VIETNAM MEDICAL JOURNAL N°2 - OCTOBER - 2017
DANH GIA CUA NGirai BENH VE THITC HANH KIEM SOAT NHlf M KHUAN TAI KHOA RANG HAM MAT BENH VIEN QUAN 7,
THANH PHO HO CH! MINH
Nguyin H^ng R^nh^, Ph^m Thi LSm^, DiroTng Thi Hanh^
Tr5n Dir Bfing'*' Nguyen Diic Hue^, Nguyen Van Tsip*
T O M TAT
Muc tieu. Xac djnh ty le thi/c hanh dung kiem soat nhiem khuan qua danh gia cua ngu'di benh va t / le ngu'di benh hai long ve cong tac kiem soat nhiem khuan tai khoa Rang Ham Mat, benh vien Quan 7, thanh pho Ho Chi Minh. Phu'dng phap. Dieu tra ngang 200 benh nhan ngoai tru tai khoa Rang Ham Mat tai benh vien quan 7, thanh pho Ho Chi Mmh nam tif'th^ng'01/2017 - 04/2017. Ket qua. Thi/c hanh kiem scat nhilm khuan cua nhan vien y te tai khoa rang ham mat, benh vien Quan 7 la tot, dUdc the hien qua danh gia ciia ngu'di benh vdi 57,5% ngu'di benh quan sat thay nhan vien y te thi/c hanh rda tay va quan sat thay 100% NVYT siy dung day du phu'dng tien bao ve ca nhan, 87,5% cho rang cong tac ve sinh du'dc thu'c hien tot. Ty le ngu'di benh hai long ve cong tac kiem soat nhiem khuan tu'dng doi cao la 79%. Can CO mot so bien phap cai tien chat lu'dng nham tang su"
hai long ngu'di benh, dap dng nhu cau nhan dan.
Tifkhoa: Kiem soat nhiem khuan, khoa rang ham mat.
SUMMARY
SATISFACTION OF PATIENT ABOUT INFECTION CONTROL AT DENTAL DEPARTMENT OF DISTRICT 7 HOSPITAL,
HO CHI M I N H CITY Objective. Determining the propotion of right practice about infection control through the evaluation of the patients and propotion of patients who satisfied about infection control at dental department at district 7 hospital. Ho Chi Minh city. Methods. A cross- sectional study was conducted on 200 out patients at dental department of the district 7 hopital, Ho Chi Minh City. Results. The practice on infection control in dental department at district 7 hospitals is good, as shown by the evaluation of the patient, 57,5% of the patients observed that dental staff practiced hand washing and 100% dental staffs utilized personal protective equipment, 87.5% said that hygiene was well done. The proportion of patients who were ''^^'^ Benh vien Quan / - TPHCM,
^Benh viSn RHM Trung ddng Tp HCM,
^Dai Hoc Y Dude TP HCM
Chiu trach nhiem chinh: Nguyen Hong Hanh Email: [email protected] Ngay nhan bai: 20.8.2017 Ngay phan bien khoa hpc: 29.9.2017 Ngay duyet bai: 5.10.2017
satisfied with infection control was relatively high at 79.0%. There are some solutions to improve the quality to increase patient satisfaction, response people's demands.
Keywords. Infection control, dental department, out patient.
I. OAT VAN OE
Cdng tac kiem soat nhiem khuan tai cac cd sd y te la mot trong nhii'ng moi quan tam cua nganh y te tren toan the gidi cijng nhu' tai Viet Nam. Hien nay, cong tac kiem soat nhiem khuan tai cac benh vien van cdn nhieu ton tai, tinh trang nhiem khuan benh vien va nguy cd lay nhiem cheo trong benh vien van cdn cao. Mot so benh lay nhilm, dac biet la hpi chu'ng suy giam mien dich mac phai (HIV/AIDS), viem gan sieu vi B, viem gan sieu vl C va nhieu benh lay nhiem khac chu'a du'dc giam sat chat che d nhieu benh vien, c d s d y t e [1],[2],[3].
Trong thu'c hanh nha khoa, nguy cd lay nhilm cd the xay ra trong qua trinh cham sdc dieu tri, nguon lay nhiem cd the tiT benh nhan lay truyen cho nhan vien y te hoac tu' benh nhan nay den benh nhan khac qua thao tac ky thuat dieu trj, dung cu y te bj nhiem ban neu khdng xCr ly dung theo quy trinh khCf khuan, tiet khuan [4],[6]. Oe cd cd sd giup nang cao chat lu'dng dieu trj va su"
hai long cua ngu'di benh chung tdi tien hanh khao sat mpt so y kien cua ngu'di benh den kham va dieu tri vdi muc tieu:
LXae dinh ty li thdc hanh diing ve kiem soat nhiim khuan qua danh gia eiia ngu'di benh tai khoa Rang Ham i^at, Benh vien Quan 7, thanh phd Ho Chi Minh.
Z.Xic dinh ty lengi/di benh hai long ve eong tic kiem soat nhiem khuan tai khoa Rang Ham Mat, benh vien Quan 7, thanh phd Ho ChfMinh.
II. o d l TUpNG VA PHU'aNG PHAP NGHIEN CUU 2 . 1 . Doi tu'dng nghien cu'u: Benh nhan den kham va dieu trj tai khoa Rang Ham Mat tii"
01/2017-04/2017, tai benh vien Quan 7, thanh phd Ho Chi Minh
Cd mau. Cd mau tdi thieu du'dc xac djnh • theo cdng thtfc u'dc lu'dng mot ty le
272
TAP CHl Y HOC VIET NAM TAP 459 - THANG 10-502-2017
2^-0/2=1,96 la trj so tu' phan phdi chuan vdi dp tin cay 95%; chgn p=0,97; Theo Nguyen Du'c Hue, ty le ngu'di benh hai Idng hoac chap nhan ve kiem soat nhilm khuan tai cd sd rang ham mat cong lap tai thanh pho Ho Chi Minh la 97,2%. d=0,03 la sai sd cho phep. Vay cS mau toi thieu n = i 2 5 ngu'di. Thi/c te dieu tra 200 benh nhan.
Chpn mau. Chon ngau nhien 200 benh nhan den kham va dieu tri ngoai tru tai khoa Rang Ham Mat tir 01/2017- 04/2017 dong y tham gia nghien cii'u, ngoai triy cac benh nhan khong cd kha nang nghe, ndi, tam than.
2.2. Phu'dng phap nghien cu'u Thiet Ke nghien edu. Nghien cu\i cat ngang mota.
Ndi dung nghien cdu. Khao sat y kien cua benh nhan theo bd cau hdi cau true da du'dc dieu chinh qua cac nghien cu'u, thiet ke vdi noi
cau hdi da du'dc nghien cu'u thLT tru'dc khi tien hanh.
dc chi so nghien euii. Khao sat mot sd dac dienn dan so xa hpi cua benh nhan gom gidi tinh, tuoi, hoc van, nghe nghiep...; mpt so dac diem cua ngu'di benh nhu': li/a chon ndi dieu tri rang ham mat, so lan dieu tri tai khoa rang ham mat va ly do li/a chon khoa rang ham mat tai benh vien. Ghi nhan cac nhan xet ciia benh nhan ve thdc hanh kiem soat nhiem khuan cua nhan vien y te bang each hdi benh nhan ve qua trinh thy'c hanh kiem soat nhiem khuan cua nhan vien y te. Sd hai Jong ciia ngu'di benh ve cong tac kiem soat nhilm khuan tai khoa rang ham mat.
2.3. Xiir ly va phan tich diJ lieu: Cac dCi' lieu du'dc nhap va quan ly bang phan mem EPIDATA 3.1 va du'dc xd ly, phan tich bang phan mem STATA-12.0. Sir dung phu'dng phap thdng ke y sinh hpc, md ta va trinh bay tan sd, t / le phan tram (%).
2.4. Oao dii'e nghien cii'u: Quyen va ldi ich dung du^ vao cac hu'dng dan ve kiem soat ciJa ddi tu'dng nghien ciru du'dc dam bao theo nhiem khuan va khao sat y kien ngu'di benh ciia
nganh y te, cac tir ngU va ndi dung du'dc hdi du'dc thiet ke ngan gpn, ngu'di benh de hieu. Bo
quy dinh ciia Hdi dong dao dire trong nghien cufu y sinh hpc. Nghien cu'u du'dc su' chap thuan ciia Sd Y te TP.HCM, Ban Lanh dao benh vien Quan 7 va Hpi dong dao dire nghien ciTu y sinh eiia Vien Pasteur, thanh pho Ho Chi Minh.
lit. KET QUA
3.1. Mot so dac diem cua benh nhan du'dc khao sat
Bang i. Mpt so dac diem dan so xa hdi cua doi tu'dng nghien cu'u (n=200) fiac diem
Gidi tinii Trinii do iigc van
Ngiie ngtiiep
Nliom tuoi Ty ie benh nhan nu" 57
Nam NO"
< Cap3
> C a p 3 Conq chi^c vien chirc
Cong nhan Kinh doanh tu" do
NOI trO Hoc sinh,sinh vien
I*^at SLTC lao donq Khac
< 40 tuoi
> 40 tuoi 5%, cd 62% trinh do du'di cap
So lu'cfng 85 115 124 76 36 40 42 28 23 17 14 136 64 3. Ve nghe nghiep, d
Ty le (»/o) 42,5 57,5 62,0 38,0 18,0 20,0 21,0 14,0 11,5 8,5 7,0 68,0 32,0 a phan benh niian ia kinh doanh, cdng nhan, vien chirc nha nddc, ty le lan lu'dt la 21,0%; 20,0% va 18,0%. Do tuoi hau het du'di 40 tudi, ty le 68,0%.
Bang 2. Ly do lu'a chpn cd sd dieu trj nha khoa cua benh nhan (n^200)
Pac diem So lu'Ong Ty le ( % )
Cd sd rang ham mat lu'a chpn dieu trj
Cong lap 135
Cdng lap va td nhan 46
VIETNAM MEDICAL JOURNAL N°2 - OCTOBER • 2017
Ly do chon l<hoa RHM de dieu tri
Nhieu i n Gan nha Ngi/di quen gidi thieu An tam vi chat iUdng tot
Vi cd sd cua cong lap
89 93 25 38 44
44,5 46,5 12,5 19,0 22,0 Ket qua ghi nhan, benh nhan thu'dng \da chpn cd sd cong lap de dieu trj cac van de ve rang ham mat la 67,5%; tu' nhan chi la 9,5%; chpn ca cdng lap va td nhan la 23,0%. Ty \f BN da dieu trj va cham sdc cac van de rang ham mat nhieu hdn 2 lln la 44,0%; cd 35,5% ngu'di benh dieu tri lan dau tien. Da phan ngu'di benh li/a chpn khoa rang ham mat ciia benh vien quan 7 de kham va dieu tri rang ham mat vi ly do gan nha va vi yen tam vdi cd sd cong lap, ty le la 46,5% va 22,0%; ty le ati tam vi chat lu'dng djch vu tai khoa la 19,0%.
3.2. Thitc hanh kiem soat n h i l m khuan cua nhan vien y t e tai benh vien Quan 7 qua danh gia ciia benh nhan
Bang 3. Thu'c hanh kiem soat nhiem khuan qua quan sat ciia ngu'di benh (n=200)
TtiLTc hanh Ve sinh tay
Su'dung phu'dng tien
baove Phdng tranh
lay nhiem
Thu'c hanh rij'a tay I^anq qanq tay r4anq l<liau tranq
Odi non v te Manq kfnh mat Siy dung iy nhu'a sach 1 lan Sue mieng vdi dung djch sat khuan
Ve smh qhe nha khoa
Cd So lu'dnq
115 200 200 184 108 189 81 134
T y l e
(%)
57,5 100 100 92 54 94,5 40,5 67
Khonq So lUdnq
85 0 0 16 92 11 119 69
Tyle (%j 42,5 0,0 0,0 8 46 5,5 59,5 33,0 Quan sat ciia benh nhan ghi nhan nhan vien y te co thdc hanh riTa tay la 57,5%. Ve sir dung cac phu'dng tien bao hp ca nhan, t / le ngu'di benh quan sat thay nhan vien y te cd mang gang tay la 100%; mang^khau trang la 100%; dpi ndn y te la 92%; mang kinh mat 54%. Ve thu'c hanh phong tranh lay nhiem, ty le sd dung ly nhifa sach 1 lan la 94,5%; ty le cd ve sinh ^he nha khoa la 67%.
Bang 4. Banh gia cua benh nhan ve thu'c hanh kiem soat nhiem khuan tai khoa rang ham mat (n=200)
Noi dung Tinh trang ghe may
nlia khoa Ndi nho nu'dc bot cua
ghe nha khoa Cong tac ve sinh tai cd
sd nha khoa
Mufc do Sach Khong sach Khonq y kien
Sach Khong sach Khdng y kien
Tdt Chu'a tot Khdnq y kien
So lu'Ong 172
0 28 182 6 12 175 2 23
Ty le ( % ) 86,0
0,0 14,0 91,0 3,0 6,0 87,5
1,0 11,5 Danh gia ve tmh trang ghe nha khoa sach se la 86,0%; co 91,0% BN cho rang bon nho nu'dc bpt cua ghe nha khoa sach. Danh gia chung ve cong tac kiem soat nhilm khuan tai khoa rang ham mat cd 87,5% cho rang dddc thu'c hien tot, tuy vay cd 11,5% tam chap nhan du'dc^lioac khdng y kien. _
3.3. SU hai long ciia ngu'di benh ve cong tac kiem soat nhiem khuan tai khoa rang ham mat, benh vien Quan 7. ^ « -
Bang S. Sd hai long cua ngu'di benh ve cdng tac kiem soat nhiem khuan tai khoa rang ham mat (n=200)
Hai long ngu'di benli Hai lonq Khdnq hai Idnq
Khdnq y kien
Tan so 158
7 35
Tv le »/o 79,0
3,5 17,5
TAP CHi Y HOC VIET NAM TAP 459 - THAHG 10 - SO 2 - 2017 . Ket qua khao sat sd hai long cua ngu'di benh ve cdng tac kiem soat nhiem khuan tai khoa rang
ham^mat ghi nhan 79% hai long; cd 17,5% ngu'di benh khong cd y kien ve cdng tae kiem soat nhiem khuan tai khoa.
Bang 6. Mpt sd y kien de xuat ciia benh nhan ve cdng tac kiem soat nhiem khuan tai khoa rang ham mat (n=200)
Y kien de xuat Lam tot cdng tac ve sinh
So lu'dng Ty le ( % ) 66,0 Lam tot cdng tac phdng tranh lay nhiem
Xd ly dung cu dung quy djnh Sir dung vat lieu mdi khi dieu trj Cd khu dieu trj rieng cho benh nhan HIV/AIDS, viem
gan sieu vi B,C 123 61,5
Hau het ngu'di benh cd de xuat rang, de thu'c hien tdt cdng tac kiem soat nhiem khuan tai khoa RHM, can chii y cdng tac ve sinh va viec thu'c hanh phong tranh lay nhiem ciia nhan vien y te, vdi t / le 66% va 66,5%. Cd 61,5% benh nhan de xuat rang can cd khu dieu tri rieng cho benh nhan HIV/AIDS, viem gan sieu vi va 54% BN de xuat can tuan thu nghiem quy trinh xd ly khu" khuan, tiet khuan dung cu; cd 33% de xuat can sd dung vat lieu mdi khi dieu trj.
IV. BAN LUAN
4 . 1 . Mot so dac diem ciia ngu'di benh den kham va dieu tri tai khoa rang ham mat: Ket qua nghien CLTU cho thay phan nhieu ngu'di benh den kham va dieu trj ve chuyen khoa rang ham mat tai benh vien quan 7 cd hoc van chii yeu la du'di cap 3 va hau het la nhDhg ngu'di kinh doanh, san xuat tiT do, hpc sinh sinh vien, cong chiTc vien chirc... Oieu nay phii hdp vdi dac diem ngu'di benh den kham chu'a benli tai benh vien tuyen quan huyen tai thanh phd Ho Chi Minh nhu'ng nam qua. Cac dac diem nay cd the giup ich ve nhuYig gdi y dinh hu'dng phat trien djch vu tai khoa.
Ty ie benh nhan thu'dng lu'a chpn cd sd cdng lap de dieu trj cac van de ve rang ham mat la 67,5%; t u nhan chi la 9,5%; ca cdng lap va tu' nhan la 23%. Da phan ngu'di benh lu'a chpn khoa rang ham mat cua benh vien quan 7 de kham va dieu trj rang ham mat vi ly do gan nha va VI yen tam vdi cd sd cong lap, t^ le la 46,5%
va 22%; ty le an tam vi chat lu'dng dich vu tai khoa chi la 19%.
Nhu' vay, ket qua nay eho thay rang, da phan ngu'di dan kham rang ham mat da tin tu'dng ve djch vu kham, dieu tri rang ham mat tai cd sd cong lap ndi chung. Ngoai ra ket qua con cho thay t / le BN da dieu tri va cham sdc cac van de rang mieng nhieu hdn 2 lan la 44%; cd 35,5%
ngu'di benh dieu tri lan dau tien, dieu nay gdi^y vg sir thay doi trong tiep can djch vu kham dieu tri ring ham mat ndi chung ciia ngu'di dan dja pliddng, ty le cao ngu'di kham va dieu tri lan dau tien gdi y su" gia tang nhu cau kham kham va dieu tri rang ham mat ciia ngu'di dan.
4.2. Danh gia ciia ngu'di benh ve kiem soat n h i l m khuan tai khoa rang ham mat, benh vien Quan 7, thanh pho Hid Chi Minh
Ket qua cho thay ty le benh nhan quan sat thay nhan vien y te cd thu'c hanh rii^ tay la 57,5%. Ket qua nay thap hdn so vdi khao sat ciia Tran Hai Sdn, nam 2013 tai 76 cd sd rang ham mat, tinh Tien Giang, ty le thifc hanh rda tay tru'dc khi dieu tri la 68,4% va sau kham, dieu tri la 61,8%. Sir khac biet nay cd the do tieu chi danh gia va ngu'di danh gia [5]. Cd nhieu yeu to anh hu'dng den viec tuan thii ve sinh ban tay cua nhan vien y te, cac yeu t d quan trpng la nhan thire eiia ho ve viec tuan thii riTa tay, phu'dng tien thu'c hanh ve sinh tay va so lu'dng benh nlian den dieu tri tai khoa.
Ve sir dung phu'dng tien bao ho ca nhan, tat ea ngu'di benh quan sat thay nhan vien y te cd mang gang tay, mang khau trang va ddi non y te, deo kinh mat. Cac nghien cii'u tai Tien Giang va An Giang cung cho thay ty le nlian vien y te mang gang tay la tir 59,2% - 100%; mang khau trang la 68,41% - 100%, mang kinh mat la 64,47% - 56,9%. Nhu'ng phu'dng tien du'dc nhae tdi tren day la nh&ng phu'dng tien bao ve quan trpng de phong tranh lay nhiem qua mau, djch tiet, nu'dc bpt [4],[5]. Nghien ciTu ciia Mohammad Abdul Baseer va cdng su', nam 2013 tai A Rap, ty le benh nhan cho rang, cac nhan vien y te dieu tri nha khoa cd 99% mang gang tay; 93,7%mang khau trang va 82,7% mang kinh mat [7].
Ve viec phdng tranh lay nhiem, ty le sir dung ly nhda sach 1 lan la 94,5%; ty le cd ve sinh ghe nha khoa la 67,0%. Nghien ciTu ciia Tran Thi Lai, tai An Giang cho biet 100% cae cd sd rang ham
VIETNAM MEDICAL JOURNAL N°2 - OCTOBER - 2017 mat diing dng hut nu'dc bpt va ly sir dung 1 lan
[4], trong khi khao sat ciia Tran Hai Sdn, tai Tien Giang cho thay ty le nay chi la 71,4% [5J. Viec su" dung ly nhda sach diing 1 lan la rat can thiet phai thu'c hien d tat cac eac tru'dng hdp vi day la nguy cd lay nhiem qua djch tiet, mau va nu'dc bpt g\da benh nhan vdi benh nhan.Nghien eiru cat ngang cua Taha, Farheen va_ epng sir nam 2015 tai thanh pho Ernakulam, An Op cho biet 77% ngu'di benh da nhan thii'c dddc nguy cd lay nhiem cheo khi dieu trj nha khoa.
Ket qua nghien cuii nay tai khoa rang ham mat, benh vien Quan 7 cho thay hau het benh nhan danh gia tdt ve cdng tac ve sinh tai khoa, cd 86,0% tra ldi tinh trang ghe may nlia khoa sach se, 91,0% cho rang ndi nho nu'dc bpt ciia ghe nha khoa sach se. Danh gia chung ve cdng tac ve sinh tai khoa, cd 87,5% BN cho rang cdng tac nay du'dc thu'c hien tdt, tuy vay cd 11,5%
cho rang tam chap nhan ddr^c hoac khdng cd y kien.
4.3. Su' hai long cua ngu'di benh ve kiem soat n h i l m khuS'n t^i khoa rang ham mat, benh vien Qu$n 7, thanh phfii Ho Chi Minh
Ket qua khao sat eho thay, ty le ngu'di benh hai Idng ve cong tac kiem soat nhiem khuan tai khoa rang ham mat, benh vien Quan 7 la tu'dng doi cao vdi 79,0%. Tuy vay van cdn mpt so benh nhan chu^ thdc sd hai Idng ve kiem soat nhilm khuan tai khoa, cd 17,5% ngu'di benh khdng cd y kien lioac tam chap nhan; 3,5% ngu'di benh khdng hai long. Nhu' vay trong cong tac kiem soat nhiem khuan van cdn mpt so ban che chu'a lam hai long tat ca ngu'di benh, mat khac vdi sd phat trien ciia dich vu cham sdc siTc khde ndi chung va trong cac cd sd rang ham mat tai thanh pho Ho Chi Minh dat ra yeu eau can cd nhieu bien phap cai tien chat lu'dng can dddc thi/c hien nham tang sir hai Idng ngu'di benh, dap iTng nhu cau ciia nhan dan.
Ve cac de xuat cho nhan vien y te thu'c hanh tot kiem soat va lam hai long ngu'di benh, hau het ngu'di benh deu de xuat rang, de thiTc hien tot cong tac kiem soat nhiem khuan tai khoa, can chu y cdng tac ve sinh va viec thdc hanh phdng tranh cac lay nhiem cua nhan vien y te, vdi t / le la 66% va 66,5%. Ben canh dd, phan nhieu benh nhan de xuat rang can thdc hien tot cdng tac ve sinh phdng ngira lay nhiem, cd 61,5% benh nhan d ^ xuat rang ran cd khu dieu trj rieng cho benh nhan HIV/AIDS, viem gan sieu
vi B, C; 54,0% BN de xuat can tuan thii nghiem i quy trinh xi^ ly khir khuan, tiet khuan dung cu.
Dieu nay la phii hdp, cho thay nhiJng nhan thiTc dung dan ciia ngu'di benh trong phdng tranh cac benh lay nhiem, phdng tranh lay nhiem cheo giiJa cac benh nhan. Khao sat cua Suryakant C.
Deogade va cdng SLT nam 2016 tai Jabalpur, Madhya Pradesh - An Dp, cho biet 73,3% BN se tir choi dieu tri neu nha sT chu^ du'dc tiem ngiTa viem gan B.
V. KET LUAN
Cdng tac kiem soat nhiem khuan tai khoa rang ham mat, benh vien Quan 7, thanh phd Ho Chi l^inh du'dc thirc hien tu'dng doi tot, du'dc t h i hien qua danh gia ciia ngu'di benh; vdi 57,5%
ngu'di benh quan sat thay nhan vien y te thiTc hanh ruTa tay va sir dung day du phu'dng tien bao ve ca nhan, 87,5% cho rang cdng tac ve sinh dirdc thu'c hien tdt. Ty le ngu'di benh hai Idng ve cdng tac kiem soat nhiem khuan tu'dng dol cao la 79,0%. Can cd mpt sd bien phap cai tien chat lu'dng can dddc thdc hien nham tang sir hai long ngu'di benh, dap iTng nhu cau nhan dan.
TAI LIEU T H A M KHAO
1. Bd Y te (2009), Hudnp dan to chui: thdc hiSn cong tac kiem soat nhiem khuan trong cac cdsd kham benh, chu^ benh, Thong tu" 18/2009AT-BYT ngay 14/10/2009.
2. B6 Y te (2012}, Hudng dan khd khuan, tiet khuan dung cu trong cac cd sd kham binh, chi/S benh, Quyet dmh so 3671/QD-BYT ciia Bo y te ngay 27/9/2012.
3. Ngo Dong Khanh (2009), "Thy'c trang kiem soat nhiem khuan d mot so cd sd R§ng Ham M3t cac tinh phia Nam", Tap chi Y hrjc thanh phd Ho Oil Minh, Chuyen de Rang ham mat, Tap 13, Phu ban so 2, trang 84-92.
4. Tran Thj Lai (2015), Thu'c trang kiem soat nhiim khuan tai cac cd sd Rang Ham Mat dnh An Giang, nSm 2014, Luan an Chuyen khoa cap 2, 5. Tran Hai Sdn (2012), "Thi/c trang kiem soat
nhiem khuan tai cac cd sd rang ham mat, tinh Tien Giang", Tap chi Yhoc Thdc hanh 2012, so 831, tr.
40-50.
6. Guidelines for infection control in dental health care settings (2003], T A e centers for disease control and prevention (GX:)", MMWR 2003; 52 (RR-17), pp. 1-61.
7. Mohammad Abdul Baseer, Ghousia Rahman, and Mona Ali Yassin (2013), Infection control practices in dental school: A patient perspective from Saudi Arabia, Dent Res J (Isfehan). 2013 3an- Feb; 10(1), pp.25-30
