Behind
the
Shield
the
Shield
Who Can
Do It?
Do It?
Rub It
Or
Scrub It
Or
Scrub It
Don't Cross
The Line
The Line
Wound
Warriors
Warriors
100
This piece of personal protective equipment (PPE) must always be removed last when exiting a patient's isolation room.
What is the mask?
DOFF: Gloves, Gown, Goggles, Mask
DON: Gown, Mask, Goggles, Gloves
100
According to the rules of delegation, this critical assessment of a newly post-operative wound can only be performed by the registered nurse (RN).
What is the initial assessment (or unstable assessment)?
100
This is the minimum required alcohol concentration percentage in an alcohol-based hand rub recommended by the CDC.
What is 60%? (60% to 95%)
100
To prevent contamination, a nurse must always keep their hands above this anatomical level once sterile gloves are donned.
What is the waist level?
100
When cleansing a linear surgical incision, the nurse should always wipe in this direction relative to the wound bed.
What is from top to bottom (or clean to dirty/center outward)?
200
This is the standard, preferred room assignment for a patient placed on Contact Precautions to prevent cross-contamination.
What is a private/single-occupancy room?
(Cohorting with a patient with the identical organism is the backup option)
200
This type of nursing professional can perform sterile dressing changes and insert Foley catheters, but cannot create the initial nursing care plan.
What is a Licensed Practical/Vocational Nurse (LPN/LVN)?
200
This mechanical action, lasting for at least 15 to 20 seconds, is the most important part of washing hands with soap and water.
What is friction?
200
This is the maximum outer border width of a sterile drape or kit wrapper that is considered unsterile or contaminated.
What is one inch (2.5 cm)?
200
This isotonic fluid is the standard, safest clinical choice for irrigating and cleansing a healing open wound.
What is 0.9% Normal Saline (or sterile water)?
300
Along with standard exam gloves, this specific piece of PPE must be worn by the nurse before entering the room of any patient on Contact Precautions.
What is a fluid-resistant isolation gown?
300
After applying a clean dressing, the nurse labels it with these three pieces of information.
What are the date, time, and nurse’s initials?
300
The nurse must use soap and water instead of hand sanitizer when leaving the room of a patient with this spore-forming diarrheal illness.
DAILY DOUBLE
What is Clostridium difficile (or C. diff)?
300
This fundamental rule of movement dictates that a nurse must never do this action over an open sterile field.
What is turning your back or reaching across the sterile field?
300
A narrow passage that extends from the wound bed into surrounding tissue.
What is tunneling?
400
When preparing to enter a room, this is the correct, standard sequence for donning full PPE
What is Gown, Mask, Goggles, Gloves
(Gloves go over the gown cuffs)
400
An RN is caring for a postoperative client on the surgical floor 24 hours after a cholecystectomy. Which task is most appropriate for the RN to delegate to the Unlicensed Assistive Personnel (UAP)?
A. Assessing the client's surgical dressing for signs of excessive serosanguineous drainage.
B. Instructing the client on deep-breathing and coughing exercises to prevent atelectasis.
C. Recording the client's oral intake and urinary output at the end of the shift.
D. Evaluating the effectiveness of pain medication administered 30 minutes prior.
What is C. Recording the client's oral intake and urinary output at the end of the shift.
TAPE (RN NEVER DELEGATE)
Teaching: Initial patient education, discharge teaching, and complex instructional plans. (Note: LPNs can only reinforce teaching that the RN has already initiated).
Assessment: Initial admission assessment, first post-op assessment, or any assessment of an unstable, newly admitted, or deteriorating patient.
Planning: Developing the nursing care plan, establishing patient goals, and creating nursing diagnoses.
Evaluation: Analyzing patient outcomes, determining if a medication worked, checking if goals were met, and interpreting trends in clinical data.
400
The nurse touches the patient’s bedside table but does not touch the patient. This action is still required before leaving the room.
What is hand hygiene?
400
When opening a sterile package for a sterile field, this flap should be opened first.
What is the flap furthest from your body(the top flap)?
400
These two common household antiseptics are strictly avoided on healthy granulating wounds because they are cytotoxic and destroy new tissue growth.
(NAME ONE)
What are hydrogen peroxide and povidone-iodine (Betadine)?
500
This is the immediate action a nurse must take if their sterile glove accidentally brushes against the side of the bedrail while setting up a sterile field.
What is removing the contaminated gloves, performing hand hygiene, and donning a new sterile pair?
500
This acronym stands for the five criteria a nurse must check before delegating any wound care or safety task to another team member.
What are the Five Rights of Delegation? (Tom Cruise Performs Daily Stunts)
Task
Circumstance
Person
Direction/Communication
Supervision/Evaluation
500
This type of non-enveloped virus, famous for outbreaks on cruise ships and in hospitals, is highly resistant to alcohol-based sanitizers and requires soap and water.
What is Norovirus?
500
If a sterile fluid splashes onto a sterile drape, the field is considered contaminated due to this specific process of moisture drawing bacteria through the barrier.
What is capillary action (or wicking/striking through)?
500
The CDC recommends keeping primarily closed surgical wounds covered with a sterile dressing for this specific timeframe post-op to allow epithelialization.
What is 24 to 48 hours?
***The surgeon removes the first postoperative dressing.