Predictors of dentists' level of knowledge regarding the recommended prophylactic regimen for patients with rheumatic heart disease

Advancing infection control in dental care settings: factors associated with dentists' implementation of guidelines from the Centers for Disease Control and Prevention

BACKGROUND AND OVERVIEW

The authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention's Guidelines for Infection Control in Dental Health-Care Settings-2003.

METHODS

In 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists' demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling.

RESULTS

Responding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied.

CONCLUSIONS

Implementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education requirements and developing multiple modes of instruction may increase implementation of current and future Centers for Disease Control and Prevention guidelines.

Relationships among and demographic predictors of dentists' self-reported adherence to national guidelines

How dentists learn about and integrate new procedures and techniques into dental practice are major concerns in innovation research in dentistry. The purposes of this study were to: (1) develop reliable measures of self-reported adherence to different national guidelines; (2) to examine the relationships among the different measures; and (3) to determine if predictors of these adherence behaviours exist. One thousand U.S. general dentists were asked to complete a survey of adherence behaviours to established guidelines in infection control, radiation protection, and antibiotic prophylaxis. Thirty-five percent responded to the mailed survey. Reliable scales were developed in infection control and antibiotic prophylaxis behaviors. Step-wise multiple regression analysis produced several weak predictors of adherence to guidelines in these two areas. Characteristics of early adopters such as office complexity, membership in professional associations, and year of graduation, were consistent with other dental innovation literature. Significant correlations were found between adherence behaviors in infection control and antibiotic prophylaxis. These correlations do support the findings that practitioners who are early adopters of innovation are likely to do so in more than one area.

The dentist and infectious diseases: a national survey of attitudes and behavior

Two national surveys of infection control practices in 1986 and 1988 suggest several trends. A massive educational effort has brought about impressive acceptance and use of the hepatitis vaccine. Dramatic changes have occurred in respect to use of gloves and other barrier techniques. However, increased understanding of HIV infection has not, in the years surveyed, totally eradicated irrational fears about this disease.

Professional life cycle changes and their effect on knowledge level of dental practitioners

Utilizing a national data set (U.S.A.), the effect of age and age-related professional characteristics on dentists' knowledge with regard to prevention of infective endocarditis was examined. The following research questions were addressed: (1) Do age-related characteristics produce different effects on knowledge level at various stages of professional careers?; (2) What are the key changes in these age-related characteristics and what processes are suggested by these changes? Multiple regression analysis assessed the influence of potential predictors of variation in knowledge level with regard to prevention of infective endocarditis for the entire sample. Using these findings as a guide, variation in the effect of significant predictor variables was then analyzed for three time segments of approximately equal duration: early professional life less than 40, mid-professional life 40-54, and older professional life 55 or greater than. Age had a profoundly negative effect on knowledge level, i.e. the level progressively declines as clinicians grow older. The impact of the age-related characteristics on knowledge level of infective endocarditis prevention also varied according to the stage of the professional life cycle. Indices measuring the size or extent of theoretical understanding, in-office networks, institutional affiliations, and consulting networks were significant predictors of endocarditis prevention knowledge for younger clinicians. For those 40-54, only practice organization (office business and staff size and diversity) was a significant predictor, while for older clinicians theoretical understanding was the only significant predictor. Differences in the mean levels of these predictor (independent) variables across age groups were also examined via ANOVA.(ABSTRACT TRUNCATED AT 250 WORDS)

How oral surgeons learn: an epistemological investigation

The elements of knowledge required for the successful management of patients at high risk for bacterial endocarditis were used to construct a scale that was the dependent variable in a study designed to investigate factors influencing the knowledge level of oral surgeons. A telephone interview was used to collect data from a sample of New York State members of he AAOMS. Analyses of these data showed comparatively high knowledge levels among respondents. Variations in knowledge were accounted for by age, access to highly reviewed journals, career patterns that maximized the opportunity for continuous professional interaction with colleagues, and a predilection for being up-to-date. The latter, in turn, was correlated with additional opportunities for integration into a community of oral surgeons.