SNLE Infection Control 3 — Questions and Answers
Question 1: What is 'healthcare-associated infection' (HAI)?
- An infection acquired in a healthcare setting, not present on admission, occurring after 48 hours (Correct answer)
- Any infection in a hospital patient
- An infection caused by antibiotic-resistant organisms only
- An infection acquired in the community
Correct answer: An infection acquired in a healthcare setting, not present on admission, occurring after 48 hours
HAIs (nosocomial infections) are infections not present or incubating at admission, typically developing ≥48 hours after admission or within 30 days of healthcare exposure. Common HAIs include CLABSI, CAUTI, VAP, SSI. They are largely preventable through evidence-based bundles.
Question 2: What are the components of the 'CLABSI bundle' to prevent central line infections?
- Hand hygiene, maximal barrier precautions, chlorhexidine skin antisepsis, optimal site selection, daily line review (Correct answer)
- Simple hand washing before insertion
- Antibiotic-coated catheters only
- Weekly dressing changes
Correct answer: Hand hygiene, maximal barrier precautions, chlorhexidine skin antisepsis, optimal site selection, daily line review
The CLABSI prevention bundle (from the Institute for Healthcare Improvement): hand hygiene, maximal sterile barrier precautions during insertion (cap, mask, gown, gloves, large sterile drape), chlorhexidine 2% skin preparation, optimal catheter site selection (subclavian preferred), and daily assessment of line necessity with prompt removal.
Question 3: Which pathogen is the most common cause of catheter-associated urinary tract infection (CAUTI)?
- Escherichia coli (E. coli) (Correct answer)
- Staphylococcus aureus
- Pseudomonas aeruginosa
- Clostridium difficile
Correct answer: Escherichia coli (E. coli)
E. coli from the perineal/fecal flora is the most common cause of CAUTI, accounting for approximately 25–30% of cases. The urinary catheter provides a pathway for ascending infection. CAUTI prevention focuses on catheter necessity, aseptic insertion, and early removal.
Question 4: What is the purpose of an autoclave in healthcare?
- To sterilize heat-resistant instruments using pressurized steam at high temperature (Correct answer)
- To disinfect surfaces
- To clean instruments with soap and water
- To store sterile supplies
Correct answer: To sterilize heat-resistant instruments using pressurized steam at high temperature
Autoclaves use pressurized saturated steam (typically 121°C at 15 psi for 15–20 minutes, or 134°C for faster cycles) to achieve sterilization by denaturation of microbial proteins. It is the gold standard for sterilizing heat/moisture-stable instruments.
Question 5: A patient is diagnosed with VRE (vancomycin-resistant Enterococcus). What precautions are implemented?
- Contact precautions: gloves and gown for all patient contact, dedicated equipment, private room if possible (Correct answer)
- Airborne precautions
- Droplet precautions
- No additional precautions beyond standard
Correct answer: Contact precautions: gloves and gown for all patient contact, dedicated equipment, private room if possible
VRE is transmitted by direct contact and contaminated surfaces. Contact precautions prevent further spread. Dedicated patient equipment (stethoscope, blood pressure cuff) prevents cross-transmission. Environmental cleaning with appropriate disinfectant is critical.
Question 6: What is the correct technique for removing soiled gloves to prevent self-contamination?
- Grasp outside of first glove at the wrist and peel off, then insert fingers inside second glove and peel off (Correct answer)
- Pull both gloves off at the fingertips together
- Remove gloves from the fingertips using the other gloved hand
- Cut the gloves off with scissors
Correct answer: Grasp outside of first glove at the wrist and peel off, then insert fingers inside second glove and peel off
The safe glove removal technique: 1) Grasp the outside of one glove at the wrist (avoiding bare skin contact), peel it inside out and hold it, 2) Slide the finger under the wrist of the second glove and peel it inside out over the first. Both gloves end up inside out, containing contamination.
SNLE Infection Control 3
What is 'healthcare-associated infection' (HAI)?