Knowledge, Attitude and Practice (KAP) Of Spread of HIV Infection through Needle Stick Injury among Dental Paramedics

Introduction

Dental surgeons are trained to follow a strict infection control protocol, as it has been inculcated in a trained professional through their academic curriculum. But in a dental hospital set up it's not just a dental surgeon who runs the entire show, theirs a major role even played by the dental paramedics.

Dental paramedics are equally exposed to needle stick injury as much as a dental surgeons. In order to prevent the spread of HIV infection through the mode of needle stick injury among paramedics it is important to know how much knowledge do they have regarding this mode of spread, how strictly they follow the departmental protocol and also to know their attitude for the same.

Studies conducted in various other countries showed that knowledge of health care workers about the risk associated with needle-stick injuries and use of preventive measures was inadequate. A standing order procedure (SOP) should be formulated regarding needle-stick injuries in all the health institutions.^1–5

As most of the studies regarding spread of HIV through needle stick injury are done on the medical paramedics we found a need to know the knowledge, attitude and practice of the dental paramedics as they are equally prone to such injury in day to day practice.

Materials and Methods

Results

Demographic Characteristics of the paramedical staff working at institute

Among the total sample size of 100; 37 worked in sterilization area, 24 were sweepers, 14 were receptionist, 13 were laboratory technicians, 9 were chair side attender, 3 were dental nurse. (Fig. 1)

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Fig. 1

Distribution of Nature of Work

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When their educational qualification was surveyed it was observed that majority i.e. 58% have not completed their 10th std., 14% had finished their education till 10th std. and 18% till 12th std., 5% had finished their graduation and 5% had got a degree in Dental Technician course. (Fig. 2)

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Fig. 2

Distribution of Academic Qualification

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92% of the paramedical staff knows what HIV infection is and that it can be spread through needle stick injury irrespective of their academic background. 42% of the paramedics have experienced needle stick injury, among which 95% have experienced 1-2 times a year. 61% of the needle stick injury have been reported by the paramedics with majority of them reporting to the head of the department followed by colleagues. According to the survey 95% of the paramedics followed the correct post injury protocol even though only 90% of them knew how to manage it correctly. 88% of the paramedics have been educated regarding the management of needle stick injury through the programme they have attended conducted by their respective institution.

Discussion

In this study out of 100 paramedics who participated 92% were aware that HIV infection can be transmitted through needle stick injury. A data combined from more than 20 prospective studies worldwide of health care workers exposed to HIV-infected blood through percutaneous injury revealed an average transmission rate of 0.3% per injury.⁶ One study reported that transmission occurred only from hollow-bore needles as compared with other sharp objects.⁷

Out of 42 paramedics experiencing needle stick injury, 61% of them have reported. Data from EPINet system suggest that at an average hospital, workers incur approximately 30 needle-stick injuries per 100 beds per year.⁸ It is believed that only one out of three needle-stick injuries are reported in the US, while these injuries virtually go undocumented in many developing countries.⁹

The circumstances leading to needle-stick injury depend partly on the type and design of the device and certain work practices. In this study 84% of the paramedics wear double gloves when in contact with potential sharp objects, while in other studies they used double glove as precaution only in 23% of cases.¹

In 1985, in order to increase awareness among health care workers of the dangers of sharp injuries and other types of disease transmission, the Centre for Disease Control (CDC) and the Occupational Safety and Health Administration (OSHA) in the United States introduced the “Universal Precaution Guidelines”, which have been the worldwide standard in both hospital and community care settings.¹⁰ In our study we found that 90% of the participants knew how to manage needle stick injury, which is statistically high compared to various other studies.^{1, 2, 3, 4}

Conclusion

This survey revealed that knowledge of paramedics about the risk association of spread of HIV infection with needle-stick injuries and use of preventive measures was adequate. A standing order procedure (SOP) which if formulated regarding needle-stick injuries should be further encouraged by the head of the respective departments especially to those who have newly joined the institution to obtain still better safety measures.