Improvement of dental nurses awareness of school dental sealant quality following the audit and feedback system: First phase of implementation

Aims To examine whether an audit and feedback system administered to groups of dental nurses could improve their awareness of dental sealant quality. Methods: A randomized cluster trial was performed among 45 dental nurses in 12 hospitals (6 control and 6 intervention hospitals). The dental nurses' baseline awareness about sealant effectiveness was ascertained by self-administered questionnaires. Dental nurses applied dental sealant to 1703 children 4121 teeth as their routine works. All sealed children were examined for sealant retention and caries. The audit and feedback system consisted of an examination of sealed teeth followed by confidential feedback of the data collected to the dental nurses who had applied the sealant. Logistic regression was used to estimate the influence of baseline awareness on sealant effectiveness. After the audit and feedback, focus group discussions (FGD) were conducted in the intervention hospitals to establish the dental nurses' awareness about service quality, and thematic content analysis was performed. Results: Forty percent of the dental nurses had low awareness about the effectiveness of sealant application. The rate of complete sealant retention and the rates of caries on sealed surfaces were poor at 41.2% and 4.2%, respectively. The dental nurses' baseline awareness had significant effect on sealant effectiveness. The results from the FGDs showed an improvement in the subjects' awareness of dental service quality. Conclusion: The intensive audit and feedback system was able to improve the dental nurses' awareness of dental service quality.