infection control

What is the role of surgical asepsis in infection control?

Involves using sterile techniques to prevent infection of a surgical wound by eliminating pathogens from the client, medical personnel, and surgical environment

What is the main purpose of hand hygiene in medical and surgical asepsis?

To prevent transmission of microorganisms that can cause infection

What are the two tiers of CDC precautions used to prevent the transmission of infectious agents in healthcare settings?

Standard precautions and transmission-based requirements

When should standard precautions be applied in a healthcare setting?

Should be applied to the care of all patients in all healthcare settings regardless of suspected/confirmed presence of infectious agent

Which types of body fluids or materials require the application of standard precautions?

Blood, blood products, body fluids, secretions, excretions (except sweat), nonintact skin, mucous membranes

What is the primary goal of transmission-based precautions in infection control?

To interrupt the transmission of pathogens from clients who are infected or colonized with highly transmissible infectious agents

What is the primary purpose of PPE in healthcare settings?

To protect healthcare workers and patients from exposure to infectious agents and hazardous materials like blood, body fluids, secretions, and excretions

When should hand hygiene be performed during client care to prevent cross-contamination?

Before and after contact with client, after removing gloves, between client contacts, and between tasks/procedures on the same client to prevent cross-contamination

Why is hand hygiene necessary both before and after using gloves?

To ensure hands are clean and after removing gloves to avoid transferring microorganisms to other clients or environments

Under what conditions can alcohol-based hand rubs be used for hand hygiene?

When hands are not visibly soiled.

Why is alcohol-based hand sanitizer not effective when hands are visibly soiled?

It cannot adequately remove dirt and organic material which may harbor microorganisms

Why is it important to rub hands together until alcohol-based hand sanitizer has completely evaporated?

It ensures the full antiseptic effect and prevents a moist environment that could encourage pathogen growth

What is the recommended water temp for handwashing and why?

Warm water as it is effective in removing microorganisms and prevent skin irritation

What is the recommended maximum length for fingernails in healthcare settings and why?

No longer than 0.6 cm past the nail bed. Longer nails harbor pathogens, reducing the effectiveness of hand hygiene

Why should artificial nails and gel polish be avoided in healthcare settings?

They can harbor microorganisms, increasing risk of infection transmission

What is the difference between standard hand hygiene and surgical hand asepsis?

Standard hand hygiene: involves decontamination of hands using antimicrobial or plain soap and water or an antiseptic hand rub\n\nSurgical asepsis: involves an antiseptic surgical hand scrub or antiseptic surgical hand rub performed before applying sterile surgical attire

What is the primary purpose of performing a surgical hand scrub before a sterile procedure?

To remove debris and transient microorganisms from the nails, hands, and arms, reduce the resident microbial count to a minimum, and inhibit the rapid regrowth of microorganisms to maintain surgical asepsis

What steps should be taken before beginning the surgical hand scrub?

Apply surgical cap, shoe covers, mask, protective eyewear, remove jewelry, perform pre scrub wash using antimicrobial soap and warm water

Why is hot water not recommended during the surgical hand scrub?

It can dry the skin, leading to cracking, and may make it uncomfortable to wash for the recommended amount of time

What is the recommended practice for cleaning the subungual area during a surgical hand scrub?

Should be cleaned using a nail-cleaning tool to remove debris from under the nails

What is the counted stroke method in a traditional surgical hand scrub?

It involved scrubbing each surface with a specific number of strokes, such as 15 strokes for the fingernails and 10 strokes for each side of the fingers, palms, and forearms

When performing a timed surgical scrub, what is the general recommendation for scrubbing the fingers and hands?

At least two minutes or depending on facility policy

Why is it important to keep the hands higher than the elbows during the surgical hand scrub?

It ensures that water flows from the cleanest area (hands) to the less clean area (elbows), preventing recontamination of the hands

What is the significance of rinsing the hands and arms in one direction during the surgical scrub?

Rinsing from fingertips to elbows prevents recontamination by ensuring that the rinse water flows away from clean hands

What should be done if hands or forearms are damp before using an alcohol-based rub?

Should be thoroughly dried before applying alcohol-based rub as damp or wet skin can reduce the effectiveness of the product

What is the key difference between the traditional surgical hand scrub and the alcohol-based hand rub technique?

Traditional: involves using an antimicrobial agent with a sponge and brush\n\nAlcohol-based: uses any alcohol-based rub that is applied after drying the hands and forearms completely

What is the advantage of the brushless alcohol-based surgical scrub technique?

Reduced potential for skin irritation while being as effective as the traditional scrub in preventing surgical site infections

How should the sterile towel be used to dry hands and forearms after a surgical scrub?

Use one corner of the towel to dry one hand and forearm with a rotating motion, then use the opposite end or side of the towel to dry the other hand and forearm, ensuring no cross-contamination

What precautions should be taken to prevent contamination after completing the surgical hand scrub?

Keep hands in front of body above the waist, avoid touching non sterile surfaces, back through the door

What PPE is typically used under standard precautions?

Gloves, gowns, masks, face shields, eye protection as appropriate based on anticipated exposure

Which types of PPE are commonly used to prevent exposure to blood borne pathogens during patient care?

Gowns, gloves, masks, eye protection, and respirators

What types of PPE should be used during procedures likely to generate splashes or sprays of body fluids?

Gloves, gowns, masks, eye protection

Why is it important to select the appropriate size gloves before donning them?

Gloves that fit comfortably provide better protection and reduce the risk of contamination or tearing during use

What is the first step before donning gloves to ensure proper infection control?

Perform hand hygiene until the product disappears and the hands are dry

When should gloves be changed during the care of a single patient?

Between tasks or procedures on the same patient after contact with materials that may contain high concentrations of microorganisms to prevent cross-contamination

What are the key steps for safely removing gloves to avoid contamination?

Grasp cuff of one glove and peel it off turning it inside out, hold removed glove in palm of gloved hand, slide ungloved fingers under the cuff of the remaining glove and peel it off encasing first glove, dispose of gloves properly and perform hand hygiene

What precautions should be taken for healthcare workers or clients with a latex allergy during sterile procedures?

Should use powder-free non-latex or latex-free gloves, equipment, and supplies, avoid latex-containing products, and ensure availability of latex-free supplies in workspace

What is the primary function of a sterile gown during surgical procedures?

To establish a barrier that minimizes the passage of microorganisms from non sterile to sterile areas, ensuring a sterile surgical environment

Which parts of the gown are considered sterile after donning it?

The front of the gown from the chest to the waist level and the sleeves from 5cm above the elbow to the seam of the inside cuff are considered sterile

Which areas of a sterile gown are considered non sterile after it is donned?

The neckline, shoulders, ancillary area, back of gown, and cuff

Why should the sterile gown be folded inside out when pre opened and placed on the sterile field?

Folding the gown inside out allows the team member to pick it up with scrubbed hands and don it while touching only the inside surface preserving sterility

How should the sterile gown be lifted from the sterile field to avoid contamination?

Should be lifted by touching only the inside surface just below the neck band, ensuring the outer surface remains sterile

How should the sterile gown be unfolded to maintain sterility during the donning process?

Should be held at arms length, unfolded away from body, and only the inside surface should touch the body to keep the outer surface sterile

What steps are involved in donning a sterile gown with assistance?

The assistant holds the gown at shoulder height with the inside facing the team member, helps insert the arms into the sleeves, secures gown at the back, and assists with front tie if necessary

What precautions should be taken with hands and arms while wearing a sterile gown?

Should be kept above the waist, below neckline, close to body, and in view at all times to avoid contaminating the gown or sterile field

Why should gowns be tied at the neck and waist during patient care?

To ensure full coverage and prevent the gown from slipping, minimizing exposure of skin and clothing to contaminants

Why is it essential to cover the cuffs of a sterile gown with sterile gloves?

The cuffs are considered nonsterile, and covering them with sterile gloves prevents contamination and maintains asepsis during the procedure

What is the key difference between the open gloving and closed gloving techniques?

Open gloving: uses skin to skin and glove to glove approach without requiring sterile gown\n\nClosed gloving: involves wearing sterile gown and prevents hand contact with outside of gloves

Why is the closed gloving technique preferred in surgical procedures?

Because it prevents contamination by ensuring that hands only touch the inside of the gown and gloves keeping the outside sterile

How should the dominant hand be gloved when using the closed gloving technique?

Should be placed in the palm of the dominant hand with the glove opening pointing toward the fingers. The nondominant hand grasps the cuff by the top fold and pulls it over the end of the sleeve

When using the open gloving technique how should the second glove be donned?

The gloved hand should slide the fingers under the cuff of the second glove, lifting it away from the sterile wrapper, and carefully pull it over the nondominant hand, keeping the cuff folded over the glove

What should the nurse instruct assistive personnel regarding the open gloving method?

That the inside of the glove is nonsterile and should only be touched by the ungloved hand, while maintaining a skin-to-skin and glove-to-glove technique

What are the risks associated with leaving the procedure room while wearing a sterile gown?

Increases the risk of contamination, as the gown may come into contact with non sterile surfaces or environments

What should be done if the sterile gown becomes soiled or potentially contaminated during surgery?

It should be replaced to maintain sterility and prevent the risk of introducing microorganisms into sterile field

What steps should be followed to safely remove a soiled gown?

Untie waist tie, untie neck tie, pull gown forward away from body, roll inside out into a bundle while avoiding contact with the outside, dispose of gown and perform hand hygiene

What steps should be followed to safely remove a mask after patient care?

Untie or lift elastic straps from the back of the head without touching the front, remove mask and dispose of it properly, perform hand hygiene

What is the difference between surgical masks and N95 respirators?

Surgical masks: protect against splashes, sprays, and droplets\n\nN95: provide higher level of filtration protecting against airborne particles and pathogens

When is it necessary to use an N95 instead of a regular surgical mask?

When caring for patients with airborne diseases like TB, measles, Covid-19, where there is a high risk of inhaling infectious particles

What is the importance of performing a fit test before using an N95?

It ensures that the N95 respirator forms a proper seal on the wearers face, preventing inhalation of airborne particles and ensuring maximum protection

What are the key differences between direct-vented and indirect-vented goggles?

Direct-vented: may allow penetration of splashes\n\nIndirect-vented: designed to prevent splashes from reaching the eyes, making them more reliable for infection control

Why are prescription eyeglasses or contacts not suitable as eye protection in healthcare settings?

They do not provide adequate coverage against splashes or sprays of infectious materials which can lead to ocular exposure and disease transmission

What steps are involved in achieving surgical asepsis before performing a sterile procedure?

Applying a hair cover, mask, protective eyewear, shoe covers, performing hand scrub, donning sterile gown and sterile gloves

What is the minimum distance team members not implementing aseptic measures should maintain from a sterile field?

Should be at least one foot away from the sterile area

Why is it necessary to prepare a sterile field at waist level or higher?

To ensure that the field remains within the line of sight as any area below waist level is considered nonsterile and at risk of contamination

What is the appropriate surface for placing the sterile glove package before opening it?

On a clean dry surface at or above waist level as the area below waist level is considered contaminated

What steps should be taken to expose the sterile gloves without contaminating them?

The flaps of the sterile glove package should be folded up and away from the gloves without touching the inside of the package or the gloves

How should a nurse position a sterile drape on a work surface to maintain sterility?

Place the drape with the fluid-resistant side down, carefully opening the flaps farthest from the body first, followed by the side flaps, and finally the closet flap to the body, without touching the sterile surfaces

What features of a sterile drape ensure that it maintains sterility during use?

Are fluid resistant and have an inner sterile surface except a 1 inch border around the edges. This prevents contamination and allows sterile items to be placed on the drape safely

Why is it important to keep sterile items away from the edges of a sterile field?

The edges are considered nonsterile. Keeping them away from the edges reduces the risk of contamination

How should a nurse handle the outer wrapper of a sterile item to maintain sterility?

The nurse should hold the sterile item in the nondominant hand, peel the wrapper back with the dominant hand, and drop the sterile item onto the sterile field without letting the arms pass over the field. The outer wrapper should then be discarded

What precautions should be taken when pouring the sterile solution onto a sterile field?

Verify solutions expiration date and integrity, avoid touching bottles lip, hold bottle 10-15cm above sterile container, and avoid splashing to maintain sterility

Why is it necessary to keep sterile areas in view at all times during a surgical procedure?

It ensures that contamination can be avoided or identified immediately to maintain asepsis

What actions should a nurse take if the sterility of a field or item is in doubt during a procedure?

The nurse should immediately bring it to the attention of the person in charge and take steps to correct the issue, such as preparing a new sterile field or replacing the item

Which types of diseases require contact precautions, and what PPE is necessary?

MRSA, VRE, C.Dif, herpes. PPE includes gloves and gowns upon entering patients room

Which actions should be taken when coughing or sneezing to minimize the spread of respiratory infections?

Cover the mouth and nose with a facial tissue or the elbow if no tissue is available, dispose of tissue promptly, and disinfect hands

Why is wearing a surgical mask recommended for individuals who are coughing in healthcare settings?

It helps minimize contamination of the surrounding environment by containing respiratory secretions and reducing the risk of airborne transmission

What is the purpose of incorporating respiratory hygiene/cough etiquette into infection control in healthcare settings?

To prevent transmission of respiratory infections at the first point of contact with potentially infected individuals by implementing evidence based practices

How can healthcare facilities promote adherence to respiratory hygiene/cough etiquette among clients and visitors?

They can post signs in appropriate languages with instructions about hygiene practices and educate clients and families about these guidelines

What distance is recommended to maintain between individuals with respiratory symptoms and others in common waiting areas?

At least 1 meter (three feet) to reduce risk of transmission

How far can respiratory droplets travel and what precautionary measures are used to prevent their spread?

1-2 meters (3-6 feet) in any direction; droplet precautions involve wearing a surgical mask within 1 meter of the client, practicing proper hand hygiene, and using dedicated care equipment

What additional precautions should be observed when examining and caring for clients with respiratory symptoms?

Standard and droplet precautions including hand hygiene

What should you do if clean linens come into contact with the floor or an unclean surface?

Immediately place them in the soiled linens container to prevent contamination

What is the proper way to handle linens soiled with blood or body fluids?

Place them in a leak-resistant bag at the site of client care, secure bag, hold linens away from your body to prevent contamination of clothing

Why is it important to handle soiled items carefully and avoid shaking or tossing the item?

Shaking or tossing soiled linens can spread microorganisms to other clients and the environment, increasing risk of infection transmission

What precautions should be taken when dealing with specimens in a healthcare facility?

All specimens should be considered potentially infectious, must be collected in a container that closes securely with no contamination of the containers outside, specimens should then be placed in a plastic bag labeled biohazard before transport

What is the recommended method for disposing of sharp instruments such as needles or syringes?

A puncture resistant container. Never break, recap, bend or manipulate sharp injuries before disposal to prevent injuries

How should blood, body fluids, and suctioned fluids be disposed of in a healthcare setting?

Should be flushed into the sewage system or disposed of according to facility protocol. Care should be taken to avoid splashing on uniforms or the surrounding environment

How should reusable equipment contaminated with blood or body fluids be managed before being used for another client?

It should not be used for another client until it has been properly cleaned and reprocessed according to facility protocols

What should students focus on when gathering information from a clients medical record in clinical settings?

Gather only the information necessary to provide safe and efficient care, ensuring that the details are relevant to the clients current condition and treatment plan

Why is it important to exclude identifiable demographic information when preparing written materials in a clinical setting?

Ensures compliance with HIPAA regulations and protects the clients privacy and confidentiality

What key elements should be included in documentation for infection control measures in a clinical setting?

Infection control measures used, whether clean or sterile gloves were used, any latex allergy, procedure performed, clients response to care, specimens or cultures obtained and sent to lab, type and timing or transmission-based precautions implemented and discontinued

What information is NOT required to be documented when performing a procedure requiring aseptic technique?

The surgical hand scrub or the application of a sterile gown and gloves, as these are outlined in the facilities policy and procedure manual and are expected to be routinely followed