CIC Outbreak

Question 1

Environmental sampling

Answer 1

• not usually recommended
• routine dialysis water and dialysate testing and biological monitoring of sterilization processes
• rarely helpful in outbreak investigation

Question 2

Relative risk ratio

Answer 2

• used in cohort studies, e.g., patients with a central line
• prospective (starts at 0 and continues into the future, begins before event occurs)
• asks “What is risk of developing disease if exposure to identified risk factor”?

Question 3

Odds ratio

Answer 3

• used in case control studies
• compares those with disease with those who do not have disease
• retrospective (disease already present)
• not appropriate with chronic diseases
• asks “if disease is present, what is risk of being exposed to risk factor?”

Question 4

Research use

Answer 4

• findings statistically significant?
• sample size large enough?
• groups being compared truly similar?

Question 5

Relative risk calculation

Answer 5

• use 2x2 table

- relative risk (RR) = [a/(a+b)]/[c/(c+d)]

Question 6

2x2 table

Answer 6

Disease No disease total
Factor present A B A+B
Factor not present C D C+D
total A+C B+D A+B+C+D

Question 7

Odds ratio calculation

Answer 7

-use 2x2 table

Question 8

Negative predictive value

Answer 8

• percentage of negative tests when disease not present
• use 2x2 table
• d/(c+d) x 100

Question 9

Root cause analysis

Answer 9

• retrospective review of adverse outcomes

- used to discover basic and contributing causes for undesired outcome

Question 10

Positive predictive value

Answer 10

• Percentage of positive tests when disease present
• use 2x2 table
• a/(a+b) x 100

Question 11

Gap analysis

Answer 11

1. list characteristics of present situation
2. list characteristics of future situation, e.g. CMS standards
3. Identify difference between current state and desired state

Question 12

Cause & Effect diagram

Answer 12

• Ishkawa, fishbone or tree diagram
• used to display contributing factors
• used to identify key elements
• Looks backwards, asks “why”

Question 13

Failure modes effect analysis (FMEA)

Answer 13

• Proactive, preventative identification of potential failures and opportunities for error
• Prioritizes and addresses possible process failures that might lead to adverse outcome

Question 14

Multi-voting

Answer 14

-Prioritizes large list of topics to final selection for process improvement

Question 15

Strategic plan

Answer 15

1. Prioritize risks of undesired events
2. Set goals based upon prioritized risks
3. Describe activities to achieve goals
4. Describe goal achievement evaluation process

Question 16

SWOT analysis

Answer 16

-Identifies strengths, weaknesses, opportunities and threats

Question 17

PDSA

Answer 17

1. Plan: identify risks, goals and activities to achieve goals
2. Do: implement strategies
3. Study: analyze data for improvement outcomes
4. Act: Continual change to achieve goals and stay abreast of new expectations

Question 18

Outcome measure

Answer 18

-Indicates results, e.g., VAP rates

Question 19

Process measure

Answer 19

-Indicates compliance rate to desired process, e.g. VAP bundle

Question 20

Cognitive learning domain

Answer 20

• Intellectual abilities

- Recall, application and analysis

Question 21

Psychomotor learning domain

Answer 21

• New skills

- New ways of acting or doing

Question 22

Adult learner

Answer 22

• Prefer knowledge that they need and can apply vs. academic knowledge
• Value relationship between knowledge content and personal experience
• Problem-centered
• Immediate application enhances retention
• Expects respectful & self-directional methods

Question 23

Affective learning domain

Answer 23

• Learning involves new attitudes, beliefs, values, etc

- Caring, respectful relationship enhances learning

Question 24

Learning objectives

Answer 24

• Specific
• Measurable
• Achievable
• Relevant to content

Question 25

Mission Statement

Answer 25

-Answers “why” the program exists

Question 26

Vision statement

Answer 26

• Long term statement of what program will be

- Focus on program’s strategic advantages to organization

Question 27

Values statement

Answer 27

• Description of how program functions on day-to-day basis

- Answers “how” the program is carried out

Question 28

Antibiotic regimens

Answer 28

• therapeutic - treatment
• prophylactic - prevention
• empiric - broad coverage, initiation of treatment prior to confirmed culture results when regimen should be narrowed to sensitivity patterns

Question 29

-Goal statement

Answer 29

• Describe what we hope to attain

- Long term

Question 30

Pareto chart

Answer 30

-Helps identify top issues that contribute to 80% of problem