AORN Infection Prevention and Control 3 — Questions and Answers
Question 1: What hand hygiene product is preferred by AORN for routine decontamination before and after patient contact in the perioperative environment?
- Plain soap and water for all situations
- Alcohol-based hand rub (ABHR) when hands are not visibly soiled (Correct answer)
- Antimicrobial soap for every hand hygiene opportunity
- Chlorhexidine scrub for all perioperative staff
Correct answer: Alcohol-based hand rub (ABHR) when hands are not visibly soiled
ABHR is preferred over soap and water for most hand hygiene moments because it is more effective against most pathogens and less damaging to skin, except when hands are visibly soiled or after C. diff contact.
Question 2: The Spaulding Classification System categorizes medical devices based on which criterion?
- Cost of reprocessing
- Manufacturer's country of origin
- Risk of infection based on intended use (Correct answer)
- Material composition of the device
Correct answer: Risk of infection based on intended use
Spaulding's classification (critical, semi-critical, non-critical) categorizes devices by the infection risk associated with how they contact patients, determining the required level of reprocessing.
Question 3: A flexible endoscope used for bronchoscopy is classified as which Spaulding category, and what level of reprocessing is required?
- Critical — sterilization required
- Semi-critical — high-level disinfection minimum (Correct answer)
- Non-critical — intermediate-level disinfection
- Critical — high-level disinfection acceptable
Correct answer: Semi-critical — high-level disinfection minimum
Flexible endoscopes contacting mucous membranes are semi-critical devices requiring at minimum high-level disinfection, though sterilization is preferred when feasible.
Question 4: When performing surgical hand antisepsis with an alcohol-based surgical hand rub, which action is correct?
- Apply for 15 seconds and proceed to gloving
- Apply per manufacturer's instructions until hands and forearms are dry (Correct answer)
- Rinse with sterile water after application
- Apply only to fingertips and nail beds
Correct answer: Apply per manufacturer's instructions until hands and forearms are dry
Alcohol-based surgical hand rubs must be applied to hands and forearms following the manufacturer's directions and allowed to dry completely before donning sterile gloves.
Question 5: Which of the following best describes the role of HEPA filtration in OR ventilation systems?
- It humidifies incoming air to prevent static electricity
- It removes particles ≥0.3 microns, including most bacteria and fungal spores (Correct answer)
- It sterilizes air before delivery to the OR
- It recirculates used OR air without filtration
Correct answer: It removes particles ≥0.3 microns, including most bacteria and fungal spores
HEPA filters capture at least 99.97% of airborne particles ≥0.3 microns, effectively removing bacteria, fungal spores, and other potential pathogens from OR air supply.
Question 6: A patient undergoing a total hip replacement is found to have an active methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization. Which preoperative intervention is recommended by AORN?
- Cancel the surgery until MRSA is fully eradicated
- Apply mupirocin nasal ointment and chlorhexidine skin bathing protocol preoperatively (Correct answer)
- Administer vancomycin prophylaxis only without decolonization
- Proceed without modification since colonization is not active infection
Correct answer: Apply mupirocin nasal ointment and chlorhexidine skin bathing protocol preoperatively
AORN recommends a decolonization protocol including intranasal mupirocin and preoperative chlorhexidine bathing for MRSA-positive patients to reduce SSI risk.
Question 7: What is the primary reason OR doors should remain closed during a surgical procedure?
- To maintain positive pressure differential and prevent contamination from corridor air (Correct answer)
- To prevent noise from disturbing the surgical team
- To keep the room temperature stable for patient comfort
- To comply with fire code regulations during procedures
Correct answer: To maintain positive pressure differential and prevent contamination from corridor air
OR positive pressure keeps unfiltered corridor air from entering; opening doors disrupts airflow patterns, allows unfiltered air ingress, and increases particle counts at the surgical site.
AORN Infection Prevention and Control 3
What hand hygiene product is preferred by AORN for routine decontamination before and after patient contact in the perioperative environment?