CBIC Hand Hygiene 5 — Questions and Answers
Question 1: Which of the following best describes the 'Hawthorne effect' as it relates to hand hygiene compliance monitoring?
- Staff become desensitized to hand hygiene reminders over time
- Observed compliance rates are artificially elevated when staff know they are being watched (Correct answer)
- Electronic monitoring systems overcount dispenser use
- Night-shift staff have lower compliance than day-shift staff
Correct answer: Observed compliance rates are artificially elevated when staff know they are being watched
The Hawthorne effect causes observed compliance to be higher than actual compliance because staff modify behavior when they know they are being observed.
Question 2: In a long-term care facility, which resident population characteristic most increases the importance of strict hand hygiene by staff?
- Residents who are ambulatory and independent
- Residents who are immunocompromised or have indwelling devices (Correct answer)
- Residents who have short anticipated lengths of stay
- Residents admitted for rehabilitation only
Correct answer: Residents who are immunocompromised or have indwelling devices
Immunocompromised residents and those with indwelling devices are at highest risk for healthcare-associated infections from pathogen transmission.
Question 3: When alcohol-based hand rub is used correctly, which organism is it LEAST effective against?
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Influenza A virus
- Clostridioides difficile spores (Correct answer)
- Vancomycin-resistant Enterococcus (VRE)
Correct answer: Clostridioides difficile spores
Alcohol-based hand rubs are ineffective against C. difficile spores because spores have protective coats that resist alcohol denaturation.
Question 4: An ICP is analyzing hand hygiene product data and finds that lotion use increased after switching to a new hand rub. This likely indicates:
- Staff are avoiding the new product due to poor efficacy
- The new product is more drying or irritating to skin (Correct answer)
- Staff are confusing lotion dispensers with hand rub dispensers
- A supply chain issue with the original product
Correct answer: The new product is more drying or irritating to skin
Increased lotion use after a product switch suggests the new hand rub causes more skin dryness or irritation, a key driver of non-compliance.
Question 5: Which statement about jewelry and hand hygiene in healthcare settings is most accurate?
- Plain wedding bands are permitted in all clinical areas if hand hygiene is performed
- Rings should be removed before surgical hand antisepsis (Correct answer)
- Wristwatches are acceptable in the OR if covered with a sleeve
- Jewelry restrictions apply only to OR staff, not general ward nurses
Correct answer: Rings should be removed before surgical hand antisepsis
Rings and other jewelry should be removed before surgical hand antisepsis because they prevent adequate scrubbing of the subungual and periungual areas.
Question 6: A healthcare facility uses electronic hand hygiene monitoring badges. The primary advantage of this technology over direct observation is:
- It provides real-time feedback to individual staff members
- It captures a continuous, larger sample without observer bias or Hawthorne effect (Correct answer)
- It verifies correct technique including duration and friction
- It can distinguish alcohol rub use from soap and water use
Correct answer: It captures a continuous, larger sample without observer bias or Hawthorne effect
Electronic monitoring systems collect continuous data across all shifts without altering behavior through observation, providing more representative compliance rates.
Question 7: According to the WHO hand hygiene guidelines, the recommended volume of alcohol-based hand rub for a single hand hygiene episode is:
- 0.5–1 mL
- 1.5–3 mL (Correct answer)
- 3–5 mL
- 5–7 mL
Correct answer: 1.5–3 mL
WHO recommends applying 1.5–3 mL of alcohol-based hand rub to cover all hand surfaces adequately until dry.
CBIC Hand Hygiene 5
Which of the following best describes the 'Hawthorne effect' as it relates to hand hygiene compliance monitoring?