INSTRUCTIONS Nursing2009 I.V. infection control survey report
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Nursing2009 I.V. infection control survey report
GENERAL PURPOSE To provide nurses with an update of evidence-based infection control practices. LEARNING OBJECTIVES After reading the preceding article and taking this test, you should be able to: 1. Describe trends in infection control over the last 3 years. 2. Discuss survey results. 3. Identify best practices to prevent infections associated with I.V. therapy.
1. Over the past 5 years, MRSA central line-associated bloodstream infections have
a. remained unchanged in acute care hospitals.
b. increased steadily in home care settings.
c. been declining in ICUs.
d. increased in acute care hospitals.
2. The driving force behind healthcare infection prevention is
a. more infection control education for staff nurses.
b. instruction in infection control in prelicensure education.
c. more infection control preventionists.
d. zero tolerance for breaches in infection prevention processes.
3. Compared with a previous survey, the results of this survey showed
a. the same percentage of correct answers.
b. a marked improvement in correct responses.
c. an insignificant decrease in correct responses.
d. comparisons weren't possible because of different demographics.
4. "Hardwiring" infection control best practice means
a. ensuring staff has only the appropriate supplies available.
b. repeating staff education frequently.
c. educating nurses in infection control techniques before licensure.
d. requiring infection preventionists to teach infection control protocols.
5. Replace peripheral-short I.V. catheters in adults as needed or every
a. 24 hours.
b. 36 hours.
c. 48 hours.
d. 72 hours.
6. The INS standard for changing peripheral-short I.V. catheters
a. may seem counter-intuitive based on current trends.
b. follows a trend to shorten the duration between changes.
c. may increase the risk of infection.
d. endorses the validity of frequent catheter changes.
7. The change in frequency for replacing peripheral-short I.V. catheters is possible due to
a. the existence of vascular access teams.
b. the availability of vein-friendly I.V. devices.
c. the increased risk of errors during insertion.
d. evidence that frequent routine changes most effectively control infections.
8. According to OSHA, the best sharps safety devices
a. require the user to take action to activate the safety feature.
b. require action to reinforce safety awareness.
c. should be labeled "Sharps" in bright red.
d. automatically activate safety features.
9. Which statement is correct regarding nurses' knowledge about sharp safety devices?
a. Nurses under age 30 showed a significant decline in knowledge in 2009 compared with 2007.
b. Overall, respondents showed an increase in knowledge in 2009.
c. The number of correct answers was the same in the 2007 and 2009 surveys.
d. Nurses over age 30 showed a significant increase in knowledge in 2009.
10. Before it's accessed, the I.V. access port/needleless connector should be
a. replaced with a sterile connector.
b. cleaned with an approved antiseptic solution.
c. quickly swiped with CHG.
d. scrubbed with an antibiotic solution.
11. What percentage of survey respondents had more than one contaminated sharps injury in the previous year?
a. less than 1%
12. In this survey, the frequency of educational sessions
a. correlated positively with sharps injury rates.
b. correlated negatively with sharps injury rates.
c. improved sharps injury rates among RNs with AD degrees.
d. had no impact on sharps injury rates.
13. According to the CDC, which device causes the most sharps injuries?
a. winged butterfly needle
c. disposable needle/syringe
d. suture needle
14. The type of sharp likely to injure a nurse is related to
a. the frequency of instruction about that device.
b. the type of sharps the nurse uses frequently.
c. the device's complexity.
d. the nurse's years of experience.
15. Regarding CVC insertion, what percentage of respondents reported use of maximal barrier precautions at least 76% of the time?
16. The best skin prep to use before CVC insertion is
b. povidone-iodine and alcohol.
c. alcohol alone.
d. CHG and alcohol.
17. Care bundles are
a. education packets for nursing students.
b. groupings of best practices to be applied together.
c. practices not yet supported by research that may improve outcomes.
d. best-practice guidelines developed by the CDC.
18. Which is not a component of the CVC care bundle?
a. use of the subclavian vein for nontunneled CVCs
b. meticulous hand hygiene
c. use of maximum barrier precautions
d. reevaluation of the need for the CVC every 48 hours
19. Antimicrobial ointment applied at a peripheral I.V. or nondialysis CVC insertion site
a. reduces cross-contamination.
b. reduces infection rates.
c. prevents antimicrobial resistance.
d. may promote fungal infections.
20. Which statement about the use of antimicrobial ointment is correct?
a. Nurses' knowledge has significantly increased since the previous survey.
b. Dialysis nurses showed the greatest gain in knowledge.
c. Scores of master's-prepared nurses declined from the previous survey.
d. Correct responses correlated positively with frequency of staff education.
21. How often should PICCs be replaced to prevent infection?
a. every 2 weeks
b. every 30 days
c. every 3 months
d. PICCs shouldn't be routinely replaced.
22. Which statement is correct regarding nurses' knowledge about the frequency of PICC replacement, compared with the previous survey?
a. Overall, nurses scored significantly better in 2009.
b. Critical care and medical-surgical nurses scored significantly lower.
c. Infection control nurses scored significantly better.
d. Education didn't correlate with correct answers in either survey.
23. Clean, dry, intact, transparent dressings on CVCs should be changed every
a. 3 days.
b. 5 days.
c. 7 days.
d. only when the catheter is changed.
24. Vascular access teams
a. improve patient outcomes significantly.
b. don't significantly affect the rate of bloodstream infections.
c. aren't recommended by the CDC.
d. improve infection control only in the ICU.
25. Which statement about vascular access teams is correct?
a. Less than 30% of respondents reported their facility has one.
b. These teams have become a priority for over 60% of acute care hospitals.
c. The percentage of teams reported hasn't changed significantly from 2007 to 2009.
d. Respondents working in facilities that have these teams were likely to receive more staff education.
26. Most respondents said a needleless connector should be cleaned by
a. wiping an alcohol pad once across the top.
b. wrapping an alcohol pad around the device and moving it in a circular motion multiple times.
c. wiping an alcohol pad across the top for 15 seconds.
d. using an alcohol pad to wipe back and forth across the top multiple times.
27. What's the best way to clean a needleless connector?
a. Determining the best way requires more study.
b. Wipe the top once with an alcohol pad.
c. Wipe the top with a povidone-alcohol pad for 15 seconds.
d. Wrap the top with an alcohol pad to avoid creating mechanical friction.
28. According to a research study cited, which factor is most important for cleaning a needleless connector?
a. cleaning the top for at least 10 seconds
b. allowing the device to dry before access
c. creating mechanical friction
d. using a circular motion without rubbing
29. As central line insertion infections have dropped,
a. errors made during insertion have increased.
b. errors made during infusion have become more significant.
c. infection rates outside the ICU have increased.
d. hospitals have begun disbanding vascular access teams.
30. Change infusion sets used for intermittent medication administration
a. after each dose.
b. every 24 hours.
c. every 72 hours.
d. every 96 hours.
31. Change infusion sets used for continuous infusions no more frequently than every
a. 24 hours.
b. 36 hours.
c. 48 hours.
d. 72 hours.
32. When should you change an infusion set used for blood administration?
a. after the second infusion
b. after every unit or after 4 hours, whichever comes first.
c. within 8 hours.
d. within 12 hours.
33. Change infusion sets used for fat emulsions every
a. 8 hours.
b. 12 hours.
c. 24 hours.
d. 36 hours.
34. Change infusion sets used for parenteral infusions without fat emulsion
a. after 72 hours.
b. every 12 hours if the glucose content is high.
c. only if it becomes contaminated.
d. at the end of the infusion, or after 8 hours, whichever comes first.
35. After disconnecting an intermittent administration set, you should
a. attach the male luer end to an injection port on the same tubing.
b. place a new capped needle on the male luer end.
c. recap the male luer end with the same dead-end cap.
d. place a new dead-end cap on the male luer end.
36. Best practice is to obtain 0.9% sodium chloride solution for I.V. catheter flushing from a
a. bag of 0.9% sodium chloride solution dedicated to flushes.
b. multidose vial.
c. prefilled syringe.
d. new bag of 0.9% sodium chloride solution.
37. What percentage of nurses working in acute care facilities reported never receiving staff education on infusion therapy?
38. This survey reports that
a. about 60% of respondents were very confident of their answers.
b. 28% of respondents were only somewhat confident of their answers.
c. younger nurses answered more questions correctly than older nurses.
d. nurses with bachelor's degrees did significantly better than those with master's degrees.