Hand Hygiene
“I just came out of an isolation room but did not touch the patient or bed. Do I need to complete hand hygiene?” Why?
Yes. When entering or exiting a patient's environment, it is required to complete hand hygiene.
What personal PPE is acceptable while working in RRMC?
None. You must only use approved RHS PPE.
If you receive a urine culture order on a patient that is asymptomatic, what would you do? What are considered symptoms?
What is...
I would question the order and consult my charge nurse/manager/or ordering provider.
Fever, suprapubic pain, urgency/frequency, dysuria, AMS (with no other cause)
“I am just going into the patient’s room on contact precautions just to turn off a beeping pump. Do I need to put on a gown?”
Yes. Regardless of the activity that is being completed in the patient's room, once you enter an isolation room, you need to wear all proper PPE.
Storing cardboard shipping boxes is allowed in your clean utility? True or False?
No. All items must be removed from shipping boxes and stored according to policy.
Artificial nails that are kept short are acceptable?
No per RHS policy.
What PPE should be worn when entering a patient’s room who is on contact precautions? Droplet? Airborne?
Contact - gown, gloves
Droplet - mask
Airborne - respirator
Who draws all peripheral blood cultures at Regional (except ED)?
Phlebotomy draws all blood cultures except for in the ED where nurses have competencies.
What color bag should you place the linens in for a patient with bedbugs? What do you do with the patient’s belongings?
Yellow bag for linens. Double bag patient items in clear patient bags and goose neck tie the bag. Give to family members to take home.
You can carry extra flushes, curos caps, tape, and extra supplies in your pocket or on the back of the WOW while going from room to room? Why or why not?
No. These items must be kept in the WOW drawer or PAR rooms. You may not take items in and out of patient rooms.
Are gloves a substitution for hand hygiene?
No. You must complete hand hygiene before and after gloves are used.
If a PUI or positive COVID patient needs to go for an X-ray, what is the process for transportation?
Place a mask on the patient with a clean sheet over the patient. The transporter will wear respirator, gown, and gloves.
After how many loose stools should you send a C-Diff sample? What tool can you follow?
3
The C-Diff algorithm
What test result do you need to remove your patient from TB precautions? How many? How often?
AFB, early morning if possible x 3 days
How often should nasal and skin decolonization be performed?
For patients in critical care - every 24 hours/daily
For patients with central lines - every 24 hours/daily
How should hand hygiene be completed after caring for a C-diff patient?
Soap and water
How many times can an isolation gown be used before disposal?
Once. Obtain a new gown every time you enter the patient's room.
When can you draw a blood culture from a central line? Can you draw from a hemodialysis line?
Only if there is an order for drawing off the central line. You should not draw from a hemodialysis line.
What isolation is required for a patient with suspected measles? Strep? TB? Shingles? Lice?
Measles - airborne
Strep - droplet
TB - Airborne
Shingles - Varies
Lice - contact
What cleaning product should be used in all C-Diff rooms?
Bleach
Who can record hand hygiene observations on the intranet? Can you explain the process?
Everyone.
Once fitted for a respirator on hire, you do not need to be fit tested for any other brand. The size is always the same?
No. You need be fitted every time the respirator brand changes.
Name the six indications for an indwelling urinary catheter?
Retention, prolonged immobilization/to unstable to turn, Stage III or IV wound, strict I&O, CMO, urologically placed
How do you remove a COVID isolation?
Follow CDC guidelines - IP will explain
What do you look for during your assessment of your central line? What should you chart?
Biopatch in place/not engorged, dressing C/D/I, dressing date, tubing labeled, no reinforced tape, curos caps, patency, line necessity