Infection Prevention and Control 1 Flashcards

A patient is admitted with confirmed pulmonary tuberculosis. Which transmission-based precaution must be implemented in addition to standard precautions?

Answer: Airborne precautions in a negative-pressure room with an FFP3 respirator

Mycobacterium tuberculosis is transmitted via airborne droplet nuclei smaller than 5 micrometres that remain suspended in the air for prolonged periods. This requires airborne precautions: a negative-pressure isolation room and an FFP3 (N95-equivalent) respirator for staff entering the room, not a standard surgical mask.

What is the correct sequence for DONNING personal protective equipment (PPE) before entering a contact-precaution room?

Answer: Apron → mask → eye protection → gloves

The correct donning sequence is: apron/gown first (to protect clothing), then mask/respirator (to protect airways), then eye protection, and gloves last so they cover the cuffs of the apron/gown. This order ensures each item is applied without contaminating the next.

A patient presents with profuse, watery diarrhoea and norovirus is suspected. Which infection control measure is MOST important when performing hand hygiene after patient contact?

Answer: Soap and water handwash for a minimum of 40–60 seconds

Norovirus is a non-enveloped virus and is resistant to alcohol-based hand rubs. Soap and water is required because the mechanical action of washing physically removes viral particles from the skin. Alcohol gel alone is insufficient and should not be used as the sole method during norovirus outbreaks.

Using the Spaulding classification of medical devices, which item is categorised as 'critical' and therefore requires sterilisation before use?

Answer: A reusable surgical instrument that enters sterile body tissue

The Spaulding classification defines 'critical' items as those that enter sterile tissue or the vascular system (e.g., surgical instruments, implants, cardiac catheters). These carry the highest risk of infection transmission and must be sterilised. Flexible endoscopes are 'semi-critical' (requiring high-level disinfection), while blood pressure cuffs and bedpans are 'non-critical'.

During an aseptic wound dressing procedure, a nurse accidentally touches the sterile field with a non-sterile gloved hand. What is the CORRECT action?

Answer: Discard all contaminated sterile items and restart the procedure with new sterile equipment

Once the sterile field has been breached, it is no longer considered sterile regardless of the method used to attempt recovery. The key parts — sterile equipment and the wound bed — must never be directly touched. The only safe course is to discard all contaminated items, reperform hand hygiene, and restart with fresh sterile equipment.

A surgical ward has an identified MRSA outbreak. Which decolonisation regimen is recommended by UK Health Security Agency (UKHSA) guidance for MRSA carriers?

Answer: Topical 2% mupirocin nasal ointment combined with chlorhexidine gluconate body wash

UKHSA guidelines recommend a 5-day decolonisation course comprising 2% mupirocin nasal ointment applied three times daily (targeting nasal carriage, the most common reservoir) alongside daily 4% chlorhexidine gluconate body and hair wash. Mupirocin resistance is a concern, so throat and perineal swabs may also guide treatment.