title: Prevention of healthcare-associated infections: knowledge among dental students in seven Italian universities.
abstract: BACKGROUND
  Lack of knowledge is the major reason for non-compliance with correct healthcare-associated infections (HAI) prevention procedures. The aim of this study was to evaluate knowledge of the Dental School (DSS) and Dental Hygiene (DHS) students with regard to the prevention of HAI, as basic knowledge for improving and harmonizing the educational content in the different Italian Universities.
  
  
  METHODS
  A cross-sectional study was carried out using an anonymous questionnaire that was completed by DSS (I, II, III, IV, and V year) in seven Universities and DHS (I, II, and III year) in three Universities. The questions dealt with three specific areas: healthcare-associated infections, standard precautions and hand hygiene. Factors associated with an unacceptable level of knowledge (score <17.5) were analyzed using a logistic regression model. A p value <0.05 was considered to be significant.
  
  
  RESULTS
  Five hundred and four questionnaires were collected: 81.5% for DSS and 18.5% for DHS. Mean overall score (±DS) achieved by the total number of students was 18.2±2.93 on an overall perfect score of 25; 18.2±3.04 for DSS and 17.8±2.31 for DHS. Stratifying by area, the average score 2.7±1.07 (53%) for HAI, 10.3±1.61 (85.9%) for standard precautions, and 5.2±1.44 (64.8%) for hand hygiene was observed. A significantly different level of knowledge (p<0.001) between DSS and DHS was observed only for HAI (2.8±1.07 for DSS vs 2.1±0.96 for DHS). Significant differences among the academic years were found only for DSS concerning HAI and standard precautions. The logistic regression model showed that an age <23 years was a risk factor for lack of knowledge on HAI, but a protective factor for lack of knowledge about standard precautions and hand hygiene; attending DH degree course was associated with lack of knowledge on HAI.
  
  
  CONCLUSIONS
  Although the overall score obtained both by DSS and DHS indicated an acceptable level of knowledge, lack of knowledge was highlighted, in particular, for hand hygiene. Therefore, it is necessary to implement and validate effective teaching models in undergraduate courses in order to provide the scientific basis and the theoretical and practical preparation for the prevention and control of HAI.
authors.affiliation: Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Italy.
authors.forename: Cesira
authors.initials: C
authors.lastname: Pasquarella
authors.affiliation: Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Veronesi
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Castiglia
authors.affiliation: Department Civil Building and Environmental Engineering, "Sapienza" University, Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: D'Alessandro
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Legnani
authors.affiliation: Department of Experimental Medicine, University of Perugia, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Minelli
authors.affiliation: Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Montagna
authors.affiliation: Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Napoli
authors.affiliation: Department Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Righi
authors.affiliation: Department of Health Sciences, University of Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Strohmenger
authors.affiliation: Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Tesauro
authors.affiliation: Department of Public Health, University of Napoli "Federico II", Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Torre
authors.affiliation: Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Italy.
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Tanzi
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007558:Italy; D016015:Logistic Models; D008297:Male; D013335:Students, Dental / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult
keywords: Dental practice; Healthcare-associated infections; Knowledge; Standard precautions; Students