SMQT - Surveyor Minimum Qualifications Infection Prevention and Control Questions and Answers — Questions and Answers
Question 1: A surveyor observes a staff member entering the room of a resident on contact precautions for MRSA without donning a gown or gloves. This practice is a significant breach of which fundamental infection control principle?
- Antibiotic stewardship
- Transmission-Based Precautions (Correct answer)
- Environmental cleaning protocols
- Respiratory hygiene and cough etiquette
Correct answer: Transmission-Based Precautions
Transmission-Based Precautions (which include contact, droplet, and airborne precautions) are used in addition to Standard Precautions for residents with known or suspected infections. For MRSA, Contact Precautions are required, which includes wearing a gown and gloves for all interactions that may involve contact with the patient or their environment.
Question 2: The primary goal of an Antibiotic Stewardship Program in a long-term care facility, as required by 42 CFR §483.80, is to:
- Ensure all documented infections are treated with broad-spectrum antibiotics.
- Reduce the facility's annual pharmacy expenditures.
- Promote the appropriate use of antimicrobials to combat resistance and improve resident outcomes. (Correct answer)
- Mandate specific antibiotics for common infections to streamline care.
Correct answer: Promote the appropriate use of antimicrobials to combat resistance and improve resident outcomes.
The core purpose of an antibiotic stewardship program is to optimize the clinical outcomes of antimicrobial use while minimizing unintended consequences, such as the emergence of resistance and infections like C. difficile. The program focuses on ensuring antibiotics are prescribed only when necessary and that the correct drug, dose, and duration are chosen.
Question 3: A surveyor is reviewing the facility's response to an influenza outbreak. Which of the following interventions demonstrates correct implementation of Droplet Precautions?
- Placing all residents on a prophylactic course of antibiotics.
- Requiring staff to wear N95 respirators for all resident contact.
- Cohorting ill residents and having them wear a facemask when outside their room. (Correct answer)
- Disinfecting all surfaces with an EPA-registered sporicidal agent.
Correct answer: Cohorting ill residents and having them wear a facemask when outside their room.
Droplet Precautions are used for infections spread by respiratory droplets, like influenza. Key interventions include placing patients in a private room or cohorting them (placing them in a room with other infected residents), and having the patient wear a mask when they must be transported outside the room to contain respiratory secretions.
Question 4: According to federal regulations, which of the following is a mandatory component of a facility's Infection Prevention and Control Program (IPCP)?
- A system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases. (Correct answer)
- A policy requiring all staff and residents to receive an annual influenza vaccine.
- An on-site microbiology laboratory for rapid testing.
- A mandatory 7-day isolation period for all new admissions.
Correct answer: A system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases.
Federal regulation 42 CFR §483.80 explicitly requires that the IPCP must include, at a minimum, a system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases for everyone in the facility.
Question 5: A resident has been diagnosed with a Clostridioides difficile (C. diff) infection. For terminal cleaning of the resident's room after discharge, the surveyor should confirm that housekeeping staff use:
- An alcohol-based cleaning solution.
- A standard quaternary ammonium disinfectant.
- Soap and water only.
- An EPA-registered sporicidal disinfectant. (Correct answer)
Correct answer: An EPA-registered sporicidal disinfectant.
C. difficile produces spores that are resistant to standard disinfectants and alcohol-based products. The CDC and EPA recommend using an EPA-registered disinfectant with a sporicidal claim (found on EPA List K) to effectively kill the spores on environmental surfaces.
Question 6: Per CMS requirements, the individual designated as the facility's Infection Preventionist (IP) must meet several qualifications, including:
- Being a board-certified infectious disease physician.
- Working at least part-time at the facility. (Correct answer)
- Holding a master's degree in public health.
- Having at least 10 years of experience as a Director of Nursing.
Correct answer: Working at least part-time at the facility.
CMS regulations require that the designated Infection Preventionist (IP) must work at least part-time at the facility and have primary professional training in a relevant field (like nursing, epidemiology, etc.), and have completed specialized training in infection prevention and control. While extensive experience or specific advanced degrees are valuable, the 'part-time, on-site' requirement is a specific regulatory mandate.
SMQT - Surveyor Minimum Qualifications Infection Prevention and Control Questions and Answers
A surveyor observes a staff member entering the room of a resident on contact precautions for MRSA without donning a gown or gloves.
This practice is a significant breach of which fundamental infection control principle?