Routine Practices & Additional Precautions
Cleaning & Disinfection
Norovirus
Fun Facts!
100

True or False? I should use ABHR over soap & water when caring for a resident with GI symptoms.

  • False—soap and water should be used if your hands are visibly soiled and when caring for residents with active GI symptoms.
  • Note, ABHR may be used following hand washing with soap and water (in the absence of HH sink near point of care).
100

How often should highly touched surfaces be cleaned during a GI outbreak?

  • Recommended minimum at least 2 times per day with sporicidal agent (i.e. bleach).
100

What precautions should a resident be placed on if they have suspect or confirmed norovirus?

  • Residents should be placed on Contact Plus precautions if they have diarrhea.
  • Residents should be placed on Droplet precautions if they’re actively vomiting.
100

What is the most effective method to prevent the transmission of GI?

  • Hand hygiene
200

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 symptoms; type of interaction to occur; potential of contamination; determine PPE required; etc. before interacting with a resident.
  • 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.
200

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.
200

When can a resident with norovirus be taken off contact plus/droplet precautions?

  • Residents can be taken off additional precautions 48 hours after their symptoms have ended.
200

True or False? CDI spores can live on environmental surfaces for a long period of time.

  • True—this is why enhanced cleaning measures are so important.
  • Environmental cleaning agent to be changed to a sporicidal agent and a second clean/disinfect is to be completed 6-8 hours following the initial clean/disinfect.
300

True or False—Contact Plus precautions should be followed when a resident is actively vomiting?

  • False—if a resident is vomiting droplet precautions, in additional to routine practices, should be followed due to the risk of droplet spread.
  • Note, the contact plus precautions poster allows you to don additional PPE based on a POCRA.
300

What PPE should be worn when cleaning grossly contaminated areas i.e., vomit or feces?

  • Droplet precautions PPE i.e., gown, gloves, eye protection and medical mask.
300

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:

  • Touching surfaces or objects with norovirus and then putting fingers in mouth
  • Having direct contact with someone who is infected with Norovirus e.g., providing care
  • Eating contaminated food or drinking water
300

How many cases of gastrointestinal illness are needed to declare an outbreak?

  • The definition of a GI outbreak is 3 or more GI illness in residents or staff over a 4 day period (where cause is suspected or confirmed to be a virus).
400

Provide 3 examples of when you should change your gloves?

Gloves should be removed:

  • Immediately after the activity they were used for
  • Before exiting the environment of the resident i.e. gloves should never be worn between residents.
  • When moving from one site of body to another
400

True of False—Many commonly used disinfectants are unable to kill viruses that cause GI?

  • True—When there is a GI outbreak at a facility they will likely need to change their disinfectant as many commonly used disinfectants aren’t able to kill viruses that cause GI.
  • Disinfectants that are effective for common viruses responsible for GI outbreaks are sporicidal agents such as sodium hypochlorite 1000ppm (i.e. bleach) and accelerated hydrogen peroxide 4.5%. Other disinfectants with a Health Canada-assigned Drug Identification Number (DIN) and a virucidal claim (including the non- enveloped viruses-Norovirus, Poliovirus and/or Hepatitis A virus) can also be used effectively.
  • Disinfection is a very important tool to prevent the spread of GI
400

True or False— ABHR is more effective at killing norovirus than hand washing with soap and water?

  • False—ABHR isn’t as effective as washing your hands with soap to remove norovirus particles.
  • ABHR may be used following handwashing with soap and water; however, ABHR alone is NOT effective against norovirus.
400

What are common signs and symptoms of GI?

  • Nausea, vomiting, non-bloody diarrhea, abdominal pain, muscle ache, headache, low grade fever, fatigue
  • Note, illness could be more prolonged and severe among older adults
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