CMS dialysis Vtags (Infection control) Flashcards
When would a V110 non-compliance reach condition level?
If defecting practices are “multiple, pervasive, or of an extent to present a risk to patient health and safety”
What is Vtag 111 and what does it require?
Sanitary environment
The dialysis facility must provide and monitor a sanitary environment to minimize the transmission of infectious agents within and between the unit and any adjacent hospital or other public area
What is Vtag 112 and what does it do?
It includes CDC documents as regulation
What are “Standard Precautions”?
Used on all patients when necessary to prevent contact to the healthcare worker with blood, secretions, excretions, or contaminated items
They include:
Gloves
Gown
Mask and/or Face shield
What are “Dialysis Standard Precautions”?
They are more stringent than CDC standard precautions and prohibits the use of many common supplies, instruments, etc
What is Vtag 113, what does it require, and why is it the most important measure for prevention of contaminant transmission?
Wear Gloves/Hand Hygiene
Requires wearing gloves when caring for patients, touching equipment, as well as removing gloves and washing hands between each patient and station
When must gloves be changed? (5 answers)
When soiled
When moving from a dirty area or task to a clean one
Moving from a contaminated site to a clean site on the same patient
After touching one patient, machine, access, and before caring for another patient, machine, or access
After contact with any patient, infectious waste, or contaminated surface
When do hands need to be washed or cleansed?
After every glove change (gel can be used when gloves did not come into contact with blood or other substance)
When is hand hygiene required? (5 answers)
When arriving to or leaving the work area
Before putting gloves on
After taking gloves off
After touching the machine
After contact with the chair side computer
What are considered contaminated during treatment? (4)
The patient’s machine, chair, blood lines, and dialyzer
The barrier used to access the fistula
Supplies after they are taken chair side
Blood pressure cuff
What is Vtag 114 and what does it require?
Sinks available
Sinks should be easily accessible and readily available in the treatment area, reuse area, and medication area, home training room and isolation area. Sinks must have hot and cold water plumbed.
What is the difference between a clean and dirty sink?
Clean sinks are dedicating to hand washing
Dirty sinks are utility sinks where saline bags can be drained and equipment cleaned
Soap and paper towels are required at each clean sink
Paper towels must be stored where they cannot be contaminated by splashes
What is Vtag 115 and what does it require?
Gowns, shields/masks - no staff eat or drink
PPE is worn as appropriate
When is POE required?
Treatment initiation and termination
Manipulating access needles or catheters
Medication administration
Cleaning and disinfecting patient, supplies, and/or equipment
Reuse
Wherever blood or fluid splashes may occur
What is V116 and what does it require?
If to station = dispose or disinfect
Items taken to the station are disposed of, dedicated for that patient’s use, or are cleaned and disinfected
What is V117 and what does it require?
Clean/dirty med prep area no carts
Clean areas designated for the preparation, handling, and storage of medication, supplies and equipment. Do not use common medication carts to deliver medications to patients.
Do not carry supplies in pockets
What is Vtag 118 and what does it require?
Single use vials
IV medication vials labeled for single use should not be punctured more than once
What is Vtag 120 and what does it require?
Transducer protections not wetted/changed
External venous and arterial pressure transducers are used for the patients treatment, changed between treatments, and not reused. If the external transducer becomes wet, change immediately and inspect for breakthrough
This prevents the spread of Hep C
What is Vtag 121 and what does it require?
Handling infectious waste
Potentially infectious waste is handled, stored, and disposed of in compliance with applicable laws
What is Vtag 122 and what does it require?
Disinfect surfaces/equip/protocols
Contaminated surfaces, medical devices, and equipment are cleaned and disinfected
When do you need to use 1:100 vs 1:10 bleach solution?
1: 100 is for general disinfection
1: 10 is for blood spills and surfaces visibly contaminated by blood
What Vtags deal with Hep B controls?
Vtags 124-131
What is Vtag 124 and what does it require?
Test all/rev status/results b4 admit
Routinely test all patients for Hep B
What is Vtag 125 and what does it require?
If any patient seroconverts to Hep B positive then review all patient labs and investigate potential sources
