Investigation of Student Injuries and Post-Injury Behaviors in the First Two Years of Preclinical Dental Education

Abstract

Background: The attitudes and behaviors of students after their injuries in preclinical education in the faculties of dentistry are very important in terms of blood-borne diseases and infection risks. For this reason, this study aimed to determine the injuries experienced by dentistry students in preclinical courses in detail and to determine their post-injury behaviors. Methods: The study was conducted on students who completed their first and second education years. The surveys we prepared were conducted anonymously by sending to the volunteer participants via "Google Forms". In the surveys, we questioned the types of injuries they experienced in the courses; the materials that caused the injury; the number of injuries; the time period of the course and in which preclinical training course the injuries occurred; and their behaviors after injury and their reasons. In the study, information (n) and (%) were given as descriptive statistics of the data. In the analysis of the relationship between two categorical variables, Pearson Chi-Square analysis was applied when the sample size assumption was met, and Fisher's Exact test was applied when the sample size assumption was not met. Analyzes were carried out in IBM SPSS 25 program. Results: 66% of the students (n:87) stated that they were injured at least once in pre-clinical courses. The most common injuries were cutting-penetrating (72.9 %) due to the use of dental spatula and injury from direct fire source (59.4 %) in the first-year students. Dental wires (96 %) dental explorer (78 %) and burning injuries with hot dental wax (64 %) resulted in high rates of students who completed the second year. 87.5 % of the students who completed their second year stated that they were injured mostly in the preclinical education courses of Prosthodontics. It was found that only 24 % of the students reported all their injuries. Conclusions: The high injury rates in our study revealed the inability of the students to use cutting-penetrating tools and laboratory materials safely. In addition, their attitudes and behaviors after injuries showed that blood-borne diseases and cross-infection knowledge were insufficient. In order to take precautions in these issues, students must be educated before preclinical courses.

Keywords

• Bloodborne Pathogens
• Dental Education
• Occupational injury

Diş Hekimliği Klinik Öncesi Eğitiminin İlk İki Yılında Öğrenci Yaralanmalarının Araştırılması ve Yaralanma Sonrası Davranışlarının İncelenmesi

Abstract

Amaç: Diş hekimliği fakülteleri klinik öncesi eğitimlerinde yaralanan öğrencilerin tutum ve davranışları, kan yoluyla bulaşan hastalıklar ve enfeksiyon riskleri açısından oldukça önemlidir. Bu nedenle bu çalışma, diş hekimliği öğrencilerinin klinik öncesi uygulama derslerinde yaşadıkları yaralanmaları ayrıntılı olarak tespit etmeyi ve yaralanma sonrası davranışlarını belirlemeyi amaçlamaktadır. Gereç ve Yöntemler: Çalışma, birinci ve ikinci eğitim yıllarını tamamlayan öğrencilere yapıldı. Hazırladığımız anketler gönüllü katılımcılara "Google Forms" üzerinden gönderilerek anonim olarak gerçekleştirildi. Anketlerde, uygulama derslerinde yaşanan yaralanma türleri, yaralanmaya neden olan malzemeler, yaralanma sayıları, yaralanma zamanları ve yaralanmaların hangi klinik öncesi eğitim dersinde meydana geldiği, yaralanma sonrası davranışlar ve nedenleri soruldu. Çalışmada verilerin tanımlayıcı istatistikleri olarak (n) ve (%) bilgileri verildi. Örneklem büyüklüğü varsayımı karşılandığında Pearson Ki-Kare karşılanmadığında Fisher's Exact testi uygulanmıştır. Analizler IBM SPSS 25 programında gerçekleştirildi. Bulgular: Öğrencilerin %66'sı (n:87) klinik öncesi kurslarda en az bir kez yaralandığını belirtmiştir. En sık karşılaşılan yaralanma, birinci sınıf öğrencilerinde spatül kullanımına bağlı batma-kesme (% 72,9) ve doğrudan ateş kaynağından yaralanma (% 59.4), ikinci sınıf öğrencilerinde kroşe teli (% 96), sond (% 78) ve sıcak muma bağlı yanma yaralanmaları (% 64) olmuştur. İkinci sınıflarda yaralanmaların en fazla (% 87,5) protetik diş tedavisi uygulama derslerinde meydana geldiği tespit edilmiştir. Öğrencilerin sadece % 24'ünün, yaralanmalarının tamamını sorumlu öğretim üyesine bildirdiği tespit edilmiştir. Sonuçlar: Yüksek yaralanma oranları öğrencilerin kesici-delici aletleri ve laboratuvar malzemelerini güvenle kullanamadığını ortaya koymuştur. Ayrıca yaralanma sonrası tutum ve davranışları, kan yoluyla bulaşan hastalıkların ve çapraz enfeksiyon bilgilerinin yetersiz olduğunu göstermiştir. Öğrencilerin klinik öncesi dersler başlamadan önce eğitilmeleri gerekmektedir.

Keywords

• Diş Hekimliği Eğitimi
• Kandan Geçen Patojenler
• Meslek Yaralanmaları

References

1. Referans1: Lee JJ, Kok SH, Cheng SJ, Lin LD, Lin CP. Needlestick and sharps injuries among dental healthcare workers at a university hospital. J Formos Med Assoc. 2014;113:227-33.
2. Referans2: Siew C, Gruninger SE, Miaw CL, Neidle EA. Percutaneous injuries in practicing dentists. A prospective study using a 20-day diary. J Am Dent Assoc. 1995 Sep;126:1227-34.
3. Referans3: Kohn WG, Harte JA, Malvitz DM, Collins AS, Cleveland JL, Eklund KJ. Centers for Disease Control and Prevention. Guidelines for infection control in dental health care settings--2003. J Am Dent Assoc. 2004;135:33-47.
4. Referans4: Kennedy JE, Hasler JF. Exposures to blood and body fluids among dental school-based dental health care workers. J Dent Educ. 1999;63:464-9.
5. Referans5: Younai FS, Murphy DC, Kotelchuck D. Occupational exposures to blood in a dental teaching environment: results of a ten-year surveillance study. J Dent Educ. 2001;65:436-48.
6. Referans6: Wicker S, Rabenau HF. Occupational exposures to bloodborne viruses among German dental professionals and students in a clinical setting. Int Arch Occup Environ Health. 2010;83:77-83.
7. Referans7: Callan RS, Caughman F, Budd ML. Injury reports in a dental school: a two-year overview. J Dent Educ. 2006;70:1089-97.
8. Referans8: Ramos-Gomez F, Ellison J, Greenspan D, Bird W, Lowe S, Gerberding JL. Accidental exposures to blood and body fluids among health care workers in dental teaching clinics: a prospective study. J Am Dent Assoc. 1997;128:1253-61.

9. Referans9: Smoot EC. Practical precautions for avoiding sharp injuries and blood exposure. Plast Reconstr Surg. 1998;101:528-34.
10. Referans10: Cleveland JL, Barker L, Gooch BF, Beltrami EM, Cardo D; National Surveillance System for Health Care Workers Group of the Centers for Disease Control and Prevention. Use of HIV postexposure prophylaxis by dental health care personnel: an overview and updated recommendations. J Am Dent Assoc. 2002;133:1619-26.
11. Referans11: Ayar M., Olcay E., Olcay M. A Survey of Occupational Injuries During Preclinical Courses Among Dental Students Turkiye Klinikleri Journal of Dental Sciences 2020; 26:242–6,
12. Referans12: Zaidi MA, Griffiths R, Beshyah SA, Myers J, Zaidi MA. Blood and body fluid exposure related knowledge, attitude and practices of hospital based health care providers in United arab emirates. Saf Health Work. 2012;3:209-15.
13. Referans13: Milward MR, Cooper PR. Competency assessment for infection control in the undergraduate dental curriculum. Eur J Dent Educ. 2007;11:148-54.
14. Referans14: Imran A, Imran H, Ashley MP. Straight to the point: considering sharp safety in dentistry. Br Dent J. 2018;225:391-394.
15. Referans15: Matsumoto H, Sunakawa M, Suda H, Izumi Y. Analysis of factors related to needle-stick and sharps injuries at a dental specialty university hospital and possible prevention methods. J Oral Sci. 2019;61:164-170.
16. Referans16: Western JS, Dicksit DD. A systematic review of randomized controlled trials on sterilization methods of extracted human teeth. J Conserv Dent. 2016;19:343-6.
17. Referans17: Dominici JT, Eleazer PD, Clark SJ, Staat RH, Scheetz JP. Disinfection/sterilization of extracted teeth for dental student use. J Dent Educ. 2001;65:1278-80.
18. Referans18: Kotelchuck D, Murphy D, Younai F. Impact of underreporting on the management of occupational bloodborne exposures in a dental teaching environment. J Dent Educ. 2004;68:614-22.
19. Referans19: Myers JE, Myers R, Wheat ME, Yin MT. Dental students and bloodborne pathogens: occupational exposures, knowledge, and attitudes. J Dent Educ. 2012;76:479-86.
20. Referans20: Zakrzewska JM, Greenwood I, Jackson J. Introducing safety syringes into a UK dental school--a controlled study. Br Dent J. 2001;190:88-92.
21. Referans21: An N, Yue L, Zhao B. [Droplets and aerosols in dental clinics and prevention and control measures of infection]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2020;55:223-228.
22. Referans22: Wu L, Yin YL, Song JL, Chen Y, Wu YF, Zhao L. Knowledge, attitudes and practices surrounding occupational blood-borne pathogen exposure amongst students in two Chinese dental schools. Eur J Dent Educ. 2016;20:206-212.
23. Referans23: Sofola OO, Folayan MO, Denloye OO, Okeigbemen SA. Occupational exposure to bloodborne pathogens and management of exposure incidents in Nigerian dental schools. J Dent Educ. 2007;71:832-7.
24. Referans24: Stewardson DA, Palenik CJ, McHugh ES, Burke FJ. Occupational exposures occurring in students in a UK dental school. Eur J Dent Educ. 2002;6:104-13.
25. Referans25:The Centres for Disease Control and Prevention. (2018) Sharps Safety for Healthcare Settings Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program. Retrieved online from: https://www.cdc.gov/sharpssafety/tools.html.