CIC- Infection Control Exam Questions With Correct Answers

Healthcare Personnel - Answer All paid and unpaid persons who work in a healthcare facility who, 1) Have professional or technical training and provide patient care, and 2) Provide services that support the delivery of healthcare. Nosocomial Infection - Answer An infection acquired during hospitalization; they are potentially caused by organisms that are resistant to antibiotics. Ex: MRSA Standard Precautions - Answer Precautions that apply to the care of all patients in all healthcare settings, regardless of the suspected or confirmed presence of an infectious agent, & constitutes the primary strategy for the prevention of HAIs (Healthcare Associated Infections). Chain of Infection - Answer 3 Elements 1) Source of reservoir of infectious agents. 2) Susceptible host with a portal of entry receptive of the agent. 3) Mode of transmission for the agent. HBV - Answer What is consider the major occupation hazard to HCP? HBV, HCV, HIV - Answer The transmission of which of the following pathogens is prevented or reduced by standard precautions? Measles Virus, Mumps Virus, Rubella Virus - Answer Pathogens transmitted primarily by droplet inhalation? HSV type 1 (Herpes), HSV type 2, VZV (Chickenpox) - Answer Pathogens transmitted primarily by direct contact with vesicular fluids/exudates? Source Control Measures - Answer -Hand Hygiene -PPE -Cough Etiquette -Have policies in place -Clean Environment -Safe disposal of waste -Medical History Prior to Treatment Respiratory Protection Controls - Answer Employees must wear respirator to cover nose, mouth, entire face or head to protect themselves from harmful agents. OHCP providing care to a patient with suspected or confirmed airborne infectious disease must use a respirator with a filtration capacity of >/= 95%. HCP must wear a surgical mask for all close contact with the patient. The mask should be donned upon entering and removed before exiting the DTR. Diseases that are preventable by vaccines in the US - Answer Measles, Pertussis (whooping cough), Influenza, Polio, Tetanus, Hepatitis B, Mumps, HPV, Tuberculosis, Varicella Hepatitis B Vaccine - Answer Injection given in 3 dose series on a 0,1, and 6-Month Schedule Influenza Vaccine - Answer Given yearly and changes every year because the virus changes. Usually given in the arm or as a nasal mist. MMR Vaccine - Answer Measles, mumps, and rubella vaccine. Given to children around 9-15 months of age, with a second dose at 15 months to 6 years of age, with at least 4 weeks between doses. This trivalent vaccine is the vaccine of choice for routine adult vaccination. This vaccine contains live attenuated virus grown in chick embryo and live attenuated virus grown in human diploid cell culture. There is no evidence to support a causal association between this vaccine and autism. HPV - Answer human papilloma virus, sexually transmitted. There is a vaccine that prevents the HPV strains most likely to cause genital warts and cervical cancer. The vaccine given is named Gardasil and consists of 3 separate shots, the second shot is given 2 months after the first; the third shot is given 4 months after the second shot. 3 IM doses at 0, 2, 6 months. A bivalent vaccine (Cervarix) is approved for use in girls and young women 9-15 years of age to prevent diseases. Hepatitis A Virus (HAV) - Answer The most preventable type of hepatitis. It is spread through the fecal-oral route, and contaminated food. Recommended for adults with chronic liver disease, illicit drug users, and those at risk of healthcare-associated exposure. Vaccines Vaqta and Havris consists of 2 doses; vaccination with Twinrix requires 3 doses. Documentation of vaccination and immune status of OHCP - Answer 1) An immunization record should be established for each OHCP at the time of initial employment. 2) At each subsequent immunization encounter, the record should be updated. 3) If there is any doubt as to the immune system status of an OHCP, it is best to assume that the person is not immune. PPE (Personal Protective Equipment) - Answer Medical devices designed to protect healthcare personnel from acquiring HAIs. In oral healthcare settings, include the use of surgical gowns, surgical masks, respirators, goggles, face shields, & gloves. Mandated by Standard & Transmission-Based Precautions. CDC (The Centers for Disease Control & Prevention) - Answer Federal agency that makes evidence-based recommendations related to the prevention & control of disease, injury, & disability. Promotion, prevention, & preparedness with the goal of improving overall public health in the United States. OSHA (Occupational Safety & Health Administration) - Answer Federal agency responsible for setting & enforcing regulations to assure safe & health working conditions for men & women by setting & enforcing standards & by providing training, outreach, education, & assistance. PPE - Answer Personal Protective Equipment: Surgical gowns, surgical masks, respirators, goggles, face shields, & gloves. Alcohol-based hand rub (ABHR) - Answer (Antiseptic Handrub) refers to a 60-95% ethanol or isopropyl (types of alcohol) containing preparation designed for application to the hands to reduce microorganisms. -This method is recommended by the CDC and WHO if hands are NOT visibly soiled or visibly contaminated with blood or other proteinaceous. Sterilization - Answer A validated process that destroys all forms of microbial life. The term is intended to convey an absolute meaning, although the probability of the presence of pathogenic and other organisms can never be reduced to zero. Disinfection - Answer Defines a process that is less lethal than sterilization, i.e., disinfection destroys some, but not all recognized pathogens and it does not predictably eliminate bacterial spores Disinfectants - Answer Germicides that are applied to inanimate objects such as instruments and other devices and environmental surfaces Germicide - Answer refers to both disinfectants and antiseptics Antiseptics - Answer Germicides applied to skin and other living tissue Detergents - Answer are compounds with both hydophilic and lipophilic parts - the term "soap" is often used to refer to such products. High-level disinfectants - Answer They kill all pathogens but not all bacterial spores Intermediate-level disinfectants - Answer Kill mycobacteria, vegetative bacteria, most viruses and fungi, but they will not kill spores Low-level disinfectants - Answer Kill most vegetative bacteria and some viruses and fungi. Cleaning - Answer The physical action of scrubbing patient-care items with water and a detergent or an enzymatic product and rinsing them with water to remove contaminants. Spaulding's classification of patient-care items - Answer Patient-care items can be categorized as critical, semi-critical and non-critical predicated on the degree of risk for healthcare-associated transmission of infectious diseases with their use. Steam Sterilizers (Autoclaving) - Answer *Requires exposure of each item to direct steam contact at a specified temperature and pressure for a defined period of time. *The most dependable and economical process. It is the most widely used method for wrapped and unwrapped critical and semi-critical items that are not heat and/or moisture sensitive. 2 basic types: 1) Gravity Displacement. 2) High-Speed Prevacuum. Processing contaminated reusable patient-care items - Answer There should be a central processing area (CPA) of adequate size with four successive stations for: (1) receiving and cleaning (2) preparation and packaging (3) sterilization or disinfection (4) storage of sterilized units (e.g., individual packs, peel pouches, containers, etc...) *Each station should be physically separated to control traffic flow and to contain contaminants during the process. If physical separation is not practical, spatial separation might be satisfactory.* Preparing and packaging instruments - Answer At the second station of the CPA, the individual instruments may be placed in self-sealed or heat-sealed plastic and paper pouches; or they may be arranged in rigid or perforated trays/cassettes and wrapped. Complex instruments must be disassembled according to manufacturer's instructions and hinged instruments must be in an open, unlocked position. The packaging material must allow penetration of the sterilization agent to the items being sterilized. Sterilizing unwrapped instruments - Answer (1) Instruments must be thoroughly cleaned & dried prior to the cycle. (2) Mechanical indicators must be checked and, at a minimum, a chemical indicator must be placed with the items to be sterilized. (3) Care should be taken to avoid thermal injury to OHCP or patients. (4) Items must be transported aseptically to the point of use. *Unwrapped or flash sterilization of implantable items is not recommended. *Unwrapped sterile instruments and other devices exposed to air can become contaminated with dust, airborne organisms, and other contaminants before use on a patient and should never be stored. *Critical items sterilized unwrapped must be transferred from the sterilizer to the point of use by an aseptic method for immediate use. *Semi-Critical Items must be handled in a similar manner and should be used within a short time of sterilization. Storing Sterilized Items - Answer -After the sterilization cycle is completed and the instrument units are dry and cool, inspect all packages for proper color change by visible chemical indicators. -The units should then be stored in a clean, dry, closed cabinet. -Storage practices for wrapped sterilized instruments should be event-related. -Event-related practices recognize that packages remain sterile indefinitely, unless an event causes a package to become contaminated (e.g., torn, wet, or open packaging). -Prior to distribution to the point of use, the sterile instrument units should be inspected to verify barrier integrity and dryness. -When the packaging is compromised (i.e., torn, wet, or open), the instruments should be re-cleaned, re-packaged in a new wrap, and re-sterilized. -The date of sterilization and the sterilizer used, noted on the outside of the packaging material, should facilitate the retrieval of suspected instrument units in the event of a sterilization failure. Sterilization Monitoring Record (SMR) - Answer *Documentation in the form of a log, is an absolute requirement of quality assurance.* -What is the 4th component of quality assurance, that provides evidence the monitoring process is ongoing and that the cycle parameters are being confirmed in a timely manner by all appropriate indicators. -It provides a mechanism for determining if a recall is indicated and, in combination with the date and sterilizer number on each pack, the extent of the recall. -Finally, it establishes accountability. What are the procedures to follow in the event of a positive spore test? - Answer -The sterilizer should be removed from service! -All records of physical and chemical monitoring since the last negative BI test should be reviewed. -If the physical (ex: time, temperature, and pressure) & chemical (ex: internal or external) indicators demonstrate the sterilizer is functioning CORRECTLY, a single positive spore test probably does not indicate sterilizer malfunction, consider the possibility of an operator error*