental students in central India reported that the significant linear correlation between attitude and practice scores and the level of knowledge and practice of infection control measures was poor among dental students. In this study, the intragroup comparison of attitude scores in the experimental group showed a statistically significant increase in attitude scores from 1 to 3 months and from 3 to 6 months. Also, the intragroup comparison of attitude scores in the control group showed that attitude scores did not increase significantly from 1 to 3 months, but it increased significantly from 3 to 6 months. However, intergroup comparison of attitude scores between both groups showed that at baseline, there was no statistically significant difference in the attitude scores but at every follow-up, that is, 1, 3, and 6 months; perhaps, the attitude scores among the experimental group were significantly higher than that among control group subjects. Similarly, a study conducted by Agrawal et al.[19] among dental students in central India showed that the mean scores of knowledge, attitude, and practice were significantly higher among the study subjects. Another study conducted by Santra et al.[20] among dental professionals showed that the mean scores of knowledge, attitude, and practice were adequate among the study participants.

A study conducted by Mohiuddin and Dawani[21] among dental practitioners showed that the mean knowledge, attitude, and practice scores regarding infection control were found poor among senior dental professionals as compared to house officers and junior professionals. Also, a moderate level of correlation existed between the knowledge and attitude, knowledge and practice, and attitude and practices. In our study, the intragroup comparison of practice scores in the experimental group showed that there was a statistically significant increase in practice scores from 1 to 3 months and from 3 to 6 months. Also, intragroup comparison of practice scores in control group showed that practice scores did not show any significant increase from 1 to 3 months, and then it further increased significantly from 3 to 6 months. However, intergroup comparison of practice scores between both groups showed that at baseline, there was no statistically significant difference in the practice scores, but at every follow-up, that is, 1, 3, and 6 months the practice scores among the experimental group were significantly higher than that among control group subjects. Similarly, outcomes were highlighted in the study conducted by Sanjeev et al.[22] among dental health-care personnel. Also, a study by Basarkar[23] among hospital staff observed that there was a highly significant improvement among knowledge and practice scores after educational intervention. Also, a significant statistical difference (pretraining and post-training) was found among study participants who have received training in biomedical waste management, which is evident from the raised level of knowledge and awareness about biomedical waste management. The small sample size has been noted as a limitation of this study. However, more specific measures can be used in the further experimental study to investigate the knowledge, attitude, and practices related to infection control and biomedical waste management and to find out the effectiveness of such training programs.


  Conclusion Top


The educational training program was found to be effective in improving the knowledge, attitude, and practice regarding biomedical waste management and infection control among undergraduate dental students.

Public health significance

The waste produced in the course of health-care activities carries a higher potential for infection and injury than any other type of waste. Inappropriate and inadequate handling of biomedical waste may have serious public health consequences. Thus, sound management of biomedical waste is a crucial component of environmental health protection.

Recommendations

  1. Field and practical training regarding biomedical waste management should be included in the dental curriculum.
  2. Further research with a larger sample size that includes all other groups of health-care workers including grade IV workers is required in the country.
Acknowledgement

All authors would like to acknowledge the principals and students of participated dental colleges for their support and cooperation during the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
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Central Pollution Control Board. Environmental standard and guidelines for the management of hospital waste. New Delhi, India: CPCB, Ministry of Environment and Forest; 1996. (Last accessed on 2018 Dec 30).  Back to cited text no. 3
    
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Sood AG, Sood A. Dental perspective on biomedical waste and mercury management: A knowledge, attitude, and practice survey. Indian J Dent Res 2011;22:371-5.  Back to cited text no. 6
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National guidelines on Hospital waste management. Biomedical waste regulations. 1998. http://www.vpci.org.in/circular/810_bio%20waste.pdf (Last accessed on 2018 Dec 30).  Back to cited text no. 7
    
8.
Central Pollution Control Board. Manual on Hospital Waste Management. Delhi, India: Central Pollution Control Board; 2000. (Last accessed on 2018 Dec 30).  Back to cited text no. 8
    
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Agrawal N, Gandhi P, Sharma S. Knowledge, attitudes, and practice regarding infection control measures among dental students in central India. Int J Sci Res 2014;3:400-2.  Back to cited text no. 19
    
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Mohiuddin S, Dawani N. Knowledge, attitude and practice of infection control measures among dental practitioners in public setup of Karachi, Pakistan: cross-sectional survey. J Dow University Health Sci 2015;9(1): 3-8.  Back to cited text no. 21
    
22.
Sanjeev R, Kuruvilla S, Subramaniam R, Prashant PS, Gopalakrishnan M. Knowledge, attitude, and practices about biomedical waste management among dental healthcare personnel in dental colleges in Kothamangalam: A cross-sectional study. Health Sci 2014;1:1-2.  Back to cited text no. 22
    
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