hand hygiene

Question 1

finger nail length should be no longer than ?

Answer 1

2mm

Question 2

what is not recommended during hand scrubs?

Answer 2

using a brush during hand scrub is no longer recommended

Question 3

What are some risks with hand dermatitis?

Answer 3

1. negative effect on hand hygiene
2. increase risk for infection
3. result in hand colonization of pathogens
4. less likely to wash hands due to irritation

Question 4

Why is it mandated to use health care moisturizers versus personal ones?

Answer 4

prevents team members from using personal products that might have a negative effect on pt and personal safety. Pt may be allergic, smells maybe too strong

Question 5

What is the least amount of time you should wash your hands for ?

Answer 5

15 seconds

Question 6

Correct order to perform hand hygiene?

Answer 6

1. remove jewelry from hands
2. adjust water temperature
3. Wet hands thoroughly
4. apply soap
5. rub hands together vigorously
6. rinse with water and remove all soap
7. dry hands
8. turn off water with paper towel

Question 7

What is the minimum ratio of sinks to patient care stations

Answer 7

one hand washing station to for every four patient care station

Question 8

What jewelry should you not wear in patient care areas?

Answer 8

1. Watches
2. Rings
3. Bracelets

Question 9

What measures help to prevent dermatitis?

Answer 9

1. Moisturizing skin with products approved by health care facility
2. Completely dry hands before donning gloves
3. Water temp should be 70 to 80 F
4. In absence of soiled hands use alcohol hand rub
5. Cotton glove liners maybe worn under non sterile gloves
6. Discard single use cotton glove liner-follow manufactures instruction for reprocessed or reusable
7. Provide education regarding how to prevent dermatitis

Question 10

Are ultraviolet cured nails (gel, shellac)lowed?

Answer 10

no research evidence support or refute use

Question 11

In the event that performing hand hygiene would put the patient’s safety at risk, weigh the risks and benefits of delaying hand hygiene.
In a situation which involves airway manipulation what should anesthesia do?

Answer 11

The anesthesia professional may wear two pairs of gloves (ie, double glove), remove the contaminated outer gloves after airway manipulation, and continue patient care until the patient’s status allows for removal of the inner gloves and performance of hand hygiene.

Question 12

When hands are not visibly soiled or dirty what should you use?

Answer 12

perform hand hygiene using an alcohol-based hand rub according to the manufacturer’s instructions for use

Question 13

Perform a standardized hand hygiene protocol using an alcohol-based hand rub in the following order:

Answer 13

1. Remove jewelry from hands and wrists (eg, rings, watches, bracelets).3,4
2. Apply the amount of alcohol-based hand rub recommended by the manufacturer to cover all surfaces of the hands.3,4
3. Rub hands together, covering all surfaces of the hands and fingers until dry.3,4

Question 14

why should hand washing stations be placed in convenient locations as determined in an infection control risk assessment and in accordance with federal, state, and local regulatory requirements and applicable construction guidelines.

Answer 14

1. For areas with multiple patient care stations, include at least one hand washing station for every four patient care stations. Position the hand washing station to be approximately an equal distance between the furthest stations
2. Sinks designated for hand hygiene should only be used for hand hygiene.

Question 15

Select hand washing station sinks with controls that can be operated without using hands, including single-lever or wrist blade devices and electronic sensor controls. When the operation of the scrub sink is dependent on the building electrical service, connect the controls to the essential electrical system

Answer 15

Hands-free sinks reduce the risk of cross-contamination after hand hygiene is performed.

Question 16

Place alcohol-based hand rub product dispensers (eg, wall-mounted, table-top) in convenient locations as determined by the infection control risk assessment and in accordance with federal, state, and local regulatory requirements.

Answer 16

1. Dispenser placement and storage of flammable alcohol-based hand hygiene products must be in compliance with local, state, and federal regulations
   2.

Question 17

Alcohol-based hand hygiene product dispensers should

Answer 17

be at least 4 ft apart;

hold a maximum of 1.2 L in rooms, corridors, and areas open to corridors;

not be placed above an ignition source (eg, electrical outlet, switch) or within 1 inch of the ignition source; and

not total more than 10 gallons (37.8 L) outside of a storage cabinet in a single smoke compartment.

Question 18

Provide education and competency verification activities that address performance of hand hygiene in accordance with the product manufacturer’s instructions and the health care organization’s policies and procedures

Answer 18

Provide education and competency verification when new hand hygiene products or processes are introduced

Question 19

Perform a standardized surgical hand antisepsis protocol using a surgical hand rub in the following order:

Answer 19

1. Remove jewelry from hands and wrists (eg, rings, watches, bracelets).3,4
2. Don a surgical mask.3,56
3. If hands are visibly soiled, wash hands with soap and water.3,4
4. Remove debris from underneath fingernails using a disposable nail cleaner under running water.3,4
5. Dry hands and arms thoroughly3,4 with a disposable paper towel.
6. Apply the surgical hand rub product to the hands and arms according to the manufacturer’s instructions for use (eg, amount, method, time).3,4
7. Allow hands and arms to dry completely3,4 before using sterile technique to don a surgical gown and gloves.56

Question 20

Perform a standardized surgical hand antisepsis protocol using a surgical hand scrub in the following order

Answer 20

1. Remove jewelry from hands and wrists (eg, rings, watches, bracelets).3,4
2. Don a surgical mask.3,56
3. If hands are visibly soiled, wash hands with soap and water.3,4
4. Remove debris from underneath fingernails using a disposable nail cleaner under running water.3,4
5. Apply the amount of surgical hand scrub product recommended by the manufacturer to the hands and forearms using a soft, nonabrasive sponge.
6. Visualize each finger, hand, and arm as having four sides. Wash all four sides effectively, keeping the hands elevated.3
7. Scrub for length of time recommended by the manufacturer.4 The scrub should be timed to allow adequate product contact with skin.3
8. For water conservation, turn off water when it is not in use, if possible.
9. Avoid splashing surgical attire.3
10. Discard sponges, if used.
11. Rinse hands and arms under running water in one direction from fingertips to elbows.3
12. Hold hands higher than elbows and away from surgical attire.
13. In the OR or procedure room, dry hands and arms with a sterile towel using sterile technique before donning a surgical gown and gloves.3,56

Question 21

Do not perform the surgical hand scrub using a brush

Answer 21

Scrubbing with a brush may damage skin and increase the amount of bacteria shedding from the hands.4 Several studies have shown that use of a brush is not necessary to reduce the number of bacteria on the hand

Question 22

Install hand scrub sinks that have foot, knee, or electronic sensor controls.14 When the operation of the scrub sink is dependent on the building electrical service, connect the controls to the essential electrical system.

Answer 22

operating the scrub sink with hands-free controls allows perioperative team members to maintain sterile technique during surgical hand antisepsis. The FGI14 recommends that hand scrub sinks have foot, knee, or electronic sensor controls

Question 23

The multidisciplinary team should include the infection prevention committee or designated authority with specialized knowledge in infection prevention. Committee representatives should include perioperative RNs and other perioperative team members.

Answer 23

Members of the infection prevention committee have specialized knowledge in the selection of hand hygiene products.

Question 24

Develop a mechanism for product evaluation and selection of hand hygiene products.

Answer 24

Developing a mechanism for hand hygiene product selection provides a structured process for product evaluation by the health care organization

Question 25

Evaluate the safety and efficacy of hand hygiene products

Answer 25

Select products for hand hygiene and surgical hand antisepsis that meet US Food and Drug Administration (FDA) requirements.77 [Recommendation]Expand/Collapse section link

5. 4.2Non-antimicrobial and antimicrobial soaps may be selected for evaluation. [Conditional Recommendation]Expand/Collapse section link
6. 4.3Do not select soaps containing triclosan for evaluation

Question 26

The FDA currently categorizes active ingredients in the 1994 Tentative Final Monograph (TFM) for hand antiseptic products as either Category I, II, or III.

Answer 26

Category I means that the product is generally recognized as safe and effective;

Category II means that the product is not generally recognized as safe and effective; and

Category III means that available data is insufficient to classify the product as safe and effective, and additional testing is required.

Question 27

Evaluate hand hygiene product dispensers (eg, wall-mounted, table-top, personal) for adequate, reliable function and delivery of the recommended product volume

Answer 27

The multidisciplinary team may evaluate automated wall-mounted dispensers

Question 28

Use dispensers of alcohol-based hand hygiene products that

Answer 28

do not release products except when the dispenser is activated,

only activate when an object is placed within 4 inches of the sensor,

only activate once when an object is left in place in the activation zone,

do not dispense more product than the amount recommended by the manufacturer for hand hygiene, and

are designed to prevent accidental or malicious activation of the dispenser.

Question 29

Soaps containing what ingredient is not recommended?

Answer 29

Do not select soaps containing triclosan for evaluation

Question 30

Provide feedback on hand hygiene performance to perioperative team members.

Answer 30

Professional organizations1,3,4 recommend providing health care personnel with performance feedback when monitoring adherence to hand hygiene practices.