Infection control

Question 1

What are the Surgical Care Improvement Project (SCIP) measures for infection control?

Answer 1

-abx w/in 1hr of incision and dc’d (if appropriate) w/in 24hrs after procedure
-removal of hair w/ clippers not razors
-periop glycemic control
-periop normothermia
-early removal of foley

Question 2

What are the 3 most common causes of nosocomial infections?

Answer 2

-CAUTI
-VAP
-CLASBI

Question 3

What are strategies to reduce CAUTIs?

Answer 3

-place aseptically
-avoid placement when possible
-dc when feasible
-maintain a closed system w/o dependent loops in tubing

Question 4

What are strategies to reduce VAPs?

Answer 4

-avoid ETT when possible
-use cuffed ETT
-head of bed at 30deg or more
-appropriate vent settings
-frequent oral hygiene w/ CHG based products

Question 5

What are strategies to reduce CLABSIs?

Answer 5

-appropriate insertion site
-abx impregnated catheters when possible
-use central line bundles during insertion
-dc when appropriate

Question 6

What are the components of the CDC checklist for CVC insertion?

Answer 6

-hand hygiene
-aseptic technique
-use maximal sterile barrier precautions (mask, gown, sterile gloves, drape)
-CHG prep
-avoid femoral sites
-apply abx-impregnated dressings)

Question 7

What are the components of the CDC checklist for CVC maintenance, handling and removal?

Answer 7

-hand hygiene before manipulation
-clean access ports w/ alcohol or CHG immediately before use
-access only w/ sterile devices
-replace wet, soiled, or dislodged dressings
-dressing changes w/ aseptic technique

Question 8

What is the protocol to clear MRSA in colonized pts?

Answer 8

-5 day protocol
-BID mupirocin
-chlorhexidine baths daily

Question 9

What is the decrease in SSI risk seen due to SCIP bundle measures?

Answer 9

18%

Question 10

What are the most common errors in adherence to SCIP bundle measures for preventing SSI?

Answer 10

-errors in abx dosing
-errors in timing of abx administration