Infection Control

Question 1

The AANA position statement, 2.13, stresses a strong position on which practice?

Answer 1

one time use for needles and syringes

Question 2

The AANA campaign “Only One Time” includes which of the following concepts?

Answer 2

ALL: one patient, one syringe, one needle, one single-dose vial

Question 3

what is the major force driving change in infection control policy?

Answer 3

regulatory agencies

Question 4

which concepts are included in the USP Pharmacopeia Chapter 797 rules adopted by anesthesia?

Answer 4

• label, date, time, initial all vials opened and syringes filled
• drug preparation must be done immediately before use
• drugs not used within 1 hour must be discarded

Question 5

in the fall of 2007, the HCV cluster outbreak in patients in a Nevada endoscopy center led to what charges for 2 CRNAs and one MD?

Answer 5

2nd degree murder

Question 6

infection control is what type of risk management requirement?

Answer 6

ethical

Question 7

what is the single most important personal infection control preventive measure the CRNA can do in the clinical setting?

Answer 7

handwashing

Question 8

what are universal (standard) precautions?

Answer 8

• hand hygiene before and after pt. contact
• gloves for any pt. contact; change after each contact
• protective eye shields
• protective facemasks

Question 9

what are transmission based precautions?

Answer 9

• added to standard precautions
• contact: surgical gown for any direct contact (VRE, Cdiff)
• droplet: face mask within 6-10 ft. (influenza, pertussis)
• airborne: N95 respirator 5 micro filter (TB, measles, varicella)
• spongiform: prion destruction measures i.e. extreme temp, disposable equipment use incinerated after case

Question 10

what is proper regional anesthesia asepsis?

Answer 10

• chlorhexidine (> or = .5%) + alcohol (70%) superior to povidone-iodine in reducing skin flora
• iodine cant be used for lumbar puncture d/t possible neurotoxicity
• masks during neuraxial blocks (meningitis spread)

Question 11

describe proper asepsis for central line and art line insertion

Answer 11

art line: prep and drape; sterile gloves; sterile field; sterile catheter
CVL: full sterile barrier- gowns, gloves, cap, mask, sterile sleeve (PA catheters and ultrasound probes)

Question 12

what is the best site for least risk of infection with CVLs?

Answer 12

subclavian

*SC

Question 13

what are measures to prevent surgical related infections?

Answer 13

• pre-op antibiotic within one hour prior to incision; 2 hours for Vancomycin and fluroquinolones
• proper hair removal using clippers (no razors d/t nicks)
• blood glucose less than 200 mg/dL
• normothermia, greater than 36 degrees C

Question 14

describe critical items in infection risk

Answer 14

• contact sterile body tissues
• must sterilize, keep sterile
  ex: vascular catheters

Question 15

describe semi-critical infection risk items

Answer 15

• contact mucous membrane
• require high level disinfection/sterilization
  ex: laryngoscope blades

Question 16

describe non-critical infection risk items

Answer 16

• only contact skin
• must be cleaned between patients
  ex: laryngoscope handles, oral/nasal airway; stylets/bougies, LMAs

Question 17

how must laryngoscopes be stored?

Answer 17

• 3 Cs
• clean
• covered
• confined