LTC Infection Prevention & Control
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| What is the GAO? | Government Accountability Office is the US government's audit institution & is part of the legislative branch.
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| What purpose does the Government Accountability Office (GAO) serve? | Supports Congress in meeting constitutional responsibilities & help improve performance & ensure accountability of the federal government. Provides Congress with timely information that is objective, fact-based, nonpartisan, nonideological & balanced.
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| What does the GAO do? | They conduct objective, nonpartisan, fact-based research on behalf of the U.S. Congress. They help prevent & reduce waste, fraud, & abuse of taxpayer dollars. They are the oversite for CMS.
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| Why is this information important? | The GAO found that between 2013-2017 48% of facilities received more than 1 infection control deficiency. Citations can be issued for different issues, none of which could be indicative of a repeat/persistent program issue.
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| But, why is this important for me as a surveyor? | 1 )Because approximately 99% of infection control deficiencies were cited at a S/S of less than actual harm.
2) 67% of deficiencies did not have any enforcement imposed or implemented.
3) 31% had actions imposed but NOT implemented.
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| What does this all mean? | It means the GAO will review CMS guidance & oversight of infection prevention & control. Expect increased scrutiny of infection prevention & control practices of providers. The focus on infection control is not going away even after COVID.
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| There are 2 types contact transmission, what are they? Give examples please... | There are 2 types:
1) Direct contact- involves direct body surface-to-body surface contact & physical transfer of microorganisms.
2) Indirect contact- involves transmission of microorganisms through a contaminated intermediate object.
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| What is droplet transmission? Give examples please... | Droplets generated by an infected source and transmitted through the air via coughing, talking, sneezing. Droplets do not remain suspended in air therefore special ventilation is not required.
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| What is airborne transmission? Give examples please... | Occurs by airborne droplet nuclei containing microorganisms that remain suspended in air for long periods of time. Droplets can be widely dispersed by air currents & inhaled by someone depending on environmental factors. Special Ventilation is required.
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| What is the single most important way to prevent the spread of infections? | Hand hygiene.
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| How is Hepatitis A transmitted? | Ingestion of contaminated food
Handling of contaminated feces
Sexual activity with infected partner
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| What type of precaution(s) would you take for Hep A? | Standard precautions/ Universal precautions
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| What is included in Standard Precautions? | Hand hygiene
Use of Personal Protective Equipment (PPE)
Respiratory hygiene/ cough etiquette
Sharps safety
Safe injection practice
Sterile instruments & devices
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| How is Hepatitis B transmitted? | Needles
Mucous membrane
Exposure to contaminated blood or blood products
Tattoos, body piercing
Sexual activity with infected partner
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| What type of precaution(s) would you take for Hep B? | Standard precautions/ Universal precautions
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| How is Hepatitis C transmitted? | Needles
Transfusion prior to 1990
Mucous membrane
Exposure to contaminated blood or blood products
Sexual activity with infected partner
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| What type of precaution(s) would you take for Hep C? | Standard precautions/ Universal precautions
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| How long should a health care worker wash their hands with soap & water? When using alcohol rub? | Soap & water: 20 seconds
Alcohol rub: until they feel dry around 20 seconds
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| When a resident suspected of having TB is transported what kind of mask must they wear? | Surgical mask
*Remember an N95 protects YOU from the world, a surgical masks protects the WORLD from you.
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| What does HICPAC stand for? | Healthcare Infection Control Practices Advisory Committee (HICPAC)
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| What purpose do they serve? | They are a committee appointed to provide advice & guidance to DHHS & CDC regarding practice of infection control & strategies for surveillance, prevention & control of healthcare-associated infections, antimicrobial resistance in US healthcare settings.
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| How do infections occur? | When germs enter the body, increase in number, & cause a reaction of the body.
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| What 3 things are necessary to an infection to occur? | 1. A source- An infectious agent or germ
2. A susceptible person- someone not vaccinated, otherwise immune or with a weakened immune system.
3. Transmission- the way germs are moved to the susceptible person.
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| There are two tiers of HICPAC/CDC precautions to prevent transmission of infectious agents, what are they? | Standard Precautions and Transmission-Based Precautions
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| What is so important about Standard Precautions, why do we use them for everything? | Intended to be applied to care of all patients in healthcare settings, regardless of suspected or confirmed presence of an infectious agent. Constitutes the primary strategy for prevention of transmission of infectious agents among patients & personnel.
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| What is Transmission-Based Precautions? | For patients who are known/suspected to be infected or colonized with infectious agents, including certain epidemiologically important pathogens, which require additional control measures to effectively prevent transmission.
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| What is the most common yet preventable healthcare-associated infection? | Catheter-Associated Urinary tract Infections (CAUTI)
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| What are some of the appropriate ways to use a urinary catheter according to the CDC? | Insert catheters only for appropriate indications:
Acute urinary retention/obstruction
Need for accurate measurement in critically ill patients Perioperatively for select procedure
Healing of open sacral or perineal wounds
End of life care
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| For more information on Catheter use: | cdc.gov/infectioncontrol/guidelines/cauti/recommendations
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| For more information on Standard Precaution & Transmission-Based Precautions: | cdc.gov/infectioncontrol/basics/index
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Created by:
Debra Bernier 1
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