Doffing Disaster
What piece of PPE should always be removed first when leaving a room on contact precautions?
Gloves - the most heavily contaminated item
Why is putting your deck phone on the breakroom table while eating lunch an IPAC hazard?
Phones are high touch surfaces carried from resident care areas. Setting them down on the table transfers viruses/bacteria to where you eat
Name two of the four primary "Moments for Hand Hygiene"
Before initial resident/room contact.
Before aseptic/clean procedure
After bodily fluid exposure
After resident/resident room contact.
Fact or Myth : Wearing gloves replaces the need to wash your hands
MYTH! Gloves can have microscopic holes and hands become contaminated during glove removal.
What type of transmission precautions require staff to wear an N95 mask instead of a standard surgical mask?
Airborne precautions
True or false : You should grab the outside of your mask or respirator to pull it off quickly after leaving a room.
False : the front of the mask is heavily contaminated. Always unhook the straps from behind the ear after hand hygiene
What is the "danger zone" temperature for food left out of the fridge in the staff room?
4-40 degrees C. Harmful bacteria multiply rapidly at this temperature range.
What is the single most effective way to break the chain of infection?
Proper hand hygiene
MYTH! ABHR does not kill c diff. You must physically wash with soap and water to flush spores away.
During a suspected Norovirus outbreak on a unit, how long must staff remain off work after their last symptom (diarrhea/vomiting) resolves?
48 hours to ensure all viral shedding has stopped.
What critical action must be performed immediately after removing your gloves and gown?
Hand hygiene.
During an active facility outbreak, why is the breakroom historically identified as one of the highest risk areas for staff to staff virus transmission?
Staff remove masks/PPE to eat and drink in close proximity.
Coughing into your hands transfers pathogens to objects you touch. What link in the chain of infection does your hand represent?
Mode of tranmission
Fact or myth : You only need to disinfect a shared blood pressure cuff if the resident was on isolation precautions?
MYTH. All shared non critical medical equipment must be cleaned and disinfected between every resident.
What does the term "cohorting" mean when managing staff or residents during an active outbreak?
Assigning dedicated staff members to unwell residents and separating infected residents from uninfected residents to stop cross contamination and prevent further spread of illness
When removing a gown, why should you peel it down and away from your neck & shoulders, rolling it inside out into a bundle?
To keep contaminated front and sleeves contained on the inside, preventing dirty outer surface from touching your scrubs or skin
What should you do with personal ID badges before sitting down to eat in the breakroom?
Remove or secure them so they don't dangle on dining tables, food plates or shared surfaces. Badges/lanyards can carry high bacterial loads.
A resident with a severe cough covers their mouth with their hand and then touches the door handle. In this scenario, what role does the door handle play in the chain of infection?
It acts as the Reservoir holding the virus/bacteria until the next person touches it.
Fact or Myth : Wearing two pairs of gloves gives you twice the protection and is recommended for high risk care.
MYTH: Double gloving reduces dexterity, increases risk of tearing, creates false sense of security and makes proper hand hygiene between tasks more difficult.
What is the primary reason that staff working on an outbreak unit should not float to non outbreak units during an outbreak?
Prevent staff members from acting as vectors of transmission, carrying viruses or environmental microbes from an active outbreak zone to clean unit.
You've finished doffing all your PPE after caring for a resident on contact precautions, but you accidentally brush your clean bare arm against the outer edge of the dirty garbage bin. What is your immediate next step?
Wash your hands and exposed forearm with soap and water before touching anything else.
Why is using a personal cloth towel to dry your hands in the staff room sink considered an IPAC hazard compared to single use paper towels?
Reusable cloths towels quickly retain moisture and harbor bacteria transferring germs back to clean hands every time someone reuses them
How does wearing an N95 respirator mask break the chain of infection specifically at the Portal of Entry?
Provides a sealed filtration over the nose and mouth, preventing airborne pathogens from entering the workers respiratory tract.
Fact or myth : If your hands look visibly clean, using soap and water is still better than ABHR for routine care.
MYTH: Unless hands are visibly soiled/sticky or dealing with spore forming pathogens like C Diff, ABHR is preferred because it is faster, more effective against most microbes & more readily available than a handwashing sink.
How many days does a resident need to be on isolation for a positive Covid result given improvement as per the LTC guidelines?
7 days if improving and afebrile off antipyretics.