Evaluation of the steam sterilization quality and assessment of knowledge, attitude, and practice of clinical directors regarding infection control in dental clinics: A cross-sectional study in Mashhad, Iran

Background: The sterilization cycle is one of the most important parts of infection control. Accordingly, the present study was conducted to assess the quality of steam sterilization and compare the knowledge, attitude, and practice of clinical directors in dental clinics, based on the experimental work in one of the most important and famous dental departments and clinics in the Northeast of Iran. Methods: This cross-sectional study was conducted from June to September 2017 in 84 dental outpatient clinics of Mashhad, Iran. The status of sterilization quality was evaluated using biological (BI) and chemical indicators (CI) and the results of a questionnaire. The participants include the technical manager and operator of the Autoclave, who were included in this study according to the inclusion criteria by stratified cluster sampling. Information on their knowledge, practices, and attitudes were evaluated. Also, BI and CI were used to evaluate the autoclave accuracy. The data were analyzed by Mann-Whitney U, Wilcoxon signed-rank, and Fisher's exact tests using SPSS (Version 19, SPSS Inc., Chicago, IL, USA). Results: In this study, the results of 69 (82.1%) biological test were negative. Based on the questionnaire results, 64 (76%) clinics used CI, and only 4 (5%) clinics used CI and BI to evaluate the sterilization quality. The mean scores of attitude (P = 0.001), knowledge (P = 0.001), and practice (P < 0.001) of the technical manager in dental clinics were significantly higher than those in outpatient clinics. Also, there was a significant association between the knowledge and practice of the clinics' technical managers (P < 0.001). Conclusion: According to the results, 93.3% of the clinics that had a positive biological test were outpatient clinics. Also, it was revealed that insufficient knowledge, attitude, and practice lead to imperfect sterilization. Also, the mean score of dentists was higher than that of general practitioners, therefore, in addition to suggesting training programs for managers, it is recommended that employ a dental practitioner as the technical manager of outpatient clinics. In order to control infection in clinics, it is recommended to monitor the sterilization process in clinics according to the instructions of the monitoring units.