1. Define infection prevention and discuss types of infections

1. Define infection prevention and discuss types of infections
Define the following terms: infection prevention the set of methods practiced in healthcare facilities to prevent and control the spread of disease. microorganism/microbe a living thing or organism that is so small that it can be seen only under a microscope. infection the state resulting from pathogens invading the body and multiplying.

Define the following terms: pathogens microorganisms that are capable of causing infection and disease. localized infection an infection that is limited to a specific location in the body and has local symptoms. systemic infection an infection that is in the bloodstream and is spread throughout the body, causing general symptoms. healthcare-associated infection (HAI) an infection acquired within a healthcare setting during the delivery of medical care.

It is important to observe and report the following signs and symptoms of localized infections: • Pain • Redness • Pus • Swelling • Drainage (fluid from a wound or cavity) • Heat

It is important to observe and report the following signs and symptoms of systemic infections: • Fever • Body aches • Chills • Nausea, vomiting • Weakness • Headache • Mental confusion • Drop in blood pressure

2. Describe the chain of infection
Define the following terms: chain of infection a way of describing how disease is transmitted from one being to another. causative agent a pathogenic microorganism that causes disease. reservoir a place where a pathogen lives and grows.

Define the following terms: portal of exit any body opening on an infected person that allows pathogens to leave. mode of transmission the method of describing how a pathogen travels. direct contact a way of transmitting pathogens through touching the infected person or his or her secretions. indirect contact a way of transmitting pathogens from touching something contaminated by the infected person.

Define the following terms: portal of entry any body opening on an uninfected person that allows pathogens to enter. mucous membranes the membranes that line body cavities that open to the outside of the body, such as the linings of the mouth, nose, eyes, rectum, or genitals. susceptible host an uninfected person who could get sick. transmission passage or transfer.

Define the following terms: infectious contagious. medical asepsis refers to practices such as handwashing that reduce, remove, and control the spread of microorganisms. surgical asepsis the state of being free of all microorganisms; also called sterile technique.

Transparency 5-1: The Chain of Infection

REMEMBER: If even one link in the chain of infection is broken, the spread of infection is stopped.

Think about these questions: What is an example of each link in the chain of infection? How could that link be broken?

Handout 5-1: Infection Prevention Definitions
Microorganism: Microorganisms are single-celled organisms that only can be viewed with the aid of a microscope. Microorganisms can be divided into five basic categories—bacteria, viruses, fungi, protozoa, and helminthes. Most microorganisms are harmless—some are even beneficial. Others are capable of causing infection or disease. Microorganisms are often classified as either pathogenic or nonpathogenic. Nonpathogenic microorganism: A nonpathogenic microorganism is a type of microorganism that is incapable of causing or unable to cause infection or disease. Pathogenic microorganism: A pathogenic microorganism is a type of microorganism that is capable of causing infection or disease; it is also called a pathogen.

Handout 5-1: Infection Prevention Definitions (cont’d)
Bacteria: Bacteria are single-celled microorganisms that lack nuclei and organized cell structures. Bacteria can exist independently (on their own) or as parasites, dependent upon a host for life. Bacteria can be found in three basic shapes—round, rod, or spiral. While some bacteria are capable of causing disease, most are non-infectious and many have critical roles in decay, fermentation, and nutrient recycling. Bacteria help people digest food. Some bacteria destroy disease-causing cells, and some produce important vitamins in the gastrointestinal tract. Bacteria also play a role in food processing, such as in the production of yogurt and cheeses. Pathogenic bacteria can cause cell damage or death by producing substances known as toxins. Other cell damage can occur when the host’s immune system produces substances to eliminate bacteria, and these substances damage the infected cells and adjacent cells.

Virus: Viruses are small packages of DNA or RNA encased in protein shells that invade a cell (host cell) and incorporate themselves into the host cell’s DNA. When the infected host cell begins to produce (replicate) new viral particles, the infected cell dies. Fungi: Fungi are multi-celled or single-celled organisms. They can be pathogenic, causing infections in healthy persons, or opportunistic, causing infections in people with weakened immune systems. Fungi can be nonpathogenic as well, and some types of fungi are even beneficial, such as those used to make antibiotics. A few types of fungi are considered delicacies, such as truffles and edible mushrooms. Yeasts and molds are examples of fungi. Fungi are the most common causes of disease in crops and plants. Fungi receive their nourishment by secreting enzymes that break down surrounding cells. When this happens on living tissue, it is irritating and uncomfortable.

Parasite: A parasite is an organism that lives on or in an organism of a different species—a host. Infection: An infection occurs when microorganisms enter and multiply within the tissue of a host, causing damage to that tissue. Symptoms may be apparent, or the host may display no symptoms. Disease: A disease occurs when tissue that has been damaged due to the entry and multiplication of microorganisms results in clinical signs and symptoms of a recognizable process. Host: A host is an organism or cell on or in which a microorganism lives or feeds.

3. Explain why the elderly are at a higher risk for infection
Define the following terms: malnutrition poor nutrition due to improper diet. dehydration a serious condition resulting from inadequate fluid in the body.

3. Explain why the elderly are at a higher risk for infection
The following factors place the elderly at a higher risk for infection than the general public: • Weakened immune systems • Decreased circulation • Slow wound healing • Malnutrition • Dehydration • Limited mobility • Hospitalization • Difficulty swallowing • Incontinence • Feeding tubes and other tubing

4. Explain Standard Precautions
Define the following terms: Occupational Safety and Health Administration (OSHA) a federal government agency that makes rules to protect workers from hazards on the job. Centers for Disease Control and Prevention (CDC) a government agency under the Department of Health and Human Services (HHS) that issues information to protect the health of individuals and communities. isolate to keep something separate, or by itself.

Define the following terms: Standard Precautions a method of infection prevention in which all blood, body fluids, non-intact skin, and mucous membranes are treated as if they were infected with an infectious disease. sharps needles or other sharp objects.

The CDC defines body fluids as including the following substances: Saliva Sputum (mucus coughed up) Urine Feces Semen Vaginal secretions Pus or other wound drainage Vomit

Think about this question: Why should Standard Precautions be followed with every resident in an NA’s care?

REMEMBER: It is impossible to tell from looking at a person whether he or she has an infectious disease.

Standard Precautions include the following measures: • Wash hands. • Wear gloves. • Remove gloves immediately when finished with a procedure. • Immediately wash skin surfaces. • Wear a disposable gown. • Wear a mask and goggles.

Standard Precautions (cont’d): • Wear gloves when handling sharp objects. • Never attempt to recap needles or sharps. • Avoid nicks and cuts. • Bag all contaminated supplies. • Clearly label body fluids. • Dispose of contaminated waste properly.

5. Explain hand hygiene and identify when to wash hands
Define the following terms: hand hygiene washing hands with either plain or antiseptic soap and water and using alcohol-based hand rubs. antimicrobial an agent that destroys, resists, or prevents the development of pathogens.

REMEMBER: It is very important to wash hands with soap and water. NAs should not rely solely on alcohol-based rubs.

NAs should wash their hands at the following times: • When first arriving at work • Any time they are visibly soiled • Before, between, and after all resident contact • Before putting on gloves and after removing gloves • After contact with body fluids, mucous membranes, non-intact skin, wound dressings • After handling contaminated items • After contact with objects in resident’s room

Times to wash hands (cont’d): • Before and after touching meal trays or handling food • Before and after feeding residents • Before getting clean linen • Before and after using the toilet • After touching garbage or trash • After picking up things from the floor

Times to wash hands (cont’d): • After blowing nose or sneezing into hand • Before and after eating • After smoking • After touching areas on the body • Before and after applying makeup • After any contact with pets/pet care items • Before leaving facility

REMEMBER: Hand-washing is the single most important thing an NA can do to prevent the spread of disease.

Washing hands (hand hygiene)
Equipment: soap, paper towels 1. Turn on water at sink. Keep your clothes dry, because moisture breeds bacteria. Wet hands and wrists thoroughly. 3. Apply soap to your hands.

Keep your hands lower than your elbows and your fingertips down. Rub hands together and fingers between each other to create a lather. Lather all surfaces of wrists, fingers, and hands, using friction for at least 20 seconds. Friction helps clean. 5. Clean your nails by rubbing them in the palm of your other hand.

6. Being careful not to touch the sink, rinse thoroughly under running water. Rinse all surfaces of your hands and wrists. Run water down from wrists to fingertips. Do not run water over unwashed arms down to clean hands.

7. Use a clean, dry paper towel to dry all surfaces of your hands, wrists, and fingers. Do not wipe towel on unwashed forearms and then wipe clean hands. Dispose of paper towel into waste container without touching the container. If your hands touch the sink or wastebasket, start over.

Use a clean, dry paper towel to turn off the faucet then dispose of paper towel into waste container. Do not contaminate your hands by touching the surface of the sink or faucet.

6. Discuss the use of personal protective equipment (PPE) in facilities
Define the following terms: personal protective equipment (PPE) equipment that helps protect employees from serious workplace injuries or illnesses resulting from contact with workplace hazards. don to put on. doff to remove.

Define the following terms: perineal care care of the genitals and anal area. non-intact skin skin that is broken by abrasions, cuts, rashes, acne, pimples, lesions, surgical incisions, or boils.

PPE must be worn when a caregiver might come into contact with any of the following: Body fluids Mucous membranes Open wounds

REMEMBER: NAs must wear gowns, masks, goggles, and face shields any time splashing or spraying of body fluids or blood could occur

NAs should remember these points about gowns: Gowns protect exposed skin They prevent soiling of clothing They should fully cover the torso, and the sleeves should fit snugly.

Putting on (donning) and removing (doffing) gown
1. Wash your hands. 2. Open the gown. Hold out in front of you and allow gown to open/unfold. Do not shake it. Facing the back opening of the gown, place your arms through each sleeve. Fasten the neck opening. Reaching behind you, pull the gown until it completely covers your clothing. Secure gown at waist.

5. Use a gown only once and then remove and discard it. If gown becomes wet or soiled during care, remove it. Check your clothing, and put on a new gown. OSHA requires non- permeable gowns— gowns that liquids cannot penetrate—when working in a bloody situation. 6. Put on your gloves after putting on gown. The cuffs of gloves should overlap the cuffs of the gown.

7. When removing a gown, remove and discard gloves properly (see procedure later in the chapter). Unfasten gown at neck and waist. Remove the gown without touching the outside of gown. Roll the dirty side in, while holding gown away from your body. Dispose of gown properly and wash your hands.

NAs should remember these points about masks and goggles: Masks are worn when the resident has a respiratory illness. • Masks should fully cover the nose and mouth. • Masks should fit snugly over nose and mouth. • It is important to change masks between residents. • Goggles should fit snugly over eyes or eyeglasses.

Putting on (donning) mask and goggles
1. Wash your hands. 2. Pick up the mask by top strings or elastic strap. Do not touch the mask where it touches your face. 3. Pull elastic strap over your head, or if mask has strings, tie top strings first, then bottom strings. Do not wear a mask hanging from only the bottom tie or strap. Masks must always be dry or they must be replaced

Putting on (donning) mask and goggles
4. Pinch the metal strip at the top of the mask (if part of the mask) tightly around your nose so that it feels snug. Put on the goggles over your eyes or eyeglasses. Use the headband to secure them to your head. Make sure they are on snugly. 6. Put on gloves after putting on mask and goggles.

Gloves must be worn in the following situations: • If the NA might touch blood or any body fluid • During mouth care or care of any mucous membrane • During perineal care • When providing personal care on non-intact skin • When providing personal care if NA has cuts on hands • When shaving resident • When disposing of soiled linens, gowns, dressings, and pads • When touching contaminated surfaces or equipment

Gloves must be changed in these situations: • Immediately before contact with mucous membranes or broken skin • If gloves become soiled, worn, or damaged

Putting on (donning) gloves
1. Wash your hands. 2. If you are right-handed, slide one glove on your left hand (reverse if left- handed). 3. Using your gloved hand, slide the other hand into the second glove. 4. Interlace fingers to smooth out folds and create a comfortable fit. 5. Carefully look for tears, holes, or discolored spots. Replace the glove if needed.

Putting on (donning) gloves
6. If wearing a gown, pull the cuff of the gloves over the sleeves of the gown.

Gloves should be removed • After use • Before caring for another resident • Before touching non-contaminated items or surfaces

Removing (doffing) gloves
Touch only the outside of one glove. With one gloved hand, grasp the other glove at the palm and pull the glove off. With the fingertips of your gloved hand, hold the glove you just removed. With your ungloved hand, slip two fingers underneath cuff of the remaining glove at wrist. Do not touch any part of the outside of glove.

Removing (doffing) gloves
3. Pull down, turning this glove inside out and over the first glove as you remove it. 4. You should now be holding one glove from its clean inner side and the other glove should be inside it. 5. Drop both gloves into the proper container without contaminating yourself. 6. Wash your hands.

The proper order for donning PPE is as follows: • Wash hands. Put on gown. Put on mask. Put on goggles or face shield. Put on gloves.

The proper order for doffing PPE is as follows: • Remove and discard gloves. Remove goggles or face shield. Remove and discard gown. Remove and discard mask. Wash hands.

7. List guidelines for handling equipment and linen
Define the following terms: clean in health care, a condition in which objects are not contaminated with pathogens. dirty in health care, a condition in which objects have been contaminated with pathogens. disinfection process that kills pathogens, but not all pathogens; it reduces the pathogen count to a level that is considered not infectious.

Define the following terms: sterilization a method used to decrease the spread of pathogens and disease by destroying all microorganisms, including those that form spores. disposable only to be used once and then discarded.

NAs should follow these guidelines regarding equipment, linen, and clothing: • Prevent skin/mucous membrane contact. • Prevent contamination of clothing. • Prevent transfer of disease to other residents or environments. • Do not use reusable equipment until it has been cleaned properly. • Dispose of all single-use equipment properly.

Guidelines regarding equipment, linen, and clothing (cont’d): • Clean and disinfect all environmental surfaces, beds, bedrails, bedside equipment, and all frequently touched surfaces (such as doorknobs and call lights). Handle, transport, and process soiled linens and clothing in a way that prevents skin and mucous membrane exposure, contamination of clothing (hold linen away from uniform), and transfer of disease to other residents and environments. Bag soiled linen at point of origin. Sort soiled linen away from resident care areas. Place wet linen in leak-proof bags.

8. Explain how to handle spills
NAs should follow these guidelines for cleaning spills involving blood, body fluids, or glass: • Put on gloves (industrial strength). • Use proper product to absorb spill. • Scoop up absorbed spill and dispose of it in designated container. • Apply disinfectant. • Use proper cleaning solution. • Use tools, never hands, to pick up glass. • Properly bag waste.

8. Explain how to handle spills
REMEMBER: It is important the absorb a spill and remove the fluid before treating the area with disinfectant. If the spilled fluid is not absorbed and removed first, it may neutralize the disinfectant on contact.

9. Explain Transmission-Based Precautions
Define the following terms: Transmission-Based Precautions method of infection prevention used when caring for persons who are infected or suspected of being infected with a disease. multidrug-resistant organisms (MDROs) microorganisms, mostly bacteria, that are resistant to one or more antimicrobial agents that are commonly used for treatment.

REMEMBER: Transmission-Based Precautions are always used in addition to Standard Precautions.

Transparency 5-2: Airborne Diseases

Airborne diseases spread when pathogens are transmitted through the air after being expelled. The pathogens can remain floating for some time. The following illnesses are caused by airborne pathogens: Tuberculosis (TB) Measles Chicken pox

The following precautions can help prevent the spread of airborne diseases: Using a face mask Wearing a gown Handwashing Proper ventilation

Transparency 5-3: Droplet Diseases

Droplet diseases spread when pathogens are transmitted through droplets in the air. The droplets normally do not travel more than three feet, but they may travel further. The following illnesses are examples: Mumps Influenza

The following precautions can help prevent the spread of droplet diseases: Using a face mask Covering nose and mouth when sneezing or coughing Handwashing

The CDC recommends the following measures (part of Standard Precautions) to prevent the transmission of respiratory illnesses in healthcare settings: Alerts should be posted instructing patients and visitors to inform staff of respiratory symptoms and to practice respiratory hygiene/cough etiquette, which includes Cover noses/mouths with a tissue when coughing or sneezing Dispose of used tissues in nearest waste container after use Wash hands after contact with respiratory secretions or contaminated objects

CDC measures for respiratory etiquette (cont’d): Healthcare facilities must make these items available to staff, patients, and visitors: Tissues and no-touch receptacles for disposal Conveniently located hand rub dispensers and handwashing supplies During times of increased respiratory infections, masks should be offered to anyone who is coughing and coughing people encouraged to sit at least three feet away from others. Healthcare personnel should observe droplet precautions, in addition to Standard Precautions, when interacting with a patient with symptoms of a respiratory infection.

Transparency 5-4: Contact Diseases

Contact diseases can be spread when an uninfected person comes into contact with the skin, wound, or infection of an infected person. The following illnesses are spread by contact: Conjunctivitis (pink eye) Clostridium difficile Lice Scabies

The following precautions can help prevent the spread of contact diseases: Using PPE Washing hands with antimicrobial soap Not touching infected surfaces without gloves Not touching uninfected surfaces with contaminated gloves Not sharing towels, linens, and clothing Using disposable equipment when possible

When isolation precautions are required, the NA should remember these points: • Transmission-Based Precautions always used in addition to Standard Precautions • Nurses will set up the isolation unit. • Use PPE as instructed. Do not wear PPE outside resident’s room, and perform hand hygiene following removal of PPE.

Guidelines for isolation precautions (cont’d): • Do not share equipment between residents. • Wear proper PPE when serving food and drink. • Follow Standard Precautions in dealing with body waste removal. • Wear proper PPE required to take specimen. • Reassure residents that the disease, not the person, is being isolated.

10. Define bloodborne pathogens and describe two major bloodborne diseases
Define the following terms: bloodborne pathogens microorganisms found in human blood, body fluid, draining wounds, and mucous membranes that can cause infection and disease in humans. human immunodeficiency virus (HIV) the virus that attacks the body’s immune system and gradually disables it; eventually can cause AIDS. hepatitis inflammation of the liver caused by certain viruses and other factors, such as alcohol abuse, some medications, and trauma.

Define the following terms: jaundice a condition in which the skin, whites of the eyes, and mucous membranes appear yellow.

Bloodborne diseases may be transmitted in the following ways: • Infected blood • Infected semen or vaginal secretions contacting mucous membranes • Sexual contact • Needle sharing • Infected mothers • Contact with infected blood or certain other body fluids in healthcare setting

REMEMBER: It is safe to touch and spend time with residents who have bloodborne diseases. Residents with these illnesses need the same thoughtful, personal attention NAs give to all their residents.

11. Explain OSHA’s Bloodborne Pathogens Standard
Define the following terms: Bloodborne Pathogens Standard federal law that requires that healthcare facilities protect employees from bloodborne health hazards. exposure control plan plan designed to eliminate or reduce employee exposure to infectious material.

The Bloodborne Pathogens Standard designates the following as a significant exposure: • Needle stick • Mucous membrane contact • Cut from an object containing potentially infectious body fluid • Contact with non-intact skin

Employers must take the following steps to protect employees from bloodborne pathogens: • Maintain a written exposure control plan • Provide proper PPE • Provide biohazard containers for disposal of sharps and other infected waste • Offer free hepatitis B vaccine to employees • Affix warning labels to waste containers, refrigerators, and freezers that contain potentially infectious material • Keep a log of injuries from contaminated sharps • Provide in-service training on the Bloodborne Pathogens Standard

12. Define tuberculosis and list infection prevention guidelines
Define the following terms: tuberculosis (TB) a highly contagious lung disease caused by a bacterium that is carried on mucous droplets suspended in the air. latent TB infection type of tuberculosis in which the person carries the disease but does not show symptoms and cannot infect others. TB disease type of tuberculosis in which the person shows symptoms of the disease and can spread TB to others.

Define the following terms: multidrug-resistant TB(MDR-TB) type of tuberculosis that can develop when a person with TB disease does not take all the prescribed medication. resistant a state in which drugs no longer work to kill specific bacteria. phlegm thick mucus from the respiratory passage.

NAs should be familiar with these signs and symptoms of TB disease: Fatigue Loss of appetite Weight loss Slight fever and chills Night sweats Prolonged coughing Coughing up blood Chest pain Shortness of breath Trouble breathing

When caring for residents with tuberculosis, NAs should follow these guidelines: • Follow Standard Precautions and Airborne Precautions. • Wear PPE as instructed. • Handle sputum or phlegm carefully. • Ensure proper ventilation. • If resident is in AIIR isolation room, open and close door slowly. • Follow isolation procedures if ordered. • Help resident remember to take medications.

13. Discuss MRSA, VRE, and C. Difficile
Define the following terms: MRSA (methicillin-resistant Staphylococcus aureus) an infection caused by specific bacterial that have become resistant to many antibiotics. Vancomycin-resistant enterococcus (VRE) bacteria (enterococci) that have developed resistance to antibiotics as a result of being exposed to vancomycin. Clostridium difficile (C. diff, C. difficile) bacterial illness that can cause diarrhea and colitis; spread by spores in feces that are difficult to kill.

There are two types of MRSA: • Hospital-associated MRSA (HA-MRSA) • Community-associated MRSA (CA-MRSA)

REMEMBER: MRSA can be spread by direct and indirect contact. Handwashing is the single most important measure to control the spread of MRSA.

REMEMBER: VRE can be spread by direct and indirect contact. Prevention of VRE is very important, and proper handwashing is an important part of prevention.

C. Difficile is spread in the following ways: By spores via direct contact When intestinal flora is altered due to enemas, nasogastric tube, GI tract surgery, or overuse of antibiotics

REMEMBER: Proper handwashing and proper handling of wastes can help prevent C. Difficile. Soap and water must be used each time hand hygiene is performed. Disinfecting surfaces and limiting antibiotic use can also help.

14. List employer and employee responsibilities for infection prevention
The following are an employer’s responsibilities regarding infection prevention: • Establish procedures and exposure control plan. • Provide in-service education. • Have written procedures for exposures. • Provide proper PPE. • Provide HBV vaccination.

14. List employer and employee responsibilities for infection prevention
The following are an employee’s responsibilities regarding infection prevention: • Follow Standard Precautions. • Follow facility’s policies and procedures. • Follow care plans and assignments. • Use PPE. • Take advantage of free hepatitis B vaccine. • Report any exposure immediately. • Participate in education programs.

Exam Multiple Choice. Choose the correct answer.
Infection prevention is (A) The way in which infections occur (B) An infection that is prevented from traveling from one part of the body to another (C) A set of methods used to prevent the spread of disease (D) An object that has been prevented from being contaminated with pathogens The following are necessary links in the chain of infection. When an NA wears gloves, which link is broken, thus preventing the spread of disease? (A) Reservoir (place where the pathogen lives and grows) (B) Mode of transmission (a way for the disease to spread) (C) Susceptible host (person who is likely to get the disease) (D) Causative agent (pathogenic microorganism that causes disease)

Exam The following are necessary links in the chain of infection. When an NA gets a vaccination shot for hepatitis B, which link will be affected and thus prevent hepatitis B infection? (A) Reservoir (place where the pathogen lives and grows) (B) Mode of transmission (a way for the disease to spread) (C) Susceptible host (person who is likely to get the disease) (D) Portal of entry (body opening that allows pathogens to enter) A nursing assistant (NA) will come into contact with microorganisms (A) Only in high-traffic areas of the facility (B) Only during direct contact with residents (C) Only during personal care procedures (D) Every time the NA touches something

Exam The single most important thing the NA can do to prevent the spread of disease is to (A) Carry dirty linen close to her uniform so as not to spread contaminants (B) Wash and dry her disposable gloves before reusing them (C) Remove gloves before cleaning spills (D) Wash her hands The elderly are at a higher risk of infection because (A) They have strong immune systems (B) They are rarely hospitalized (C) They are always well-nourished (D) They may have limited mobility

Exam With whom should an NA use Standard Precautions?
(A) With residents who have infectious diseases (B) With residents he suspects might have infectious diseases (C) With every resident in his care (D) With residents who request that they be used Under Standard Precautions, the term “body fluids” includes (A) Sweat (B) Water (C) Juice (D) Urine

Exam Hand hygiene is (A) Washing hands with either plain or antiseptic soap and water or using alcohol-based hand rubs (B) Washing hands with soap and water only (C) Using alcohol-based hand rubs only (D) Wearing gloves when performing care procedures When washing hands, an NA should use friction for (A) At least 25 seconds (B) At least 20 seconds (C) At least 15 seconds (D) At least 5 seconds

Exam Which of the following is true of wearing gloves?
(A) Disposable gloves can be washed and reused. (B) Gloves should be changed before contact with mucous membranes. (C) After giving care, gloves are not contaminated. (D) Gloves can continue to be worn if they are torn as long as the hole is covered. Which of the following is the proper order to don PPE? (A) Put on mask and goggles, gown, and gloves. (B) Put on gloves, gown, and mask and goggles. (C) Put on mask and goggles, gloves, and gown. (D) Put on gown, mask and goggles, and gloves.

Exam Which of the following statements is true of disinfection?
(A) Disinfecting an item means that all pathogens on the item are destroyed. (B) Disinfection is carried out with an autoclave. (C) Disinfection kills some pathogens but not all of them. (D) Disinfection can be accomplished with regular soap and cold water. If an NA needs to clean up a spill, what is the first step that she should take? (A) Put the waste directly into the nearest trash can. (B) Spray bleach solution on the spill. (C) Put on gloves. (D) Vacuum the spill.

Exam Which of the following is true of Transmission-Based Precautions?
(A) An NA does not need to practice Standard Precautions if he practices Transmission-Based Precautions. (B) They are exactly the same as Standard Precautions. (C) They are practiced in addition to Standard Precautions. (D) They will not be listed in the care plan so as not to alarm anyone. What is one way that bloodborne pathogens can be transmitted? (A) By hugging an infected person (B) By contact with blood or body fluids (C) By standing too close to an infected person when he coughs (D) By touching something an infected person has touched

Exam Which of the following statements is true of hepatitis B (HBV)?
(A) HBV is a relatively minor disease and poses no real threat to healthcare workers. (B) The vaccine for HBV helps prevent the disease. (C) More people in the U.S. have HIV than have HBV. (D) HBV causes some unpleasant symptoms but cannot cause death. The Bloodborne Pathogen Standard requires that (A) Employers educate a select group of employees who will be in contact with residents with bloodborne diseases (B) Employers provide hepatitis B vaccinations to employees at a reduced cost Employers keep one set of personal protective equipment on hand for visitors to use Employers have an exposure control plan

Exam Tuberculosis may be transmitted (A) Through a protective mask
(B) By dancing (C) By wearing gloves (D) By coughing Tuberculosis is (A) A bloodborne disease (B) A sexually transmitted disease (C) An airborne disease (D) Completely eradicated (no longer exists)

Exam A person with TB disease (A) Can spread it to others
(B) Does not show symptoms (C) Cannot infect others (D) Has what is called latent TB How is MRSA most often spread? (A) By direct physical contact (B) By indirect contact (C) By being in enclosed spaces (D) Through the air

Exam What is the best way to control the spread of MRSA?
(A) By taking medication (B) Through proper handwashing (C) By using masks (D) By taking vancomycin What is the best way to control the spread of C. difficile? (A) By limiting contact of the infected person with others (B) By using more powerful antibiotics (C) By giving more enemas to clean out the GI tract (D) Through proper handwashing and handling of contaminated wastes

Exam Which of the following is an NA responsibility related to infection prevention? (A) Deciding which residents need Transmission-Based Precautions (B) Telling all visitors which patients have bloodborne diseases (C) Following Standard Precautions in caring for all residents (D) Capping needles and other sharps before disposing of them in the trash

CHAPTER 5 PRACTICE 1. A person with TB disease
(A) Can spread it to others (B) Does not show symptoms (C) Cannot infect others Has what is called latent TB 2. Which of the following is true of Transmission-Based Precautions? (A) An NA does not need to practice Standard Precautions if he practices Transmission-Based Precautions. (B) They are exactly the same as Standard Precautions. (C) They are practiced in addition to Standard Precautions. (D) They will not be listed in the care plan so as not to alarm anyone. 3. The elderly are at a higher risk of infection because (A) They have strong immune systems (B) They are rarely hospitalized (C) They are always well-nourished (D) They may have limited mobility

CHAPTER 5 PRACTICE ANSWERS
A- CAN SPREAD IT TO OTHERS C- THEY ARE PRACTICED IN ADDITION TO STANDARD PRECAUTIONS D- THEY MAY HAVE LIMITED MOBILITY

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