Instrument Sterilization Practices and Monitoring in Private and Public Dental Clinics in Eldoret, Nakuru and Kisumu Municipalities in Western Kenya

Abstract

Introduction: The safety of patients, staff and the public should always be a leading concern for all dental practitioners. It is important to ensure that safety measures are rigorously observed. One important safety practice for dental facilities is the proper sterilization of reusable dental instruments. Ensuringthat sterile instruments are present chair-side for every patient requires following a nine-step procedure (transporting, holding/pre-cleaning, cleaning, drying, corrosion inspection, packaging, sterilization, storage and distribution, monitoring ofinstrument flow). Missing or performing a step improperly jeopardizes the entire sterilization process. Monitoring sterilization is an essential activity. Monitoring includes a combination of mechanical, chemical and biological techniques designed to evaluate the performance of the sterilization process. Materials and method: This study was carried outamong dentists practising in three towns in the Western part of Kenya. All the clinics run by qualified dentists were approached to participate in the study. Out of the 31 clinics approached 29(93.5%) agreed to participate. A self-administered questionnaire was used to collect information on several parameters including; type of practice, personnel, patient load and sterilization practices. Self-contained biological indicator vials were supplied for each sterilizer in each clinic. These were incubated within eight hours after exposure to the sterilization cycle to determine the effectiveness of sterilization. Results: There was sterilization failure in 31% of the sterilizers. A majority (93.5%) of the practices use steam autoclaves.Those practices where a qualified nurse was in charge of sterilization were the least likely to have sterilization failure (p=0.046). While majority of the clinics use chemical and mechanical monitoring, only one clinic reported use of biological monitoring. Conclusion and recommendation:Mandatory sterilization monitoring using Biological Indicators in Dental practices in Kenya to ensure effective sterilization is recommended. It is also recommended that a wider study covering the whole of Kenya should be carried out to determine the true picture in the country.