Download Infection Control

HealthStream Regulatory Script
Infection Control
Release Date: June 2009
HLC Version: 602
Lesson 1: Introduction
Lesson 2: Importance of Infection Control
Lesson 3: The Chain of Infection
Lesson 4: Infection Control Strategies
Lesson 5: Employee Health and Personal Responsibility
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1001
Introduction
Welcome to the introductory lesson on infection control.
IMAGE: 1001.JPG
As your partner, HealthStream strives to provide its customers with excellence in regulatory learning solutions.
As new guidelines are continually issued by regulatory agencies, we work to update courses, as needed, in a
timely manner. Since responsibility for complying with new guidelines remains with your organization,
HealthStream encourages you to routinely check all relevant regulatory agencies directly for the latest updates
for clinical/organizational guidelines.
If you have concerns about any aspect of the safety or quality of patient care in your organization, be
aware that you may report these concerns directly to The Joint Commission.
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1002
Course Rationale
This course will teach you the basics of infection control.
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You will learn:
• How diseases are spread
• How to help prevent the spread of disease in the healthcare
setting
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1003
Course Goals
After completing this course, you should be able to:
• Recognize the importance of infection control
• Identify how infections spread
• Recognize how to block the spread of infection
• List your responsibilities for infection control
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1004
Course Outline
This introductory lesson gave the course rationale and goals.
FLASH ANIMATION
Lesson 2 discusses the importance of infection control.
Lesson 1: Introduction
Lesson 2: The Importance of Infection Control
• Healthcare-associated infection
Lesson 3: The Chain of Infection
• Links in the chain
• Breaking the chain
Lesson 4: Infection Control Strategies
• Hand hygiene
• Standard Precautions
• Transmission-Based Precautions
• Disinfection & sterilization
Lesson 5: Employee Health & Personal
Responsibility
• Vaccinations
• Exposure
• When You Are Sick
Lesson 3 describes how infections spread.
Lesson 4 explains how to block the spread of infection.
Finally, lesson 5 discusses your role and responsibility for infection
control.
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Lesson 2: The Importance of Infection Control
2001
Introduction & Objectives
Welcome to the lesson on the importance of infection control.
FLASH ANIMATION
Lesson 2: The Importance of Infection Control
After completing this lesson, you should be able to:
• Healthcare-associated infection
• Recognize the significance of healthcare-associated
infection (HAI)
• Identify the importance of infection control for preventing HAI
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2002
Healthcare-Associated Infection
Sometimes, patients come to the hospital with infections. These
infections are community-acquired infections.
IMAGE: 2002.JPG
More often, patients do not have infections when they come to the
hospital. Sometimes, these patients develop infections after being
treated or admitted.
An infection that develops in the hospital or after treatment is a
healthcare-associated infection (HAI).
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2003
Healthcare-Associated Infection: Frequency and Incidence
In recent decades, the rate of HAI has increased.
IMAGE: 2003.JPG
Approximately two million hospital patients develop HAI each year.
This is about 10% of all patients admitted to the hospital.
Death from HAI may be as high as 90,000 patients per year. Caring
for patients with HAI costs billions of dollars each year.
Reasons for the increase include:
• People coming to the hospital are sicker. This puts them at
greater risk for infection.
• Antibiotic-resistant infections have become more common.
These infections can spread rapidly in the healthcare setting.
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2004
Healthcare-Associated Infection: Prevention
A good infection control program can help:
• Protect patients from HAI
• Protect hospital visitors and staff from infection
IMAGE: 2005.GIF
You play a key role in helping to prevent the spread of disease in
your facility.
You must:
• Know the infection control practices used in your facility
• Carefully follow those practices
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2005
Healthcare-Associated Infection: The Joint Commission
In 2009, the Joint Commission added a new National Patient Safety IMAGE: 2005a.jpg
Goal:
Goal 7: “Reduce the risk of health care associated infections”
They now require hospitals to implement best practices and
evidence-based guidelines to prevent:
• Infections caused by multidrug-resistant organisms
• Central line-associated infections
• Surgical site infections
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2006
Review
Healthcare-associated infection (HAI):
a. Is never fatal
b. Develops in all hospitalized patients
c. Develops after a patient has contact with the healthcare
system
d. All of the above
e. None of the above
MULTIPLE CHOICE INTERACTION
Correct: C
A: Incorrect. HAI leads to the death of as many as 90,000
patients each year. The correct answer is C.
B: Incorrect. HAI develops in about 10% of hospitalized
patients. The correct answer is C.
C: Correct.
D: Incorrect. The correct answer is C.
E: Incorrect. The correct answer is C.
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2007
Summary
You have completed the lesson on the importance of infection
control.
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Remember:
• Many patients develop HAI each year.
• A good infection control program can help prevent HAI in
patients.
• A good infection control program also protects hospital staff
and visitors.
• All facility employees must do their part to prevent the
spread of infection.
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LESSON 3: The Chain of Infection
3001
Introduction & Objectives
Welcome to the lesson on the chain of infection.
After completing this lesson, you should be able to:
• List the links in the chain of infection
• Identify the weakest link in the chain.
FLASH ANIMATION
Lesson 3: The Chain of Infection
• Links in the chain
• Breaking the chain
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3002
The Chain of Infection
How do infections spread from person to person?
IMAGE: 3002.JPG
The process is called the chain of infection.
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3003
Infectious Agents
CLICK TO REVEAL
The elements needed to transmit an infection include:
• Infectious agent
• Reservoir
• Portal of exit
• Method of transmission
• Portal of entry
• Susceptible host
Click on each of the elements above for a basic definition.
We will discuss each of these elements in greater detail on the following
screens.
Infectious agent
Any disease-causing germ (pathogen). This includes viruses, fungi,
bacteria, and parasites.
Reservoir
Where the pathogen lives or comes from. A reservoir can be an
infected person. Food, water, an animal, and dirt can also be
reservoirs.
Portal of exit
The way the pathogen leaves its reservoir. For example, suppose the
reservoir is a person, and the pathogen is a cold virus. The pathogen
can exit the person’s nose or mouth through a sneeze or a cough.
Method of transmission
How the pathogen moves from the reservoir to the susceptible host. In
the sneeze example above, the pathogen is carried in the sneeze
droplets. Other examples of transmission modes are sexual contact,
animal bite, and needle stick.
Portal of entry
Where the pathogen enters the body of the susceptible host. In the
sneeze example, the sneeze droplets could land on the susceptible
host’s eyes, nose, or mouth. These areas would be the portal of entry.
Broken skin is another common portal of entry for pathogens.
Susceptible host
Person who could get sick with a particular infection. In the sneeze
example, almost everyone is a susceptible host when it comes to cold
viruses. In other cases, some people are susceptible to a particular
infection, and others are not. Factors such as weak immunity or lack of
vaccination can make a host susceptible to disease.
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3004
Infectious Agent
Bacteria and viruses are the most common cause of HAI.
FLASH ANIMATION
Fungi also can cause HAI. However, this is less common.
Examples of bacteria that can cause infection are:
• Staphylococcus aureus
• E. coli
• Mycobacterium tuberculosis
Examples of viruses that can cause infection are:
• Influenza
• Hepatitis B
• Varicella zoster (chickenpox and shingles virus)
CDC/Janice Carr
/Jeff Hageman
CDC/Janice Carr
CDC/Erskine
CDC
Palmer/ M.L. Martin
CDC/Janice Carr
CDC/Erskine Palmer/B.G. Partin
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3005
Reservoir
Pathogens come from reservoirs.
IMAGE: 3005.jpg
The most common reservoir (or source) for HAI is an infected
person.
Other potential reservoirs are:
• Food
• Medications
• Dust
• Medical equipment
• Computers
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3006
Portal of Exit
The portal of exit is the way a pathogen leaves its reservoir.
FLASH ANIMATION
Portals of exit from an infected person include:
• The mouth, through coughing or speaking
• The nose, through sneezing
• Cuts, scratches, punctures, or wounds that allow blood to
leave the body
• Other openings in the body that allow body fluids to escape
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Method of Transmission
The method of transmission is how a pathogen travels.
FLASH ANIMATION
From person to person, a pathogen can travel by:
• Contact. This can be direct skin-to-skin contact. It also can
be indirect contact. Indirect contact happens when an
infected person touches a surface. Later, the susceptible
host touches the same surface and picks up the pathogen.
• Droplet. Respiratory droplets come from coughs, sneezes,
or talking. They can travel only a few feet through the air.
• Airborne respiratory particles. These tiny particles can
travel a long way through the air from the reservoir to the
susceptible host.
• Bodily fluids. Blood and other bodily fluids can transmit
disease if they contact a susceptible host’s broken skin or
mucous membranes [glossary].
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3008
Portal of Entry
A pathogen must enter a host to cause an infection. This happens
through a portal of entry.
FLASH ANIMATION
Examples of portals of entry are:
• Broken skin
• Mucous membranes
• Catheter access sites
• Surgical wounds
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Susceptible Host
A pathogen must find a susceptible host to cause infection.
IMAGE: 3009.JPG
Some people are more susceptible to infection than others.
Many hospital patients are particularly susceptible to infection.
These patients include:
• Surgical patients
• Patients with weakened immunity because of certain types
of disease
• Patients with weakened immunity because of taking certain
drugs
The very old and the very young have weaker immunity.
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3010
The Weakest Link in the Chain
To prevent the spread of infection, a link in the chain of infection
must be broken.
IMAGE: 3010.JPG
The weakest link in the chain is the method of transmission.
Therefore, most infection control strategies attack this link.
We will take a closer look at these and other strategies in the next
lesson.
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3011
Review
Assemble the chain of infection in order.
FLASH INTERACTION: 3011.SWF
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3012
Review
The weakest link in the chain of infection is the:
a. Reservoir
b. Portal of entry
c. Susceptible host
d. Method of transmission
MULTIPLE CHOICE INTERACTION
[CORRECT ANSWER: D]
[RESPONSE FOR CHOICE A: Incorrect.
[RESPONSE FOR CHOICE B: Incorrect.
[RESPONSE FOR CHOICE C: Incorrect.
[RESPONSE FOR CHOICE D: Correct.
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3013
Summary
You have completed the lesson on the chain of infection.
NO IMAGE
Remember:
• There are six links in the chain of infection:
• Infectious agent
• Reservoir
• Portal of exit
• Method of transmission
• Portal of entry
• Susceptible host
• To prevent the spread of infection, a link in the chain must be
broken.
• The weakest link in the chain is transmission. Most infection
control strategies target this link.
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Lesson 4: Infection Control
4001
Introduction & Objectives
Welcome to the lesson on infection control.
FLASH ANIMATION
After completing this lesson, you should be able to:
• Recognize good hand hygiene practices
• Identify the major elements of Standard Precaution
• List types of Transmission-Based Precautions
• Define disinfection and sterilization
Lesson 4: Infection Control Strategies
• Hand hygiene
• Standard Precautions
• Transmission-Based Precautions
• Disinfection & sterilization
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4002
Hand Hygiene: Handwashing
Proper hand hygiene is the single best way to stop the spread of
infection.
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The Joint Commission requires compliance with WHO [glossary] or CDC
hand hygiene guidelines.
Hands should be washed:
• With warm water and soap
• Using friction for at least 15 seconds
• At the beginning and end of the work shift
• Before eating, drinking, or applying cosmetics
• Following contact with contaminated items or surfaces
• After gloves are removed
• After using the bathroom or blowing the nose
• Before handling food, drugs, or cleaning supplies
• Before and after each patient contact
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4003
Hand Hygiene: Alcohol Rubs
Alcohol rubs can be used instead of soap and water for hand hygiene.
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These rubs are very effective at removing pathogens from the hands.
To use an alcohol rub:
• Apply enough rub to cover all of both hands.
• Rub hands until dry. Do not rinse or wipe dry.
You may use an alcohol rub almost any time hands should be washed.
In fact, the CDC [glossary] currently recommends alcohol rubs for
routine hand hygiene in most clinical situations.
An exception is when hands are visibly dirty. In this case, wash with
soap and water.
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4004
Hand Hygiene: Other
Jewelry and artificial nails can interfere with good hand hygiene.
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They also can be good places for bacteria to hide.
Therefore, healthcare workers should not wear artificial nails or an
excessive amount of jewelry if they:
• Have direct patient contact
• Clean or prepare things that patients may use
Natural nails should be kept no longer than ¼ of an inch long.
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4005
Standard Precautions
Proper hand hygiene is one part of Standard Precautions.
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Standard Precautions are a set of tools for blocking the spread of
bloodborne disease.
To decide whether you need to use Standard Precautions, ask yourself:
Is it possible that I could have contact with patient blood or other body
fluids during this task?
If the answer is “yes,” you must use Standard Precautions. The patient’s
diagnosis does not matter.
Standard Precautions are used with all patients.
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4006
Standard Precautions: Engineering Controls
Standard Precautions include the use of engineering controls.
IMAGE: 4006.JPG
Engineering controls are devices with built-in safety features. These
features eliminate or minimize the risk of exposure to blood and body
fluids. They should be examined and maintained on a regular basis.
Common examples of engineering controls are:
• Sharps disposal containers
• Needle-less systems
• Safety needles
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4007
Standard Precautions: Work Practice Controls
Standard Precautions also include work practice controls.
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Work practice controls are ways of doing your job that minimizes your
risk of exposure to blood and body fluids.
Handwashing is an example of a work practice control.
Other examples of work practice controls are:
• Never recap used needles
• Never point a needle toward any part of your body
• Never bend or break used needles by hand
• Always place used needles in a sharps disposal container
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4008
Standard Precautions: Personal Protective Equipment
Standard Precautions may require the use of personal protective
equipment (PPE).
IMAGE: 4008.JPG
PPE consists of protective coverings that minimize the risk of exposure to
blood or body fluids. For example:
• Gloves
• Gowns
• Face shields
• Masks
• Ventilation devices
Standard Precautions require you to use PPE in cases such as these:
• Gloves must be worn if there is a possibility of contact with blood
or body fluids.
• A mask, protective eyewear, and a gown must be worn if there is a
possibility of splashes or sprays of blood or body fluids.
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4009
Transmission-Based Precautions
CLICK TO REVEAL
Remember: Standard Precautions are used with all patients.
Patients with certain diseases require additional precautions to block the
spread of disease. These precautions are:
• Contact Precautions
• Droplet Precautions
• Airborne Precautions
Click on each type of precautions to learn more.
Contact Precautions
Contact Precautions are used when a patient has, or may have, a
disease spread by direct or indirect contact. Some examples of
conditions that call for Contact Precautions are:
• Scabies
• Drug-resistant infections
• Major wound infections
• Herpes simplex
To learn more, see the “Transmission-Based Precautions: Contact and
Droplet” course.
Droplet Precautions
Droplet Precautions are used when a patients has, or may have, a
disease spread by respiratory droplets. Some examples are:
• Rubella
• Diphtheria
• Influenza
• Meningococcal meningitis
To learn more, see the “Transmission-Based Precautions: Contact and
Droplet” course.
Airborne Precautions
Airborne Precautions are used when a patient has, or may have, a
disease spread by tiny airborne particles. Some examples are:
• TB
• Measles
To learn more, see the “Transmission-Based Precautions: Airborne”
course.
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4010
Disinfection and Sterilization
Another aspect of infection control is disinfection and sterilization.
IMAGE: 4010.JPG
Routine patient care can lead to contamination of:
• Environmental surfaces
• Patient equipment
• Medical devices
Decontamination is achieved by:
• Cleaning
• Disinfecting
• Sterilizing
OSHA requires decontamination of equipment contaminated with blood
or potentially infectious material.
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4011
Disinfection & Sterilization: Cleaning
The first step in the decontamination process is cleaning. This removes
visible debris.
IMAGE: 4011.JPG
Some items must be soaked in a detergent solution. It is important to
follow the manufacturer instruction for cleaning. You should also read the
chemical instructions before use.
After soaking, items generally are:
• Scrubbed using friction
• Rinsed with water
• Dried to remove excess water
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4012
Disinfection & Sterilization: Disinfection
After cleaning, some items are disinfected to destroy pathogens.
CLICK TO REVEAL
There are two types of disinfection:
• Low-level disinfection
• High-level disinfection
Low-level disinfection
Low-level disinfection destroys most pathogens. Spores
and some viruses may remain alive. This type of
disinfection is used for low-risk items. These are items that
come into contact with intact skin only. An example is
environmental surfaces.
Click on each to learn more.
High-level disinfection
High-level disinfection destroys all pathogens. This type of
disinfection is used for moderate-risk items. These are
items that may come into contact with mucous membranes
or non-intact skin. Examples are devices that will be placed
in a patient’s mouth during a procedure.
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4013
Disinfection & Sterilization: Disinfection
Disinfection is generally performed by soaking items in a solution.
IMAGE: 4013.JPG
The disinfectant solution must be:
• Appropriate for the item
• Approved by the FDA for disinfecting medical items
Items must be soaked for the required amount of time.
Some instruments may be disinfected automatically in machines.
Always follow your facility’s policies for proper disinfection
procedures.
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4014
Disinfection & Sterilization: Sterilization
Sterilization destroys all microbes. This includes viruses and all spores.
IMAGE: 4014.JPG
Sterilization is used for high-risk items. These are items that come into
contact with sterile tissues or the bloodstream. Examples are:
• Surgical instruments
• Implantable devices [glossary]
• Intravascular devices [glossary]
Sterilization methods commonly used in the healthcare setting are:
• Steam autoclave
• Gas sterilization with ethylene oxide (EtO)
Specific training is required to perform instrument sterilization.
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4015
Disinfection & Sterilization: Aseptic Technique
Using properly sterilized items is one part of aseptic technique.
IMAGE: 4015.JPG
Aseptic means “without microorganisms.” Aseptic technique is critical for
protecting patients from infection during invasive procedures.
For example, surgery is one important area where aseptic technique must
be used.
Aseptic technique for surgery includes:
• Using sterilized items (as mentioned above)
• Hand hygiene and the surgical scrub
• Wearing proper surgical attire
• Decontaminating the patient’s skin at the site of the procedure
• Maintaining the sterile field
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4016
Review
Which patient groups require the use of Standard Precautions?
a) All patients
b) Only patients with AIDS
c) Only patients with HIV infection
d) Only patients with HBV or HCV infection
e) Both C and D
MULTIPLE CHOICE INTERACTION
[CORRECT ANSWER: A]
[RESPONSE FOR CHOICE A: Correct. Standard
Precautions are used with all patients.
[RESPONSE FOR CHOICE B: Incorrect. The
correct answer is A. Standard Precautions are used
with all patients.
[RESPONSE FOR CHOICE C: Incorrect. The
correct answer is A. Standard Precautions are used
with all patients.
[RESPONSE FOR CHOICE D: Incorrect. The
correct answer is A. Standard Precautions are used
with all patients.
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4017
Review
A high-risk item such as a scalpel blade should be ________ prior to
being used on a patient.
a. Sterilized
b. Low-level disinfected
c. High-level disinfected
MULTIPLE CHOICE INTERACTION
[CORRECT ANSWER: A]
[RESPONSE FOR CHOICE A: Correct.
[RESPONSE FOR CHOICE B: Incorrect. The
correct answer is A. High-risk items should be
sterilized.
[RESPONSE FOR CHOICE C: Incorrect. The
correct answer is A. High-risk items should be
sterilized.
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4018
Summary
You have completed the lesson on infection prevention.
NO IMAGE
Remember:
• The single most important thing you can do to stop the spread of
disease is to practice proper hand hygiene.
• Standard Precautions protect against the spread of bloodborne
disease. These Precautions should be used with all patients.
• Standard Precautions include engineering controls, work practice
controls, and the use of PPE.
• Patients with certain diseases must be isolated with Contact
Precautions, Droplet Precautions, or Airborne Precautions. This is
in addition to Standard Precautions.
• Items become contaminated during patient care. Items must be
decontaminated by cleaning, disinfecting, and/or sterilizing.
• Using sterilized items is one part of aseptic technique. Aseptic
technique should be used during all invasive procedures. This
protects patients from infection.
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Lesson 5: Employee Health & Personal Responsibility
5001
Objectives
Welcome to the lesson on employee health and personal responsibility.
FLASH ANIMATION
After completing this lesson, you should be able to:
• List immunizations for healthcare workers
• Describe exposure follow-up practices
Lesson 5: Employee Health & Personal
Responsibility
• Vaccinations
• Exposure
• When You Are Sick
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5002
Immunizations
To protect themselves and others, healthcare workers should have
immunity to vaccine-preventable diseases. These diseases include:
• Hepatitis B
• Measles
• Varicella (chickenpox / shingles)
• Rubella
• Mumps
• Influenza
IMAGE: 5002.JPG
Ask your supervisor for more information on the immunization program
at your facility.
As an employee, you may be tested to check your:
• Immune status
• Need for immunization
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5003
Exposure to Bloodborne Pathogens
If you are ever exposed to blood or other bodily fluids, report this
immediately.
IMAGE: 5003.JPG
This means that you should immediately report:
• Needle-stick
• Cut or puncture from any other contaminated sharp
• Splash or spray of blood onto unprotected areas
When you report an occupational exposure, your facility is responsible for
making sure that you receive appropriate follow-up.
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5004
Exposure to Other Communicable Diseases
IMAGE: 5004.JPG
At times, you may have contact with a patient before he or she is
diagnosed with a disease that calls for isolation precautions.
If this happens, you may need to report to occupational health for:
• Assessment
• Testing
• Other follow-up procedures
Sometimes, you will have immunity to the disease in question. In this
case, nothing more will need to happen.
Other times, you may have to stay home from work for a few days. You
may also receive medications to keep from getting sick, depending on the
patient’s diagnosis.
Your supervisor and occupational health professionals will provide
information and follow-up.
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5005
When You Have a Communicable Disease
If you have an infection, report to your supervisor before your shift
starts.
IMAGE: 5005.JPG
In most cases, you will need to stay home from work until you have
recovered or started treatment.
Do NOT come to work if you have:
• Fever
• Conjunctivitis [glossary]
• Vomiting or diarrhea
• Coughing or sneezing
• Unexplained rash
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5006
Review
Report to your supervisor immediately if:
a. You cut yourself with a contaminated scalpel.
b. You stick yourself with a contaminated needle.
c. You are splashed in the face with blood, and you are not wearing
goggles or a mask.
d. All of the above
e. None of the above
MULTIPLE CHOICE INTERACTION
Correct: D
A: Incorrect. The correct answer is D. All of these
exposures should be reported immediately.
B: Incorrect. The correct answer is D. All of these
exposures should be reported immediately.
C: Incorrect. The correct answer is D. All of these
exposures should be reported immediately.
D: Correct.
E: Incorrect. The correct answer is D. All of these
exposures should be reported immediately.
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5007
Summary
You have completed the lesson on employee health and responsibilities
NO IMAGE
Remember:
• Make sure you have been vaccinated against important diseases.
• Report unprotected blood or body fluid exposures to your
supervisor immediately.
• Report any unprotected contact with communicable disease.
• Do not come to work if you are sick.
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Glossary
antibacterial
containing chemical agents that reduce or inhibit microbes
blood
blood or blood products including serum, packed cells, and plasma
body substances
any body fluid, secretion, or excretion: urine, feces, amniotic fluid, joint fluid, cerebrospinal fluid, wound drainage, saliva,
breast milk, and others
CDC
Centers for Disease Prevention and Control
communicable disease
disease that can be transmitted directly or indirectly from one person to another
community-acquired infection
infection acquired by a patient prior to admission to a medical facility
conjunctivitis
highly contagious infection of the clear covering over the white part of the eye
contamination
introduction of infectious material onto a clean or sterile surface
disinfection
process of using chemical agents to kill most infectious organisms
environmental surface
items in the physical environment with which patients and staff routinely come in contact
51
ethylene oxide
chemical used to sterilize heat-sensitive or delicate equipment that cannot be steam-autoclaved
immunization
protection against disease
implantable device
sterile medical device introduced into a patient using an invasive procedure and remaining in the patient for a period of
time
intravascular device
sterile device that enters the bloodstream
invasive procedure
procedure requiring entry into the body or sterile tissue of a patient
healthcare-associated infection
infection that develops after treatment at or admission to a medical facility
mucous membranes
moist body lining, such as the lining of the nose and mouth
pathogen
microorganism or substance that can cause disease
PPE
personal protective equipment
PPE
Post-exposure prophylaxis
52
spore
thick-walled reproductive form of an infectious agent capable of surviving extreme conditions
sterilization
process of killing all vegetative microorganisms as well as spores by exposure to heat, steam, or chemical agents
vaccine-preventable disease
disease for which there are known vaccines that will prevent infection
WHO
World Health Organization
53
Pre-Assessment
1. Healthcare-associated infection (HAI) is:
a. An infection that cannot be treated in a standard way
b. An infection that causes a patient to seek medical care
c. An infection that results from exposure to a sick family member
d. An infection that develops in the hospital or after medical treatment
Correct: An infection that develops in the hospital or after medical treatment
Rationale: HAI is infection that develops after contact with the healthcare system.
2. Each year, how many hospital patients develop HAI?
a. About 20,000
b. About 200,000
c. About 2,000,000
d. About 20,000,000
Correct: About 2,000,000
Rationale: An estimated 2,000,000 hospital patients develop HAI each year.
3. Consider the chain of infection. In the chain, an example of a "reservoir" is:
a. Sexual intercourse
b. An infected person
c. Mucous membranes
d. Skin-to-skin contact
Correct: An infected person
Rationale: An infected person is a reservoir in the chain of infection.
4. Consider the chain of infection. In the chain, the nose during a sneeze is an example of a:
54
a.
b.
c.
d.
Portal of exit
Portal of entry
Susceptible host
Method of transmission
Correct: Portal of exit
Rationale: Germs can exit the nose during a sneeze. Therefore, this is a portal of exit in the chain of infection.
5. Consider the chain of infection. Which link in the chain is most easily broken?
a. Reservoir
b. Portal of exit
c. Portal of entry
d. Method of transmission
Correct: Method of transmission
Rationale: It is easiest to break the chain of infection at transmission. Therefore, most infection control strategies target the method of
transmission.
6. For routine hand hygiene in most clinical situations, the CDC recommends:
a. Alcohol rubs
b. Chlorine rinse
c. Iodine compounds
d. Plain soap and water
Correct: Alcohol rubs
Rationale: Under current CDC guidelines, alcohol rubs should be used for routine hand hygiene in most clinical situations.
7. To decide whether you need to use Standard Precautions with a particular patient, the best question to ask is:
a. Am I up to date on my hepatitis B and hepatitis C vaccinations?
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b. Does this patient have HIV infection or suspected HIV infection?
c. Is it possible that I could have contact with body fluids during this task?
d. Will I be able to wash my hands immediately after performing this task?
Correct: Is it possible that I could have contact with body fluids during this task?
Rationale: Standard Precautions should be used whenever there is a risk of contact with patient blood or body fluids.
8. Engineering controls are a part of Standard Precautions. These controls include:
a. Safety needles
b. Gloves and gowns
c. The practice of not recapping needles
d. Washing hands after contact with blood
Correct: Safety needles
Rationale: Safety needles are a type of engineering control.
9. Disinfection:
a. Is a substitute for cleaning items to remove visible debris
b. Is generally achieved by soaking items in a chemical solution
c. Is performed by autoclaving or treatment with ethylene oxide
d. Is most often used on items that will come in contact with a patient's bloodstream
Correct: Is generally achieved by soaking items in a chemical solution
Rationale: Disinfection is used to kill pathogens on low-risk and moderate-risk items. Most often, pathogens are killed by soaking
items in a chemical solution for a period of time.
10. Healthcare workers should be immunized against:
a. Scabies
b. Anthrax
c. Hepatitis B
d. Bubonic plague
Correct: Hepatitis B
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Rationale: Healthcare workers should be immunized against several diseases, including hepatitis B
11. When you report an occupational exposure to patient blood, _____ is/are responsible for making sure you receive appropriate
follow-up
a. You
b. The patient
c. Your facility
d. The public health authorities in your state
Correct: Your facility
Rationale: Your facility is responsible for follow-up care when you report an occupational exposure to blood.
12. There are three types of Transmission-Based Precautions. One type is:
a. Droplet Precautions
b. Standard Precautions
c. Universal Precautions
d. Drug-Resistant Precautions
Correct: Droplet Precautions
Rationale: Transmission-Based Precautions are: Contact Precautions, Droplet Precautions, and Airborne Precautions.
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Final Exam
1. In recent decades, the rate of HAI has increased. One reason is:
a. Antibiotic-resistant infections have become more common.
b. Children receive more vaccinations with a risk of side effects.
c. Alcohol-based hand rubs are not suitable for infection control.
d. People live in more crowded places and are exposed to more germs.
Correct: Antibiotic-resistant infections have become more common.
Rationale: Antibiotic resistance contributes to HAI.
2. Each year, what percent of hospital patients develop HAI?
a. About 1%
b. About 10%
c. About 50%
d. Close to 100%
Correct: About 10%
Rationale: Each year, about 10% of hospital patients develop HAI.
3. Patient deaths from HAI have been estimated. The high end of the estimate is:
a. 900 deaths per year
b. 9,000 deaths per year
c. 90,000 deaths per year
d. 900,000 deaths per year
Correct: 90,000 deaths per year
Rationale: Patient deaths from HAI may be as high as 90,000 per year.
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4. Consider the chain of infection. In the chain, an example of a "method of transmission" is:
a. An infected person
b. Skin-to-skin contact
c. The mouth during a cough
d. A contaminated medication
Correct: Skin-to-skin contact
Rationale: Skin-to-skin contact is a method of transmission in the chain of infection.
5. Consider the chain of infection. In the chain, broken skin is an example of:
a. A reservoir
b. A portal of entry
c. A susceptible host
d. An infectious agent
Correct: A portal of entry
Rationale: Germs can enter the body through broken skin. Therefore, broken skin is a portal of entry in the chain of infection.
6. Consider the chain of infection. Which link in the chain is most easily broken?
a. Portal of exit
b. Infectious agent
c. Susceptible host
d. Method of transmission
Correct: Method of transmission
Rationale: It is easiest to break the chain of infection at transmission. Therefore, most infection control strategies target the method of
transmission.
7. When hands are visibly dirty, the CDC recommends hand hygiene with:
a. Alcohol rub
b. Chlorine rinse
c. Soap and water
d. Iodine compound
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Correct: Soap and water
Rationale: When hands are visibly dirty, wash with soap and water. Otherwise, use an alcohol rub.
8. Under Standard Precautions, gloves must be worn:
a. For all patient tasks
b. For all patients tasks when a hand-washing station is not nearby
c. For all patients tasks when the patient is known to have HIV/AIDS
d. For all patient tasks when there is a risk of contact with blood or body fluids
Correct: For all patients tasks when there is a risk of contact with blood or body fluids
Rationale: Gloves should be worn whenever there is a risk of contact with patient blood or body fluids. This is true regardless of the
patient's infection status.
9. There are three types of Transmission-Based Precautions. One type is:
a. Contact Precautions
b. Standard Precautions
c. Universal Precautions
d. Drug-Resistant Precautions
Correct: Contact Precautions
Rationale: Transmission-Based Precautions are: Contact Precautions, Droplet Precautions, and Airborne Precautions.
10. Sterilization:
a. Is a substitute for cleaning items to remove visible debris
b. Is generally achieved by soaking items in a chemical solution
c. Is performed by autoclaving or treatment with ethylene oxide
d. Is most often used on low-risk items that come into contact with intact patient skin
Correct: Is performed by autoclaving or treatment with ethylene oxide
Rationale: Sterilization is used to kill pathogens on high-risk items. Pathogens are killed by steam autoclaving or treatment with
ethylene oxide.
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11. Healthcare workers should be immunized against:
a. Varicella
b. Diphtheria
c. Tuberculosis
d. Herpes simplex
Correct: Varicella
Rationale: Healthcare workers should be immunized against several diseases, including varicella (chickenpox/shingles).
12. If you experience a needle-stick injury while caring for a patient, you should:
a. Change gloves and continue with your work
b. Immediately report the injury to your supervisor
c. Not worry about it if the patient does not have HIV/AIDS
d. Go home for the day to rest, then return to work for your next shift
Correct: Immediately report the injury to your supervisor
Rationale: All occupational exposures should be reported immediately. Your facility is responsible for ensuring appropriate postexposure follow-up.
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