Cleaning & Disinfection
True or False
Clean from the area that is most contaminated to the area that is least contaminated.
False — clean from the area that is least contaminated, to the area that is most contaminated (e.g. dry, unsoiled counters first, toilets last). Work from clean to dirty.
True or False
Contact precautions should be followed when a resident is actively vomiting?
False - if a resident is vomiting, droplet precautions PPE, in additional to routine practices, should be followed due to the risk of droplet spread.
What precautions should a resident be placed on if they have suspect or confirmed norovirus?
When should you collect and send a stool sample for for CDI testing?
After three loose stools has occurred in 24 hours and there is no precipitating explanation and it is different from client's baseline.
What are common signs and symptoms of GI illness?
How often should highly touched surfaces be cleaned during a GI outbreak?
Recommended minimum at least 2 times per day.
What assessment should be completed before any interaction with a resident?
A Point of Care Risk Assessment (POCRA) should be completed to evaluate the potential risk of exposure to pathogens. We want to assess the resident’s status, task to be completed, and environment in order to determine appropriate PPE
You should be vigilant with conducting a POCRA when there is a GI outbreak at your facility to identify risk of exposure to GI pathogens, especially when caring for residents that are ill.
When can a resident with norovirus be taken off contact/droplet precautions?
Residents can be taken off additional precautions 48 hours after their symptoms have ended.
What precautions should a suspect/confirmed CDI case be placed on?
Contact Precautions
Who are the people involved during a GI outbreak?
Yourself, your RCC's, and your leadership team
Residents
CD PHO
IPC practitioner
Housekeeping manager and housekeepers
BCCDC laboratory
What is the best disinfectant to use during a GI outbreak?
Sodium hypochlorite (bleach) 1000ppm is the preferred disinfectant during a GI outbreak. The bleach solution should be freshly made daily.
Provide 3 examples of when you should change your gloves?
Gloves should be removed:
How does norovirus spread from one person to another?
You can get norovirus by getting tiny particles of feces or vomit from an infected person in your mouth i.e. fecal-oral route. Some examples of ways you could get exposed include:
How many hours should precautions remain in place for a resident with CDI?
At least 72 hours without symptoms of loose and/or watery stool OR a return to the resident’s baseline if their status quo is loose and/watery stools.
When is a GI outbreak declared by public health?
Three or more cases of Viral Gastrointestinal Illness (Gastroenteritis) in residents and/or staff in a 4 day period, where the causative agent is known or suspected to be a virus.
What are some items you can help disinfect?
Charts, work station, shared equipment, med carts, dining tables, lunch room eating areas
After providing care to a resident with GI symptoms what method of hand hygiene should be performed?
Soap and water should be used when caring for residents with active GI symptoms or if your hands are visibly soiled.
Note, in the absence of HH sink near point of care, ABHR may be used followed by hand washing with soap and water once outside.
True or False
ABHR is more effective at killing norovirus than hand washing with soap and water?
False — ABHR alone is NOT effective against norovirus. Hand washing with soap and water is needed to remove the norovirus particles.
Why is C. difficile so difficult to eliminate?
C. difficile creates spores which are resistant to many disinfectants and they are very stable in the environment.
When is a GI outbreak declared over?
In the case of a gastrointestinal illness outbreak caused by Norovirus, the outbreak will typically be declared over when 72 hours have passed since symptoms have ended for the last resident case. Other viruses or causative agents may require longer than 72 hours