SMQT Infection Prevention and Control 3 — Questions and Answers
Question 1: A facility's infection preventionist reports a cluster of three urinary tract infections in a single unit over two weeks. What is the surveyor's FIRST step in evaluating this situation?
- Immediately cite the facility for an infection outbreak
- Determine whether the facility identified the cluster and initiated an investigation (Correct answer)
- Review the dietary department's food handling logs
- Check whether the facility purchased new urinary catheters
Correct answer: Determine whether the facility identified the cluster and initiated an investigation
Surveyors must assess whether the facility detected the cluster and responded with an appropriate investigation per its QAPI and infection control program.
Question 2: Which situation would MOST likely indicate a failure of a long-term care facility's catheter-associated urinary tract infection (CAUTI) prevention program?
- Residents with catheters kept in private rooms
- No documented daily assessment of catheter necessity (Correct answer)
- Catheter bags stored below bladder level
- Use of a closed catheter drainage system
Correct answer: No documented daily assessment of catheter necessity
Daily assessment of continued catheter necessity is a core CAUTI prevention measure; absence of documentation suggests the program is not functioning.
Question 3: What does the term 'colonization' mean in the context of infection prevention?
- Active infection causing signs and symptoms in the resident
- Presence of a microorganism without causing disease or symptoms (Correct answer)
- Contamination of a wound with environmental bacteria
- A resident's positive blood culture result
Correct answer: Presence of a microorganism without causing disease or symptoms
Colonization means an organism is present and may replicate on or in the host but does not cause disease or clinical symptoms.
Question 4: A surveyor observes a nurse reusing a single-dose vial of insulin for multiple residents. This practice violates which infection control principle?
- Hand hygiene compliance
- Safe injection practices to prevent bloodborne pathogen transmission (Correct answer)
- Proper medication storage temperature requirements
- Controlled substance documentation procedures
Correct answer: Safe injection practices to prevent bloodborne pathogen transmission
Single-dose vials must never be used for more than one patient, as this can transmit bloodborne pathogens like hepatitis B and C.
Question 5: According to infection control standards, when should a surgical or procedure mask be worn by a healthcare worker during resident care?
- Only during aerosol-generating procedures
- Whenever there is risk of splashing or spraying of blood or body fluids to the face (Correct answer)
- Only when the resident has a known respiratory illness
- At all times while inside the facility
Correct answer: Whenever there is risk of splashing or spraying of blood or body fluids to the face
Masks are required as part of standard precautions when there is risk of body fluid splash or spray to the mucous membranes of the face.
Question 6: A long-term care facility is required to offer influenza vaccination annually to all residents. Under which regulatory framework is this required?
- OSHA Bloodborne Pathogen Standard
- CMS Conditions of Participation for Long-Term Care Facilities (Correct answer)
- FDA vaccine distribution guidelines
- State pharmacy practice acts
Correct answer: CMS Conditions of Participation for Long-Term Care Facilities
CMS Conditions of Participation require long-term care facilities to offer influenza and pneumococcal vaccines to residents and document refusals.
Question 7: Which infection control practice should a surveyor look for when evaluating wound care procedures in a skilled nursing facility?
- Nurses performing wound care without gloves to improve tactile assessment
- Use of sterile technique for all wound dressing changes regardless of wound type
- Performing hand hygiene and changing gloves between preparing and applying a dressing (Correct answer)
- Reusing dressing materials to reduce facility costs
Correct answer: Performing hand hygiene and changing gloves between preparing and applying a dressing
Hand hygiene and glove change between the dirty and clean phases of wound care prevents contaminating the wound and surroundings.
SMQT Infection Prevention and Control 3
A facility's infection preventionist reports a cluster of three urinary tract infections in a single unit over two weeks.
What is the surveyor's FIRST step in evaluating this situation?