CMS dialysis Vtags (Infection control) Flashcards

1
Q

When would a V110 non-compliance reach condition level?

A

If defecting practices are “multiple, pervasive, or of an extent to present a risk to patient health and safety”

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2
Q

What is Vtag 111 and what does it require?

A

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

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3
Q

What is Vtag 112 and what does it do?

A

It includes CDC documents as regulation

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4
Q

What are “Standard Precautions”?

A

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

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5
Q

What are “Dialysis Standard Precautions”?

A

They are more stringent than CDC standard precautions and prohibits the use of many common supplies, instruments, etc

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6
Q

What is Vtag 113, what does it require, and why is it the most important measure for prevention of contaminant transmission?

A

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

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7
Q

When must gloves be changed? (5 answers)

A

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

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8
Q

When do hands need to be washed or cleansed?

A

After every glove change (gel can be used when gloves did not come into contact with blood or other substance)

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9
Q

When is hand hygiene required? (5 answers)

A

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

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10
Q

What are considered contaminated during treatment? (4)

A

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

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11
Q

What is Vtag 114 and what does it require?

A

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.

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12
Q

What is the difference between a clean and dirty sink?

A

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

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13
Q

What is Vtag 115 and what does it require?

A

Gowns, shields/masks - no staff eat or drink

PPE is worn as appropriate

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14
Q

When is POE required?

A

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

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15
Q

What is V116 and what does it require?

A

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

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16
Q

What is V117 and what does it require?

A

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

17
Q

What is Vtag 118 and what does it require?

A

Single use vials

IV medication vials labeled for single use should not be punctured more than once

18
Q

What is Vtag 120 and what does it require?

A

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

19
Q

What is Vtag 121 and what does it require?

A

Handling infectious waste

Potentially infectious waste is handled, stored, and disposed of in compliance with applicable laws

20
Q

What is Vtag 122 and what does it require?

A

Disinfect surfaces/equip/protocols

Contaminated surfaces, medical devices, and equipment are cleaned and disinfected

21
Q

When do you need to use 1:100 vs 1:10 bleach solution?

A

1: 100 is for general disinfection
1: 10 is for blood spills and surfaces visibly contaminated by blood

22
Q

What Vtags deal with Hep B controls?

A

Vtags 124-131

23
Q

What is Vtag 124 and what does it require?

A

Test all/rev status/results b4 admit

Routinely test all patients for Hep B

24
Q

What is Vtag 125 and what does it require?

A

If any patient seroconverts to Hep B positive then review all patient labs and investigate potential sources

25
Q

What does Vtag 126 require?

A

Vaccinate all susceptible patients and teammates against HBV

26
Q

What is Vtag 127 and what does it require?

A

Test all vaccinated patients and teammates for reactions to the vaccine

27
Q

What are Vtags 128 and 130?

A

Isolate all Hep B patients in a room or designated area

Dedicate machines, equipment, instruments, supplies, and medications for use by Hep B patients only

28
Q

What is Vtag 131?

A

Teammates caring for Hep B patients should not care for Hep B susceptible patients at the same time

29
Q

What are the most cited Hep B related issues?

A

Not completing vaccinations

Not completing annual testing

Not dedicating equipment and supplies

Staff caring for both Hep B and Hep B susceptible patients

30
Q

What is Vtag 132?

A

Infection control training initial and ongoing

31
Q

According to the CDC: how many times greater is the incidence of bacteremia for catheters as opposed to fistula a

A

7 times higher

32
Q

What are the most commonly cited issues related to infection control education? (4)

A

No evidence of annual staff training

No evidence of infection review in monthly FHM

Lack of evidence of education and monitoring of CvC infections

Incorrect technique

33
Q

What can an FA do to make achieve infection control excellence?

A

Monthly infection control audits

Review infections in FHM and document plans

Follow hep B testing and vaccination

Make sure teammates report signs of infection

34
Q

Which Vtags deal with infection control?

A

V110 - V148