Infection Control

Question 1

Why is infection control important?

Answer 1

• As nurses we have a duty of care for the people we take care of and that includes preventing infection and controlling the spread of infectious disease.
• Need to protect ourselves.
• People who are in hospital usually have a compromised immune system and have an increased risk of infection, so we need to prevent them from getting even more sick or from getting hospital-acquired infections (HAIs) which are the leading cause of death, causes increased hospital stay and leads to economic costs.

Question 2

Factors contributing to infection?

Answer 2

• Modes of transmission: contact (including blood born), droplet, airborne.
• Infectious agent: virus, bacteria, fungi.
• Susceptible host.

Question 3

Microorganisms turn into –> ________ (infectious) which cause –> _________ and _________.

Answer 3

Microorganisms turn into pathogens (infectious) which cause illness/disease.

Question 4

Name the 5 aspects of infection control.

Answer 4

1. Hand hygiene
2. PPE
3. Standard and transmission-based precautions
4. Gowning and gloving
5. Aspeptic technique

Question 5

What is an airborne mode of transmission?

Answer 5

Inhaling disease-causing microorganisms which are suspended in the air and carried by air currents greater than 1 metre.

Question 6

Occurs when infected secretions are expelled (less than 1 metre) by sneezing, coughing or talking. This is then inhaled by a susceptible person.

Answer 6

Droplet.

Question 7

Difference between indirect and direct contact (mode of transmission)?

Answer 7

Direct: Occurs during an interaction between an infected person and a susceptible person.

Indirect: When microorganisms from an infected person are transferred onto a fomite (an inanimate object that carries infection) which is then used by another individual, such as a susceptible person.

Question 8

How can we interrupt the chain of infection?

Answer 8

Through infection control!! Like the 5 aspects.

Question 9

What is hand hygiene in its simplest form?

Answer 9

The act of hand washing.

Question 10

What are the two ways to achieve hand hygiene?

Answer 10

Through soap and water and through ABHR.

Question 11

Alcohol-based hand rub (ABHR) is basically hand sanitiser that should contain __-__% _______ to be effective.

Answer 11

Alcohol-based hand rub (ABHR) is basically hand sanitiser that should contain 60-80% ethanol to be effective.

Question 12

How does soap and water work?

Answer 12

By mechanically dislodging microorganisms and other contaminants from the hand.

Question 13

When should soap and water be used to achieve hand hygiene?

Answer 13

When hands are visibly soiled, or in ungloved episodes of care with a person who has a Clostridium difficile infection or non-enveloped virus such as norovirus.

Question 14

Why is ABHR is better than the use of soap and water?

Answer 14

Requires less time, is readily accessible, is more cost effective and results in a greater reduction of bacterial contamination compared to using soap and water in many clinical situations.

Question 15

5 moments of hand hygiene?

Answer 15

1. Before touching a patient
2. Before a procedure
3. After a procedure or body fluid exposure risk
4. After touching a patient
5. After touching a patients surroundings

Question 16

Barriers to hand hygiene?

Answer 16

• Poor knowledge or recognition of microbial contamination risks
• Poor role-modelling behaviours and lack of positive social norms
• Experience of skin irritation from hand hygiene agents
• Perceptions of the person’s needs taking precedence over hand hygiene
• Perceptions that glove usage negates need for hand hygiene
• Poor availability or inconveniently located sinks
• High workloads and insufficient time.

Question 17

What is the bare below elbows guide?

Answer 17

You have to be bare below the elbows:

• No jewellery – only a single flat ring/band may be worn.
• Long sleeves need to be rolled up above elbows.
• Fingernails are short and clean – no nail polish or artificial nails.
• Breached skin need to be covered with a waterproof dressing.

Question 18

PPE is _______ that is used to protect an individual from pathogenic microorganisms. This includes: apron/gown, ______, protective eyewear/goggles, _______ and _______.

Answer 18

PPE is equipment that is used to protect an individual from pathogenic microorganisms. This includes: apron/gown, face mask, protective eyewear/goggles, face shield and gloves.

Question 19

Donning is…

Answer 19

Putting on.

Question 20

Doffing is…

Answer 20

Taking off / removal.

Question 21

What should you consider before donning?

Answer 21

Which care activities are required? What are the infection control precautions required? What is already in the room and what do you need to bring? Then, gather the correct equipment.

Question 22

1. Perform hand hygiene.
2. Pick up a clean gown, unfold it in front of you without letting it touch any other part of your body, put the sleeves on, apply neck tie, overlap the gown at the back and tie it up so that it is secure.
3. Gather the appropriate face mask as per the infection control precautions, hold the mask by the strings/loops, apply, make sure the metal strip is pressed down on your nose.
4. Gather the appropriate gloves as per the infection control precautions, pull the gloves over the gown (or over the wrist if a gown is not worn).

Answer 22

Donning

Question 23

1. Pinch the outside of one glove at the palmar surface with the other gloved hand and pull off. Then take the fingers of the ungloved hand and put it under the other glove and pull off.
2. Discard in appropriate waste bin.
3. Perform hand hygiene.
4. Remove protective eyewear or face shield by handling them by their straps.
5. Discard in appropriate waste bin.
6. Remove gown by unfastening neck and back tie, pull away from neck and shoulders touching the inside of the gown only, turn the gown inside out, fold.
7. Discard in appropriate waste bin.
8. Remove mask by handling them by their straps.
9. Discard in appropriate waste bin.
10. Perform hand hygiene.

Answer 23

Doffing

Question 24

Doffing is done where?

Answer 24

At doorway or anteroom.

Question 25

Standard precautions

Answer 25

Work practices required to achieve a basic level of infection prevention and control. It is the minimum infection prevention and control practice. It involves appropriate hand hygiene, wearing of PPE, and appropriate disposal of sharps.

Question 26

Are an extra set of strategies specific to pathogens that pose an airborne, contact or droplet transmission risk. ________________ are used when standard precautions are not enough to control the spread of infection. This involves _______________ (more than one word). There is signage outside on the door to remind people of what precautions should be taken before entering the room of these affected individuals.

Answer 26

Are an extra set of strategies specific to pathogens that pose an airborne, contact or droplet transmission risk. Transmission based precautions are used when standard precautions are not enough to control the spread of infection. This involves wearing additional specific PPE, restricting movement of affected individuals and associated healthcare workers, or even allocation of an affected person to a single room with a door. There is signage outside on the door to remind people of what precautions should be taken before entering the room of these affected individuals.

Question 27

What is gowning and gloving?

Answer 27

As the name suggests, sterile gowning and closed gloving (sterile gloving) are what is involved in gowning and gloving. They are mainly carried out in operating rooms and with invasive procedures.

Question 28

What should you do before gowning and gloving?

Answer 28

Refer the persons chart and orders to determine exactly what procedure will be performed that requires sterile gloves. Make sure to ask about latex allergies and use non-latex gloves whenever possible.

Question 29

Rearrange in correct order:

Put your hands down the sleeves only to the beginning of the cuffs. Do not pull your hands all the way through the sleeves.

Perform a hand wash specific to the surgical Aseptic Non Touch Technique and refer to the organisational policy for a surgical hand wash in the operating room.

Get the same co-worker to tie the neckties without touching the outside of the gown.

Apply a sterile gown by holding the gown at the crease near the neck, holding it away from you and letting it unfold without touching your uniform or anything around you.

Gather the correct equipment: sterile pack containing a sterile gown and sterile gloves.

Get a co-worker who is wearing a hair cover and mask to hold inside the arm seems and pull the gown over your shoulders.

Put your hands inside the shoulders of the gown without touching the outside of the gown (outside is sterile).

Now you may move onto gloving.

Answer 29

1. Gather the correct equipment: sterile pack containing a sterile gown and sterile gloves.
2. Perform a hand wash specific to the surgical Aseptic Non Touch Technique and refer to the organisational policy for a surgical hand wash in the operating room.
3. Apply a sterile gown by holding the gown at the crease near the neck, holding it away from you and letting it unfold without touching your uniform or anything around you.
4. Put your hands inside the shoulders of the gown without touching the outside of the gown (outside is sterile).
5. Put your hands down the sleeves only to the beginning of the cuffs. Do not pull your hands all the way through the sleeves.
6. Get a co-worker who is wearing a hair cover and mask to hold inside the arm seems and pull the gown over your shoulders.
7. Get the same co-worker to tie the neckties without touching the outside of the gown.
8. Now you may move onto gloving.

Question 30

What is this?

Answer 30

Sterile gloving (closed method).

Question 31

Aseptic vs septic vs sepsis?

Answer 31

Asepsis means the absence of bacteria, viruses, and other microorganisms; not infected (prefix ‘a’ in asepsis means “not”). Septic means infected. Sepsis is the state of being infected. It is a life-threatening condition where the body’s immune system doesn’t respond properly to an infection and can lead to tissue damage, organ failure, and death.

Question 32

What is ANTT?

Answer 32

Aseptic Non-Touch Technique. Framework for guiding aseptic technique during any invasive procedure. Because it is a framework, it means that it is standardised, promotes the safety of individuals receiving health care and supports health care workers to deliver safe practice.

Question 33

What are the two types of ANTT with examples?

Answer 33

1. Surgical: Simple wound dressings, IV insertion, administration of IV medication.
2. Standard: Surgical procedures, large complex wound dressings, CVC insertion, IDC insertion.

Question 34

Define key part.

Answer 34

The part of the equipment that must remain sterile, such as a syringe hub, and must only contact other key parts or key sites.

Question 35

Define key site.

Answer 35

The area on the patient such as a wound, or IV insertion site that must be protected from microorganisms.

Question 36

What is this?

Answer 36

Standard ANTT.

Question 37

What is this?

Answer 37

Surgical ANTT.

Question 38

Once equipment and supplies are ______ to ____ they are no longer ______.

Answer 38

Once equipment and supplies are exposed to air they are no longer sterile.

Question 39

What is Critical Aseptic Field?

Answer 39

Used in surgical ANTT where sterilised or aseptic components can be placed and all key parts protected together on this using a non-touch technique.

Question 39

What is Micro Critical Aseptic Field?

Answer 39

Used in standard ANTT to protect all Key-Parts individually. These are typically sterilised caps and covers or the inside of sterilised equipment packaging.

Question 40

What is General Aseptic Field?

Answer 40

Equipment Key-Parts are transported to the person within a plastic or disposable tray. This is called the General Aseptic Field.

E.g. Sterile dressing packs, IVC starter kits, injection trays that have been cleaned with detergent wipes and allowed to dry.

Question 41

Opened bottles of sterile liquids are never used longer than __ _____.

Answer 41

Opened bottles of sterile liquids are never used longer than 24 hours.

Question 42

What should you do before establishing an aseptic field?

Answer 42

Ensure correct equipment is gathered. Check sterilisation expiry dates. Make sure package containing sterile equipment is clean and dry.

Question 43

What is the difference between airborne and droplets transmission?

Answer 43

Airborne particles are tiny, stay in the air for longer and travel longer distances.

Droplets are larger and released when an infected person coughs, sneezes, talks, or breathes hard.