CIC HAI Prevention

Question 1

CLABSI Prevention

Answer 1

Insertion
-maximum barrier protection, hand hygiene, CHG skin antisepsis
Maintenance
-line clinically needed
-dressing and clave change every 7 days and prn
-scrub hubs
-clear claves
-tubing change not more frequent than 72 hrs

Question 2

CAUTI prevention

Answer 2

• foley clinically indicated
• aseptic insertion by trained staff
• foley securement
• closed drainage system
• catheter care
• unobstructed urine flow
• drainage bag lower than bladder

Question 3

Safe Injection practices

Answer 3

• single use syringe and needle for each injection
• single use medication vials when possible
• avoid multiple use vials/dispensers

Question 4

Spinal Procedures

Answer 4

• use procedure mask for lumbar puncture, epidural placement, myelogram
• lack of mask associated with HAI meningitis

Question 5

Resp hygiene/cough etiquette

Answer 5

-tissues, hand hygiene supplies, procedure masks available

Question 6

Contact Precautions

Answer 6

• gloves and gown
• infections transmitted via contact with patient or his environment
• MDRO, lice, scabies, C diff

Question 7

Airborne Precautions

Answer 7

• PAPRs or N95 masks
• Negative pressure
• Droplets less than 5 microns molecular weight that stay suspended in air
• Varicellea, measles, TB, smallpox

Question 8

TB prevention

Answer 8

• airborne precautions for suspect/confirmed cases
• Negative pressure, monitor when in use
• Exposure management; skin test or Qgold upon exposure and 8-10 weeks after
• health department communication

Question 9

Droplet Precautions

Answer 9

• procedure mask upon room entry, gloves and gown if contact with respiratory secreations
• large droplet transmission
• influenza, pertussis, RSV, N. meningitidis meningitis, etc

Question 10

Protective Environment

Answer 10

• allogenic hematopoietic stem cell transplants

- positive pressure with HEPA filtration

Question 11

C. difficile prevention

Answer 11

• Early CDI recognition
• Contact precautions
• EPA approved disinfectant (bleach)
• soap and water hand hygiene
• antimicrobial stewardship

Question 12

CLABSI definition

Answer 12

• Central line present within 48 hours of culture
• 1 + blood culture that is not associated with other infection (or) 2 + blood cultures with common commensal not associated with other infection AND T > 38.0, chills, or hypotension

Question 13

CAUTI definition

Answer 13

• foley in place > 2days
• positive urine culture (>10-5) with no more than two identified organisms
• T> 38.0, suprapubic tenderness or costovertebral angle pain

Question 14

PNU definition

Answer 14

• at least 2 serial CXR ; new and persistant infiltrate, consolidation, or cavitation
• T>38.0, WBC 12000 and at least two s/s:
• -increased resp secretions
• -worsening cough, dyspnea, or tachypnea
• -rales or bronchial breath sounds
• -worsening gas exchange, increased O2 or ventilator demand
• -positive culture, >5% BAL bacteria, lung abscess

Question 15

Superficial SSI definition

Answer 15

• Infection occurs within 30 days of procedure
• involves only skin or subcutaneous tissue
• purulent drainage, + wound culture, MD opened, one s/s: pain, redness, swelling, heat
• MD diagnosis

Question 16

Deep SSI defintion

Answer 16

• Infection occurs within 30 days of procedure; 90 days if implant
• involves muscle and facial layers
• purulent drainage from deep incision
• deep incision dehisces or is opened by MD, with + cx or not cultured with 1 s/s: T > 38, pain,

Question 17

Organ space SSI definition

Answer 17

-Infection occurs within 30 days of procedure; 90 days if implant
-involves any body part except skin, muscles, fascia
-purulent drainage from a drain, + culture
-abscess or evidence of infection seen on imaging or gross exam
-