CHT Regulatory Standards & Infection Control 3 — Questions and Answers
Question 1: A patient with an active Clostridioides difficile infection is scheduled for hyperbaric therapy. What is the MOST appropriate infection control measure?
- Cancel all HBO treatments indefinitely
- Place patient last in schedule and use contact precautions with sporicidal disinfection (Correct answer)
- Treat patient first in the morning only
- No special precautions needed since C. diff is only fecal-oral
Correct answer: Place patient last in schedule and use contact precautions with sporicidal disinfection
C. diff requires contact precautions; scheduling the patient last and using an EPA-registered sporicidal disinfectant on chamber surfaces limits environmental contamination.
Question 2: Which level of disinfection is required for hyperbaric chamber acrylic viewports that come into direct contact with patient secretions?
- Low-level disinfection
- High-level disinfection (Correct answer)
- Sterilization
- Simple soap and water
Correct answer: High-level disinfection
Items that contact mucous membranes or non-intact skin are semi-critical and require high-level disinfection per Spaulding classification.
Question 3: Under The Joint Commission standards, a root cause analysis (RCA) is triggered in a hyperbaric unit when:
- A patient misses a scheduled treatment
- A sentinel event such as a fire or unexpected patient death occurs (Correct answer)
- A mild barotrauma of the ear is documented
- Routine equipment calibration is overdue
Correct answer: A sentinel event such as a fire or unexpected patient death occurs
TJC defines sentinel events (e.g., patient death, serious harm, fire) as requiring a root cause analysis and corrective action plan.
Question 4: According to CDC Hand Hygiene Guidelines, alcohol-based hand rub is NOT preferred over soap and water in which hyperbaric-specific situation?
- After removing gloves post-treatment
- When hands are visibly soiled with blood or body fluids (Correct answer)
- Before donning gloves for treatment
- After touching chamber surfaces
Correct answer: When hands are visibly soiled with blood or body fluids
CDC guidelines require soap and water (not alcohol rub) when hands are visibly soiled with blood, body fluids, or organic material.
Question 5: Which NFPA 99 requirement specifically governs the electrical grounding of equipment introduced into a Class A hyperbaric chamber?
- All electrical equipment must be 12V DC maximum
- Equipment must be approved for use in oxygen-enriched atmospheres and properly grounded to prevent static discharge (Correct answer)
- Standard household 120V equipment is acceptable if UL listed
- No special grounding is required if the chamber is monoplace
Correct answer: Equipment must be approved for use in oxygen-enriched atmospheres and properly grounded to prevent static discharge
NFPA 99 requires that electrical equipment used in oxygen-enriched hyperbaric environments be approved for that atmosphere and grounded to prevent ignition from static discharge.
Question 6: A hyperbaric facility's quality improvement program should review adverse events using which standardized severity classification tool most commonly referenced in HBO2 settings?
- ASA Physical Status Classification
- Baromedical Nurses Association Adverse Event Classification (Correct answer)
- Rankin Scale
- APACHE II Score
Correct answer: Baromedical Nurses Association Adverse Event Classification
The Baromedical Nurses Association (BNA) Adverse Event Classification system is the standard tool used in hyperbaric quality improvement programs.
Question 7: Per OSHA 29 CFR 1910.157, portable fire extinguishers in the hyperbaric suite must be inspected at which minimum frequency?
- Daily
- Monthly (Correct answer)
- Annually only
- Every 5 years
Correct answer: Monthly
OSHA requires monthly visual inspections of portable fire extinguishers, with annual maintenance inspections performed by a qualified person.
CHT Regulatory Standards & Infection Control 3
A patient with an active Clostridioides difficile infection is scheduled for hyperbaric therapy.
What is the MOST appropriate infection control measure?