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CBIC Section 7

Environment of Care

QuestionAnswer
The key to cleaning & disinfection of environmental surfaces is the: B. Physical removal of visible dirt, organic material, and debris
A new Environmental Services employee has been asked to clean up a large blood spill on the floor in the OR. How should he proceed? B. He should place absorbent material over the spill and pour the correct dilution of disinfectant over the material for the recommended contact time
Diluted bleach solutions stored in an open container must be changed every: A. 30 days B. 28 days C. 24 hours D. 12 hours C. 24 hours -Open container key word
Green cleaning is a new approach to environmental cleaning that aims at reducing harm to human health & the environment while maintaining or improving the hygiene of the HCE. Which of the following green strategies would be appropriate to implement? 1) Replacing floor strippers and finishes that contain heavy metals and asthmagens 3) Employing carcinogen-free carpet cleaners 4) Introducing high-filtration vacuum cleaners
If a diluted bleach solution is stored in an open container, the chlorine rapidly dissipates and therefore must be prepared daily. True or False True
When stored in a spray or wash bottle or in a closed, brown opaque container, the bleach solution will remain stable for 60 days and will retain 50 percent of its initial value. False 30 days
Survival times of S. Aureas including MRSA 7 days to >12 months
Survival time of C. Diff >5 months
Survival time of Norovirus 8 hours to >2 weeks
the removal of foreign material (e.g., soil, dust, organic material) from objects, and it is normally accomplished using water with detergents or enzymatic products. Cleaning
the reduction in microbial population on an inanimate object to a safe or relatively safe level. Sanitizing
the elimination of many or all pathogenic organisms with the exception of bacterial spores. Surfaces must be cleaned before they can be properly disinfected. Disinfection
a one-step process, unless the surface is heavily contaminated. Cleaning-disinfection
Detergents • More environmentally friendly, & produce less offensive odors • Cost less than disinfectants • Do not effectively remove microorganisms from surfaces
Disinfectants • Disinfectants are divided into low, intermediate and high levels • Have different kill capabilities based on the levels
High-level Disinfectants Kill spores as well as all other forms of microorganisms
Intermediate-level Disinfectants Kill vegetative bacteria, mycobacteria, most fungi, most viruses and some spores
Low-level Disinfectants Kill most vegetative bacteria, some fungi, and some viruses
Are approved by the FDA as antimicrobial agents safe for use on skin. They are not to be used to for cleaning inanimate objects or environmental surfaces because of their unproven efficacy on nonhuman surfaces. Antiseptics
What are the 3 most commonly reported waterborne pathogens Pseudomonas spp., Legionella, & Atypicl (or non-TB) mycobateria
Which of the following are the key to preventing water related problems in healthcare facilities? 1. Planning for remediation in the event of disaster 2. Proactive risk assessment 3. Thoughtful design 4. Routine preventive maintenance C. 2,3,4 Although planning must necessarily provide for remediation in the event of disaster—natural or manmade—the key to prevention is proactive risk assessment, thoughtful design, and routine preventive maintenance.
Water suitable for drinking Potable water
Water (as from a sink or bath) that does not contain serious contaminants (as from toilets or diapers). Gray water
Waste water containing sewage contaminants Black water
Water forced through a special membrane under pressure, which produces highly purified water. Typically requires remineralizing with essential trace elements before use. Used for various applications within healthcare, including in dialysis. Reverse osmosis water
Purified water that has had charged ions removed. Used for various applications within healthcare, including the laboratory Deionized water
When disease transmission from direct contact with waterborne microorganisms is considered what pathogen (s) should you suspect? Pseudomonas spp., atypical mycobacteria, and Legionella are the most commonly reported pathogens identified
Which waterborne pathogens are most often related to outbreaks of contaminated equipment? Pseudomonas and atypical mycobacteria often are related to contaminated equipment.
Inhalation of aerosols of contaminated water is the primary mechanism of transmission for Legionella, not personto- person transmission. True or False True
Water from flower vases has been identifies as a disease risk for immunocompetent patients because potential pathogens have been isolated from such water sources. True or False False
Faucet aerators on sinks can enhance growth of waterborne organisms. True or False True Aerators are not recommended, but if they must be used, especially in an area with immunocompromised patients, a systematic cleaning routine should be established
The organism most likely to be found in an outbreak related to outpatient whirlpool wound therapy would be: A. Coagulase-negative staphylococcus B. Streptococcus viridians C. Pseudomonas aeruginosa D. Hepatitis B Virus C. Pseudomonas aeruginosa
Inadequate refrigeration of food may permit the growth of potentially harmful microbes. Interventions to prevent the growth of pathogens due to inadequate refrigeration include: 1) Train personnel to recognize and implement safe maintenance of refrigerators 2) Establish a method to record temp on a regular basis 4) Schedule and perform regular preventive maintenance of freezer &refrigerator
The water temperature range recommended by the CDC for prevention of growth of Legionella bacteria is: A. Hot at 124°F > & cold at 68°F B. Hot at 108°F > & cold at 77°F C. Hot at 110°F > & cold at 80°F D. Hot at 77°F > & cold at 50°F A. Hot at 124°F > & cold at 68°F
Which of the following recommendations should be made to reduce the risk of infection from sinks in Pt care areas? A. Sink basins should be deep enough to prevent splashing of water onto nearby pt care items
The planning committee for your new healthcare facility would like to include a water feature just inside the entrance of the new building. Which of the following recommendations should you make to ensure that this does not put anyone @risk of infection: 2) Should be designed so that water does not remain stagnant at all, & should include built-in methods of filtering or disinfecting the water 3) Should be designed to prevent aerosolizing of water 4) The water feature must have routine maintenance
A nurse manager from a Rehabilitation Unit is requesting that aerators be installed on the sinks in the patient rooms on her unit. The IP should explain that: C. Aerators increase the risk of HAIs
A patient in has been diagnosed with Legionnaires’ disease that was possibly acquired during his stay in the hospital. What is the recommended first response to this incident? A. All water sites in the healthcare facility to which the pt was exposed should be cultured for L. pneumophila If there is suspicion of HA L. pneumophila, the water system should be tested first to determine whether the microbe is present.
OSHA recommended a schedule for flushing that follows American National Standards Institute (ANSI) recommendations for flushing the system for 3-minute period each week.
The ICRA should influence the facility design, the procedures to prevent exposure from construction debris, and the selection of equipment and surfacing materials to manage infection risk. True or False True
The IP’s role during the ICRA is to be experts in ventilation, plumbing, specialty materials, and equipment depending on the scope of the project. True or False False
The ICRA is a written plan describing how the release of potentially infectious agents from the construction activities will be controlled. True or False False: The 2006 FGI Guidelines added the requirement for written infection control risk mitigation recommendations (ICRMR ) describing how the transmission of biological contaminants from construction zones will be contained and controlled
A hospital is beginning a major construction project. The IP has been asked to join the planning team to assist with the development of the ICRA for the project. What is the purpose of the ICRA? B. Minimize infectious hazards for patients and healthcare personnel
A healthcare facility is undergoing extensive renovation. Surveillance for which of the following organisms would be particularly important during any construction or renovation project in a healthcare facility? B. Legionella and Aspergillus
Poor planning during a construction project can lead to an increase risk of infection related to: 1) Construction delays 2) Compromised air quality 3) Contaminated water 4) Increase in construction-related traffic C. 2, 3
One of the units in the facility will soon be renovated. After verifying the info, contacts the newly hired Director of Design & Construction to explain how important it is for the IP to be included. Which of the following is the most compelling argument? B. The IP provides essential input into preventing hazardous risks to patients, HCP, and visitors during design and construction projects
The IP exits the elevator & finds a major renovation area w/ non intact barriers near the OR & ICUs. Dust & debris are evident in the corridor. A meeting is immediately arranged. The IP stresses the following: An airtight barrier must be installed from floor to ceiling & taped closed w/ duct tape. All debris hauled out of the renovation area must be in closed containers. All dust tracked outside the area must be removed immediately damp mop or HEPA vacuum
Which of the following methods of air sampling is most useful for detecting low numbers of fungal spores in areas that are highly filtered? A. Sieve impactor samplers
Which of the following is the most important focus of an IC program during construction and repairs within a healthcare facility? A. Staying with the proposed time frame for the project B. Minimizing noise C. Keeping costs low D. Reducing dust D. Reducing dust
Of the CDC recommendations for air-handling systems in health-care facilities, which of the following is the most highly recommended compared to the other choices? D. Conduct an infection-control risk assessment (ICRA) and provide an adequate number of AII and PE rooms to meet the needs of the patient population
An outbreak of aspergillosis is suspected after 3+ oncology pts are ID w/ + cultures. The IP suspects a HVAC malfunction & begins an investigation. The IP has been asked to make recom for EV cultures. All of the following needs to be considered except: B. Meeting with the facility legal staff to discuss notification of the patients
All of the following may be indications of a HVAC malfunction except: A. An increase in the post op SSI rates B. 1 case of aspergillosis in a severely immunosuppressed pt C. HCA varicella infections D. Outbreak of VAP Acinetobacter infections in the ICU D. Outbreak of VAP Acinetobacter infections in the ICU
Created by: JRWeidenaar