Infection Prevention and Control Flashcards

A nurse is leaving the room of a client on contact and droplet precautions for influenza. The nurse has worn gloves, a gown, a surgical mask, and eye protection. Which sequence for removing (doffing) Personal Protective Equipment (PPE) is correct to minimize self-contamination?

Answer: Gloves, gown, perform hand hygiene, eye protection, mask, perform hand hygiene.

According to Public Health Ontario guidelines, the correct doffing sequence is designed to remove the most contaminated items first. Gloves and the gown are considered the most contaminated and are removed first. Hand hygiene is performed, followed by the removal of eye protection and the mask. A final hand hygiene is performed after all PPE has been removed.

When caring for a client with a confirmed Clostridioides difficile (C. diff) infection, which of the following hand hygiene practices is mandatory after removing gloves and before exiting the room?

Answer: Washing hands with soap and running water.

Clostridioides difficile produces spores that are highly resistant to the alcohol found in hand sanitizers. The mechanical action of washing with soap and rinsing with running water is required to physically remove the spores from the hands. This is a critical practice to prevent the transmission of C. diff.

A nurse on a long-term care unit notes that two residents in the same wing have developed a new onset of cough and fever within a 48-hour period. According to provincial guidelines, what is the most appropriate initial action?

Answer: Implement respiratory outbreak control measures and report the suspicion to the local public health unit.

Public Health Ontario's guidelines define a suspected respiratory outbreak in an institution like a long-term care home as two cases of acute respiratory illness within 48 hours in a specific geographic area (e.g., a unit or wing). The standard of practice is to act on this suspicion immediately by implementing control measures (e.g., isolating symptomatic residents, enhancing cleaning, using appropriate PPE) and reporting to the local public health unit for investigation and guidance.

A nurse is preparing to administer an intramuscular injection. According to the principles of Routine Practices, what is the minimum Personal Protective Equipment (PPE) the nurse should wear?

Answer: Gloves only.

Routine Practices are based on a point-of-care risk assessment (PCRA). When performing a procedure like an intramuscular injection, there is a risk of exposure to blood or body fluids, even if minimal. Therefore, wearing gloves is the minimum required PPE to protect the nurse from potential exposure at the injection site.

A nurse provides education to a client about the importance of handwashing after using the washroom. This action is primarily aimed at breaking which link in the chain of infection?

Answer: Mode of Transmission

The chain of infection consists of an infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Handwashing is the single most effective way to prevent the spread of infections. It breaks the chain by interrupting the mode of transmission, preventing infectious agents from being transferred from a surface (reservoir) to a susceptible host via the hands.

A nurse is assigned to care for a client with confirmed pulmonary tuberculosis. Which of the following infection control measures is a mandatory component of Airborne Precautions for this client?

Answer: Ensuring healthcare providers wear a fit-tested N95 respirator when entering the client's room.

Airborne Precautions are required for pathogens transmitted by small airborne particles (droplet nuclei), like tuberculosis. These particles can remain suspended in the air for extended periods. To protect healthcare workers, it is mandatory to wear a fit-tested N95 respirator (or equivalent) that filters these small particles. Other requirements include placing the client in a negative-pressure room and keeping the door closed.