A survey of United States dental hygienists' knowledge, attitudes, and practices with infection control guidelines.

Purpose: To assess knowledge, attitudes and practices of U.S. dental hygienists with infection control guidelines (ICG). Research has shown improved compliance with specific aspects of dental ICG is needed. This study supports the American Dental Hygienists' Association National Research Agenda's Occupational Health and Safety objective to investigate methods to decrease errors, risks and or hazards in health care. Data are needed to assess compliance, prevention and behavioral issues with current ICG practices.

Methods: A proportional stratified random sample (n=2,500) was recruited for an online survey. Descriptive statistics summarized demographic characteristics and knowledge, attitudes and practices responses. Spearman's rho correlations determined relationships between knowledge, attitudes and practices responses (p<0.05). Dominant themes were identified from open-ended responses.

Results: A 31% response rate (n=765) was attained. Respondents agreed/strongly agreed with familiarity with ICG (86%) and believed ICG are relevant to their patients (88%). Responses indicated low compliance (rarely/never used) with handpiece sterilization (n=209, 31%), utility glove use (n=317, 47%), and pre-procedural rinsing (n=324, 48%). Significant relationships were found between ICG implementation and access to necessary supplies (rs=0.549), supervisors' expectations for using ICG (rs=0.529) and no time to use (rs=-0.537). Themes from comments indicated time is a barrier, and respondents' perceived a need for involvement of all co-workers.

Conclusion: Dental hygienists are adhering with most aspects of the ICG. High compliance with ICG among respondents in this study was associated with positive safety beliefs and practices, whereas lower compliance with ICG was associated with less positive safety beliefs and practices. A safety culture appears to be a factor in compliance with ICG.