1. What is the act of cleaning one’s hands with the use of any liquid with or without soap for the purpose of removing dirt or microorganisms?
- Aseptic Technique
- Handwashing
- Medical Asepsis
- Surgical Asepsis
2. What is known as clean technique which includes procedures used to reduce the number of organisms on hands?
- Aseptic Technique
- Handwashing
- Medical Asepsis
- Surgical Asepsis
3. What is known as sterile technique, prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery?
- Aseptic Technique
- Handwashing
- Medical Asepsis
- Surgical Asepsis
4. What are we trying to reduce or eliminate when we are doing handwashing?
- Viruses
- Bacteria
- Fungi
- All of the above
5. The clinical instructor asks her students the rationale for handwashing. The students are correct if they answered that handwashing is expected to remove:
- transient flora from the skin.
- resident flora from the skin.
- all microorganisms from the skin.
- media for bacterial growth.
6. Which one of the following is a risk factor for poor handwashing?
- Female gender
- Not wearing gowns/gloves
- Being a nurse (rather than a physician)
- Being a physician (rather than a nurse)
- Working on a medicine ward (rather than intensive care)
7. Improved hand hygiene in recent hospital studies was associated with which of the following?
- A reduction of catheter-related infections from 7.7 per 1000 catheter-days to 1.3 per 1000 catheter-days in 103 ICUs.
- A significant hospital-wide reduction (57%) in MRSA bacteraemia.
- A significant reduction (100%) of superficial surgical site infections (SSI) in neurosurgery; significantly lower SSI incidence in intervention ward compared with control ward.
- A significant reduction in health care-associated infections (HCAI) in adult ICUs (from 47.5/1000 patient-days to 27.9/1000 patient-days). 5
- All are correct.
8. Which of the following is a recommendation of the World Health Organization (WHO)? Perform hand hygiene:
- Before and after having direct contact with patients
- With alcohol-based hand rub if hands are not visibly soiled
- After removing gloves
- Before handling an invasive device (regardless of whether or not gloves are used)
- All are WHO recommendations
9. You do not need to worry about washing your hands if you wear gloves when you provide care for your client
- True
- False
10. You should wash your hands before & after you wear your gloves
- True
- False
Answers and Rationale
1. Answer: B. Handwashing is the act of cleaning one’s hands with the use of any liquid with or without soap for the purpose of removing dirt or microorganisms. It is the most effective measure in reducing the risk of transmitting infectious diseases.
2. Answer: C. Medical asepsis or clean technique includes procedures used to reduce the number of organisms on hands.
3. Answer: D. Sterile Technique prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery.
4. Answer: D. In handwashing, we are trying to reduce or eliminate microorganisms and these include viruses, bacteria, and fungi.
5. Answer: A. There are two types of normal flora: transient and resident. Transient flora are normal flora that a person picks up by coming in contact with objects or another person (e.g., when you touch a soiled dressing). You can remove these with hand washing. Resident flora live deep in skin layers where they live and multiply harmlessly. They are permanent inhabitants of the skin and cannot usually be removed with routine hand washing. Removing all microorganisms from the skin (sterilization) is not possible without damaging the skin tissues. To live and thrive in humans, microbes must be able to use the body’s precise balance of food, moisture, nutrients, electrolytes, pH, temperature, and light. Food, water, and soil that provide these conditions may serve as nonliving reservoirs. Hand washing does little to make the skin uninhabitable for microorganisms, except perhaps briefly when an antiseptic agent is used for cleansing.
6. Answer D. Being a physician, as compared to being a nurse, has been shown to indicate increased risk for poor hand hygiene practices.
7. Answer E.
- Hand hygiene is the primary measure proven to be effective in preventing health care-associated infections and the spread of antimicrobial resistance in hospitals and ICUs.
- Pronovost PJ, et al. Sustaining reductions in catheter related blood stream infections in Michigan intensive care units: Observational study. BMJ 2010, 0340:c309.
- Johnson PD et al. Efficacy of an alcohol/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection. Medical Journal of Australia, 2005, 183:509-514.
- Le TA et al. Reduction in surgical site infections in neurosurgical patients associated with a bedside hand hygiene program in Vietnam. Infection Control and Hospital Epidemiology, 2007, 8:583-588.
- Rosenthal VD, Guzman S, Safdar N. Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. American Journal of Infection Control, 2005, 33:392-397.
8. Answer E. All of these are recommendations regarding hand hygiene from the WHO.
9. B. False.
10. A. True.