Infection Control

When removing PPE it is important to know what areas of the PPE are considered "clean" vs "contaminated". Select ALL the areas on PPE that are considered "clean". A. Ties on the gown B. Outside of the mask C. Sleeves of the gown D. Back of the gown E. Inside of the gloves F. Straps on the goggles

A, D, E, and F. These areas are considered "clean" on the PPE. The other areas listed are some of the areas that are considered "contaminated".

One important type of personal protective equipment is a respirator. Which statement is false about a respirator? A. A respirator is to be worn at all times when a patient is in droplet precautions. B. It is important to be fitted for a respirator annually by your employer. C. After donning a respirator, the nurse must perform a seal check. D. After providing patient care, the nurse will remove the respirator outside the patient's room.

A. This statement is FALSE. A respirator is to be worn at all times when a patient is in AIRBORNE (not droplet) precautions. A surgical mask is required for droplet precautions.

A nurse is caring for a patient receiving intravenous drug therapy via an infusion pump. The pump continues to sound an alarm and the nurse is unsure if it is administering the drug correctly. Which of these is the correct course of action for the nurse to follow? A. Continue to try to get the pump to work as to keep on schedule with the patient's drug therapy. B. Discontinue the infusion, replace the pump with a functioning one and restart the infusion, and then label the broken pump and place it in a designated area for broken equipment. C. Discontinue the infusion, replace the pump with a functioning one, and leave the malfunctioning pump outside of the patient's room for someone else to try. D. Silence the alarm, continue the infusion, and watch the patient for signs of further problems.

B. The nurse is responsible for the safe use of all equipment involved in patient care. In this instance, if the nurse is unsure if the pump is malfunctioning, then it should be replaced, labeled as broken, and removed from the work area to prevent another infusion area with a different patient. Never assume an alarm is in error and do not try to fix malfunctioning equipment if properly functioning ones are available for use. The facility may have specific requirements as to who is to be notified of broken equipment and these should be followed

A patient requires nasotracheal suction. The patient is receiving medical treatment for Mycoplasma Pneumonia. Select the PPE you would wear for this procedure: A. Gloves and mask B. Gloves, gown, goggles, and mask C. Goggles and mask D. Gloves and goggles

B. The patient will be in DROPLET precautions (it is mandatory to wear a mask at all times) due to having Mycoplasma Pneumonia. The other droplet precautions are diptheria, rubella, strep, (scarlett fever in kids/infants) pertussis, mumps

After providing care to a patient with chicken pox, you remove your PPE. Which statement is TRUE about PPE removal? A. After removing PPE, it is best to perform hand hygiene with hand sanitizer when the hands are visibly soiled. B. It is best practice to remove all personal protective equipment in the patient's room. C. When removing PPE, the respirator should be removed outside the patient's room. D. All the statements are true.

C. If a respirator is worn, it should be removed outside the room (hence the patient will be airborne precautions and the nurse would not remove the respirator in the patient's room due to becoming infected with the disease). A is wrong because it is best to perform hand hygiene with SOAP and WATER (not hand sanitizer) when the hands are visibly soiled. B is wrong because PPE should be removed at the doorway of the room or right outside of the room. Also, not ALL personal protective equipment can be removed inside the patient's room (ex: respirator).

Referring to the previous question, in what order would you doff (remove) the PPE? A. Gloves then mask B. Goggles then mask C. Gloves, gown, goggles, and mask D. Gloves, mask, googles, then gown

C. The correct order for removing PPE after patient care in question 4 is: Gloves, gown, goggles, and mask. Doff (off) the gloves FIRST, followed by the gown, then the face shield or goggles, and lastly, doff the mask or respirator.

A nurse is setting up and assisting in a sterile surgical procedure. According to the principles of surgical asepsis, which of the following statements made by the nurse demonstrates understanding? A. The surgeon holds a surgical instrument out of view of the surgical field and below waist level, but does not touch anyone or anything. This instrument is still considered sterile and may be used. B. The skin must be sterile prior to the start of the procedure. C. The edges of a sterile field are also considered to be sterile. D. The tray is considered to be unsterile if a blood-soaked gauze from the patient is placed back onto the tray.

D. Every object used in a sterile field must be sterile. If a sterile object touches an unsterile object, it is no longer sterile. A sterile object that is out of view, or below waist level, is considered unsterile. A sterile object can become unsterile via exposure to airborne microorganisms. Fluids flow in the direction of gravity. Capillary action can contaminate a sterile field via moisture passing through a sterile object and drawing microorganisms from unsterile surfaces both above and below. The edges of a sterile field are unsterile. The skin cannot be sterilized.

A nurse has just completed a blood draw for a patient with unknown HIV status. Which of the following is the correct way to dispose of the needle? A. Break the needle then place it in a puncture-resistant container far away from patient care areas. B. Carefully recap the needle and place it in the nearest puncture-resistant container. C. Place the needle into any biohazard disposal container if there is not a puncture-resistant one nearby. D. Place the needle in the nearest puncture-resistant container.

D. Regardless of a patient's blood-borne pathogen status, the same procedure should be followed when disposing of used needles. Always place them in the nearest puncture-resistant container. Never recap a needle, never place a needle into a biohazard container where it may injure or puncture someone else, and never break a needle prior to disposing of it.

A nurse inadvertently administers the wrong dose of antibiotic to a patient recovering from surgery. Which of these is the correct course of action for the nurse when documenting this in the patient's medical record? A. The nurse should just document the dosage given in the patient's chart. An incident report is not necessary because it was simply the wrong dosage of a drug that was ordered. B. The nurse should create an incident report and include a copy of the report in the patient's medical record. C. The nurse should tell the patient of the incident and ask his or her preference on if an incident report should be created and if one is, it should be included in the patient's medical record. D. The nurse should create an incident report and record the facts of the incident in the medical record, but does not have to include an actual copy of the incident report or reference its existence.

D. The nurse has to make an incident report. The facts (the dosage given) should be recorded in the patient's medical record, but an actual copy of the incident report does not have to go into the record & you do not have to acknowledge it as an incident.

True or False: The nurse should always don personal protective equipment in the patient's room.

FALSE. The nurse should always don personal protective equipment OUTSIDE the patient's room.

True or False: The correct sequence for donning PPE is the following: gloves, mask/respirator, goggles/face shield, gown.

False. Gown, Mask/Respirator, Goggles/Face Shield, Gloves

What infections require Contact precautions?

Think MRS. WEE M = multi-drug resistant organisms [e.g.,MRSA, VRSA]; R = respiratory infections [e.g., RSV]; S = skin infections [e.g., impetigo]; W = wound infections; E = enteric [e.g., c-diff, hep A]; E = eye infections [e.g., conjunctivitis]

In what order do you remove PPE?

gloves, goggles, gown, mask

In what order do you put on PPE?

gown, mask, eyewear, gloves