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ARE YOU WELL INFORMED about current infection control guidelines? Does your facility adhere to accepted infection control standards? To help us gather information on infection control practices nationwide, please take a moment to answer this survey, which also appeared in the August issue of Nursing2006. We'll compile the results and publish an analysis in an upcoming issue.
You can take this survey online at http://www.nursing2006.com; it's fast, easy, and free. Or photocopy and fax these pages to 215-367-2155 or mail to Nursing2006 Infection Control Survey, 323 Norristown Rd., Suite 200, Ambler, PA 19002. Deadline for responses is September 30, 2006.
All questions pertain to your primary work setting. Share this survey with your colleagues and encourage them to participate too.
1. Peripheral intravenous (I.V.) catheters should be replaced
[white square] every 48 hours or as needed.
[white square] every 72 hours or as needed.
[white square] once a week or as needed.
2. According to guidelines from the Occupational Safety and Health Administration (OSHA) and other experts, the best sharp safety device is one that
[white square] works when the user takes action (such as by pushing a button).
[white square] automatically activates the safety feature (passive device).
3. Activating a safety device inside a patient causes additional pain.
[white square] true
[white square] false
4. Do you routinely cleanse the I.V. access injection port prior to access?
[white square] yes
[white square] no
5. Have you had an injury involving a sharp contaminated with a patient's blood?
[white square] yes, one
[white square] yes, more than one
[white square] no, but I don't handle sharps in my job
6. According to research, the device most likely to be the cause of a reported sharp injury is a(n)
[white square] lancet.
[white square] winged (butterfly) needle.
[white square] disposable needle/syringe.
[white square] I.V. needle/catheter device.
7. When central lines are being inserted, what percentage of the time does staff use maximal barrier precautions (sterile gloves and gowns, caps, and masks)?
[white square] less than 25% of the time
[white square] 25% to 50% of the time
[white square] 51% to 75% of the time
[white square] 76% to 100% of the time
8. The use of a large sterile sheet is required for insertion of central venous catheters (CVCs).
9. What's the best skin preparation to use before insertion of CVCs, including peripherally inserted central catheters (PICCs), in adults with no allergies?
[white square] povidone-iodine (Betadine)
[white square] povidone-iodine and alcohol
[white square] chlorhexidine gluconate
[white square] alcohol alone
[white square] alcohol and zinc pyrithione (Triseptin)
10. Antimicrobial ointments have been shown to reduce CVC infection rates.
11. The preferred insertion site for a triple-lumen CVC in a nonemergency situation is
[white square] jugular.
[white square] femoral.
[white square] subclavian.
[white square] no preference.
12. To prevent infections, PICCs should be replaced
[white square] every 72 to 96 hours.
[white square] every 30 days.
[white square] every 3 months.
[white square] PICCs shouldn't be routinely replaced to prevent infections.
13. Transparent dressings on CVCs that are dry, intact, and clean should be changed
[white square] every 2 days.
[white square] every 5 days.
[white square] every 7 days.
[white square] only when the catheter is changed.
14. Tubing used for blood administration should be changed
[white square] every 4 hours.
[white square] every 24 hours.
[white square] no more frequently than every 72 hours.
[white square] at least every 72 hours.
15. Does your acute care facility have an I.V. team?
[white square] I don't work at an acute care facility.
16. Does your facility use a standard group of strategies or interventions to prevent central line infections (central line bundle)?
[white square] don't know
17. Does your facility use a ventilator bundle to prevent ventilator-associated pneumonia (VAP)?
18. Most cases of VAP are caused by
[white square] secretions above the endotracheal cuff carrying bacteria into the lungs.
[white square] bacteria that normally reside in the lungs.
[white square] bacteria carried into the lungs through the tracheal tube.
19. Which statement is correct about oral care?
[white square] It hasn't been shown to reduce VAP rates because it disturbs mouth flora, making migration into the lungs more likely.
[white square] It's been strongly shown to reduce VAP rates.
[white square] It's been recommended by the Centers for Disease Control and Prevention (CDC), but with the lowest positive rating for the science behind it.
[white square] Continued on page 64
20. To help prevent VAP, how high should you maintain the head of the bed (unless contraindicated)?
[white square] 10 to 25 degrees
[white square] 30 to 45 degrees
[white square] 55 to 65 degrees
[white square] 70 to 90 degrees
21. Which statement is correct about patients in contact precautions?
[white square] They have greater rates of depression.
[white square] They experience higher rates of medication errors.
[white square] They have fewer daily visits by their attending physicians.
[white square] All of the above
22. Always practicing standard precautions reduces infection rates.
23. Having patients cover their mouths and noses when coughing has been shown to reduce respiratory disease transmission.
24. To maintain negative pressure in a designated negative-pressure room for airborne precautions, the door must remain open.
25. Preoperative prophylactic antibiotics (except vancomycin) should be given within 1 hour of the first incision.
26. A prophylactic antibiotic should be discontinued within 24 hours after the end of surgery.
27. Perform hair removal if necessary
[white square] with clippers right before surgery.
[white square] with a razor right before surgery.
[white square] never.
28. To prevent surgical site infections, follow a standardized treatment protocol to maintain blood glucose levels at
[white square] <80 mg/dL.
[white square] <200 mg/dL.
[white square] <300 mg/dL.
29. Using a standardized temperature monitoring method intraoperatively decreases the potential for surgical site infections.
30. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) can cite a hospital if an operating room nurse wears artificial fingernails.
31. When a health care worker's hands are visibly soiled, she should wash them with soap and water instead of an alcohol-based hand rub.
32. For hand washing, which does the CDC recommend putting on your hands first?
[white square] water
[white square] soap
33. You should wash your hands with
[white square] cold water because cold inhibits bacterial growth and closes pores.
[white square] warm water because warmth enhances lather and opens pores.
34. For routine hand washing after toileting or before a meal, antimicrobial soap has been shown to be superior to regular (nonantimicrobial) soap.
35. Does your facility allow you to use alcohol-based hand rubs when caring for a patient withClostridium difficile(an anaerobic spore-forming bacterium)?
36. Use of alcohol-based hand rubs may encourage development of drug-resistant bacteria.
37. Multidrug-resistant organisms are growing more resistant to antimicrobial soap.
38. How would you appraise the rate of hand hygiene (washing hands or using alcohol-based hand rubs before and after patient care) among your colleagues (nurses, physicians, respiratory therapists)?
39. How would you appraise your own rate of hand hygiene, as described above?
40. Does your facility use bars of soap?
41. Should hospital-approved lotions be available in a health care facility for staff to use as part of a hand hygiene program?
[white square] No; lotions tend to get contaminated and have been linked to disease outbreaks.
[white square] Yes; lotions play an important role in hand hygiene because they enhance skin integrity.
42. Use of a non-hospital-approved hand lotion can result in an exposure to a bloodborne pathogen.
43. If your patients aren't getting infections while under your care, you're probably doing a good job of preventing infections.
What's your age?
[white square] under 21
[white square] 21-30
[white square] 31-40
[white square] 41-50
[white square] 51-65
[white square] over 65
45. How many years of nursing experience do you have?
[white square] less than 1
[white square] 1-5
[white square] 6-10
[white square] 11-15
[white square] 16-20
[white square] over 20
46. What's yourhighesteducational level?
[white square] student
[white square] AD
[white square] LPN/LVN
[white square] BS/BSN
[white square] RN diploma
[white square] MS/MSN
[white square] PhD or other doctoral degree
[white square] other (please specify)______
47. Are you certified in a specialty?
48. What's your primary clinical area?
[white square] medical/surgical
[white square] pediatrics
[white square] emergency
[white square] rehabilitation
[white square] geriatrics
[white square] infection control
[white square] OR/perioperative
[white square] intensive care/critical care
49. In what setting do you usually work?
[white square] hospital
[white square] home health care/community health
[white square] long-term care/subacute care
[white square] ambulatory/outpatient services/clinic
[white square] office nursing
50. In what state or province do you work?_________
51. If you have any comments or observations about infection control issues, please add them on a separate sheet.
Kim M. Delahanty is director of the infection control/epidemiology unit at the University of California, San Diego. Frank Edward Myers III is manager of clinical epidemiology and safety systems at Scripps Mercy Hospital in San Diego.
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