CIC Prevention Practices 5 — Questions and Answers
Question 1: A patient in the ICU has a femoral central venous catheter that has been in place for 5 days. What is the recommended action?
- Routinely replace it over a guidewire to reduce infection risk
- Remove and replace at a new site as soon as an alternative site is feasible (Correct answer)
- Leave it in place and reassess in 7 days
- Obtain a catheter tip culture and replace only if positive
Correct answer: Remove and replace at a new site as soon as an alternative site is feasible
Femoral sites carry a higher infection and thrombosis risk; CDC guidelines recommend removing femoral catheters and using an alternative (subclavian or jugular) site as soon as clinically feasible.
Question 2: Which term describes the practice of bathing ICU patients daily with chlorhexidine gluconate (CHG) to reduce healthcare-associated infections?
- Source control
- Universal decolonization (Correct answer)
- Targeted decolonization
- Cohorting
Correct answer: Universal decolonization
Daily CHG bathing applied to all ICU patients regardless of MDRO status is called universal decolonization, shown in the REDUCE MRSA trial to lower bloodstream infection rates.
Question 3: A visitor arrives to see a patient on contact precautions for VRE. What is the MOST appropriate instruction?
- Visitors are prohibited from entering the room
- Visitors should perform hand hygiene before entering and upon leaving (Correct answer)
- Visitors must wear full PPE (gown, gloves, mask, eye protection)
- Visitors need only wear gloves if they will touch the patient
Correct answer: Visitors should perform hand hygiene before entering and upon leaving
Visitors should perform hand hygiene upon entering and leaving the room; gown and gloves are recommended if they will have direct contact with the patient or environment, but hand hygiene is always required.
Question 4: Which element of the ventilator-associated event (VAE) surveillance definition distinguishes a ventilator-associated condition (VAC) from a patient with baseline respiratory stability?
- A new fever above 38.3°C for two consecutive days
- A sustained increase in daily minimum FiO2 ≥0.20 or PEEP ≥3 cmH2O for ≥2 days (Correct answer)
- A new infiltrate on chest X-ray for 48 hours
- A positive respiratory culture after 48 hours of ventilation
Correct answer: A sustained increase in daily minimum FiO2 ≥0.20 or PEEP ≥3 cmH2O for ≥2 days
VAC is defined by a sustained increase in FiO2 ≥0.20 or PEEP ≥3 cmH2O above the baseline minimum for at least 2 consecutive days, indicating worsening oxygenation.
Question 5: A sterile processing technician notices that a surgical instrument pouch has a compromised seal after sterilization. What is the correct response?
- Use the instrument immediately to avoid wasted sterilization resources
- Consider the item non-sterile and reprocess it (Correct answer)
- Re-seal the pouch with heat and document the repair
- Perform a sterility indicator check before use
Correct answer: Consider the item non-sterile and reprocess it
A compromised seal means the sterile barrier is breached; the item must be considered non-sterile and must be fully reprocessed before use.
Question 6: Which precaution type is used for patients with suspected or confirmed Ebola virus disease during aerosol-generating procedures?
- Standard and droplet precautions with a surgical mask
- Contact and airborne precautions with an N95 plus full PPE
- Droplet and contact precautions with face shield
- Airborne precautions with a PAPR in a negative-pressure room (Correct answer)
Correct answer: Airborne precautions with a PAPR in a negative-pressure room
CDC recommends a PAPR or N95 with full barrier PPE in a negative-pressure room for Ebola patients undergoing aerosol-generating procedures to protect against both contact and potential airborne exposure.
Question 7: What is the primary goal of an infection prevention risk assessment conducted annually by a healthcare facility?
- To satisfy Joint Commission accreditation requirements only
- To identify the facility's unique infection risks and prioritize prevention strategies (Correct answer)
- To establish benchmarks against national NHSN rates
- To evaluate individual healthcare worker compliance with hand hygiene
Correct answer: To identify the facility's unique infection risks and prioritize prevention strategies
An annual infection prevention risk assessment identifies the specific risks of a facility based on its patient population, geography, and services so that prevention resources are targeted appropriately.
CIC Prevention Practices 5
A patient in the ICU has a femoral central venous catheter that has been in place for 5 days.
What is the recommended action?