Infection Control

Question 1

Most important practice for infection control

Answer 1

Hand hygiene

Question 2

Suggested practice for anesthesia

Answer 2

Double glove, remove outer glove after intubation or other tasks

Question 3

Airborne precautions

Answer 3

N95 mask
-For: TB, chickenpox, smallpox, severe ARDS, H1N1 influenza

Negative pressure isolation with frequent air changes

Question 4

Droplet precautions

Answer 4

Surgical mask

-For: Mumps, rubella, pertussis, influenza

Question 5

How to avoid contamination on the anesthesia carts

Answer 5

• Keep carts clean: No contaminated items or drugs
• Keep all drugs exposed to the patient on the machine shelf
• Keep all contaminated/used equipment on the machine shelf or in special separate bin
• Use a filter on the gas machine

Question 6

Complication of regional anesthesia and line placement and how to prevent

Answer 6

Infection
Prevention
-Meticulous aseptic technique for skin prep (chlorhexidine 0.5% with isopropyl alcohol)
-Mask, sterile glove, hat
-For indwelling catheters/lines: All of ^ and gown, sterile occlusive dressing, check insertion site daily, remove within 48 hours if clinically possible, (infection risk is increased 40% each day the line is in)

Question 7

SCIP Measures

Answer 7

• Perioperative antibiotic therapy
• Glucose control <200
• Maintain beta-blocker
• Perioperative normothermia
• Compression stockings/venous thromboembolism prophylaxis
• Urinary catheter removal (POD 1 or 2)
• Hair removal (clip not shave)
• Smoking cessation

Question 8

Perioperative antibiotic therapy SCIP measure

Answer 8

• Prophylactic only when indicated, discontinued 24 hours after surgery end time
• IV abx within 1 hour prior to incision (vanco and fluoroquinolones 2 hours)

Question 9

Perioperative normothermia SCIP measure

Answer 9

• Temp <36C increases SSI

- Vasoconstriction decreases perfusion and oxygen delivery to wound, impairs phagocytic leukocyte function

Question 10

Spaulding Scheme

Answer 10

For disinfection and sterilization between patients

• Environmental surfaces
• Noncritical items
• Semicritical items
• Critical Items

Question 11

Spaulding scheme for environmental surfaces

Answer 11

• Knobs, table tops, anesthesia cart, laryngoscope handle, personal items, pumps, glucometers, blood/fluid warmer
• Keep materials for next case in clean place, confined and covered
• Clean with CaviWipes

Question 12

Spaulding scheme for noncritical items

Answer 12

Have contact with skin

• BP cuffs, precordial stethoscopes, arm boards, pulse ox, cables
• Clean with CaviWipes

Question 13

Spaulding scheme for semicritical items

Answer 13

Contact mucous membranes or nonintact skin

• Laryngoscope blades, magills, breathing tube components
• Need to be disinfected/sterilized
• Clean, covered, confined in a drawer NOT OPEN

Question 14

Spaulding scheme for critical items

Answer 14

Items that will contact normally sterile tissues, must be sterile at time of use

• Regional and vascular needles
• Sterile processing
• Most of these used in anesthesia are single use

Question 15

Reusing a single use item

Answer 15

Imposes additional liability on the individual and institution for proper functioning
-Permissible to reuse “multiple-use” circuits with a breathing filter if manufacturer recommendations are followed

Question 16

What reduces HAIs from being transferred from surfaces to providers and their patients

Answer 16

Hang hygiene, cleaning of environmental surfaces and equipment