CIC Hand Hygiene & Isolation Precautions 2 — Questions and Answers
Question 1: Which of the following is classified as a 'moment' for hand hygiene according to WHO's Five Moments framework?
- Before entering the hospital
- After body fluid exposure risk (Correct answer)
- Before speaking with the patient
- After reviewing the patient chart
Correct answer: After body fluid exposure risk
Moment 3 in the WHO framework is 'After body fluid exposure risk,' which protects the healthcare worker and the environment.
Question 2: A hand hygiene compliance audit shows 45% compliance on a surgical unit. Which intervention has the strongest evidence for sustained improvement?
- Mandatory in-service training once per year
- Multimodal strategy including product availability, education, reminders, and feedback (Correct answer)
- Disciplinary action for non-compliant staff
- Replacing gloves with alcohol-based hand rub dispensers
Correct answer: Multimodal strategy including product availability, education, reminders, and feedback
WHO and CDC recommend a multimodal strategy combining facility change, training, reminders at point of care, and performance feedback for sustainable compliance gains.
Question 3: A patient with vancomycin-resistant Enterococcus (VRE) bacteremia is admitted. What precaution level is appropriate?
- Standard Precautions only
- Droplet Precautions
- Contact Precautions (Correct answer)
- Airborne Infection Isolation
Correct answer: Contact Precautions
VRE is transmitted by direct and indirect contact; Contact Precautions with gown and gloves are indicated to prevent environmental spread.
Question 4: Which action best describes 'doffing' personal protective equipment correctly?
- Removing gloves last to protect hands from contamination on other PPE
- Removing the gown first, then gloves, using gloved hands (Correct answer)
- Removing the respirator before the gloves
- Removing all PPE simultaneously at the doorway
Correct answer: Removing the gown first, then gloves, using gloved hands
The gown is removed first (while gloves remain on to handle the contaminated outer surface), followed by gloves, then eye protection, and finally the mask.
Question 5: What hand hygiene product is recommended for routine care when hands are not visibly soiled?
- Antimicrobial soap and water (minimum 60 seconds)
- Plain (non-antimicrobial) soap and water
- Alcohol-based hand rub (60–95% ethanol or isopropanol) (Correct answer)
- Chlorhexidine wipes
Correct answer: Alcohol-based hand rub (60–95% ethanol or isopropanol)
Alcohol-based hand rub with 60–95% alcohol is the preferred agent for routine care because it is faster, more effective against most pathogens, and less damaging to skin.
Question 6: Which patient population requires Protective (Reverse) Isolation rather than transmission-based precautions?
- Patients with active Clostridioides difficile infection
- Severely immunocompromised patients (e.g., allogeneic HSCT recipients) (Correct answer)
- Patients colonized with ESBL-producing organisms
- Patients on mechanical ventilation
Correct answer: Severely immunocompromised patients (e.g., allogeneic HSCT recipients)
Severely immunocompromised patients (e.g., post-allogeneic HSCT) require Protective Environment with positive-pressure rooms and HEPA filtration to guard against environmental fungi and bacteria.
Question 7: How frequently should hand hygiene compliance monitoring be conducted to meet The Joint Commission standards?
- Annually
- Quarterly at minimum with ongoing monitoring (Correct answer)
- Only when an outbreak is suspected
- Monthly during flu season only
Correct answer: Quarterly at minimum with ongoing monitoring
TJC requires ongoing monitoring of hand hygiene compliance with regular performance data collection and feedback to staff.
CIC Hand Hygiene & Isolation Precautions 2
Which of the following is classified as a 'moment' for hand hygiene according to WHO's Five Moments framework?