CIC Prevention Practices 4 — Questions and Answers
Question 1: A facility is experiencing an increase in CLABSI rates on a medical-surgical unit. Which strategy is MOST effective for sustainable reduction?
- Mandatory line change every 7 days
- Implementation and auditing of an insertion and maintenance bundle (Correct answer)
- Use of antibiotic-impregnated catheters on all patients
- Restricting central line insertion to intensivists only
Correct answer: Implementation and auditing of an insertion and maintenance bundle
Evidence shows that consistent adherence to a comprehensive insertion and maintenance bundle, with regular auditing and feedback, produces the most durable CLABSI reductions.
Question 2: Which element of the WHO 'Five Moments for Hand Hygiene' occurs BEFORE a clean or aseptic procedure?
- Moment 1
- Moment 2 (Correct answer)
- Moment 3
- Moment 4
Correct answer: Moment 2
WHO Moment 2 is 'Before a clean/aseptic procedure,' emphasizing hand hygiene to protect the patient from organisms on the HCW's hands before sterile tasks.
Question 3: Which strategy is MOST effective for preventing transmission of multidrug-resistant organisms (MDROs) in a long-term care facility?
- Routine weekly MDRO surveillance cultures on all residents
- Consistent use of standard precautions for all residents plus contact precautions for known MDRO carriers (Correct answer)
- Cohorting all residents with any positive culture history
- Universal use of contact precautions for all residents
Correct answer: Consistent use of standard precautions for all residents plus contact precautions for known MDRO carriers
Standard precautions applied to all residents combined with targeted contact precautions for known carriers balances safety with residents' quality of life in long-term care.
Question 4: A newly hired nurse asks why gloves must be changed between tasks even when caring for the same patient. What is the BEST rationale?
- To comply with Joint Commission standards
- To prevent transferring organisms between body sites or contaminated surfaces to the patient (Correct answer)
- To save costs by preventing overuse of gloves on other patients
- To reduce contact dermatitis risk for the nurse
Correct answer: To prevent transferring organisms between body sites or contaminated surfaces to the patient
Changing gloves between tasks on the same patient prevents cross-contamination between body sites (e.g., from a wound to a mucous membrane) and between contaminated surfaces and the patient.
Question 5: Which occupational health measure is MOST important for preventing healthcare worker transmission of influenza to patients?
- Mandatory fit testing for N95 respirators each fall
- Annual influenza vaccination of all healthcare personnel (Correct answer)
- Mandatory droplet precautions during influenza season for all staff
- Prophylactic oseltamivir for all unvaccinated staff
Correct answer: Annual influenza vaccination of all healthcare personnel
Annual influenza vaccination of healthcare personnel is the single most important measure to reduce HCW-to-patient transmission and protect HCW health.
Question 6: When performing high-level disinfection of a semicritical device, what is the minimum action required if the process is interrupted midway?
- Continue the process from where it stopped, adding the remaining time
- Restart the full disinfection cycle from the beginning (Correct answer)
- Rinse the device and perform low-level disinfection instead
- Document the interruption and proceed with use if >50% of time elapsed
Correct answer: Restart the full disinfection cycle from the beginning
If high-level disinfection is interrupted, the entire cycle must be restarted from the beginning to ensure the required contact time is achieved for all surfaces.
Question 7: Which type of isolation precaution is indicated for a patient diagnosed with disseminated herpes zoster (shingles)?
- Contact precautions only
- Droplet precautions only
- Airborne and contact precautions (Correct answer)
- Standard precautions only
Correct answer: Airborne and contact precautions
Disseminated herpes zoster requires both airborne precautions (for the varicella-zoster virus aerosolization risk) and contact precautions (for skin lesion drainage).
CIC Prevention Practices 4
A facility is experiencing an increase in CLABSI rates on a medical-surgical unit.
Which strategy is MOST effective for sustainable reduction?