Unit 6.1: Infection Prevention and Control

• Topic 01

  Standard Precautions and Hand Hygiene

  45 questions
• Topic 02

  Transmission-Based Precautions

  41 questions
• Topic 03

  Aseptic Non-Touch Technique (ANTT)

  45 questions
• Topic 04

  Decontamination and the Spaulding Classification

  45 questions

A few questions from this unit, with the answer and a full explanation. The complete bank is available when you start practising.

1. A nurse is setting up for a large, complex wound dressing change on a patient with a surgically implanted device wound. She is deciding between Standard and Surgical ANTT. Which of the following factors would MOST support using Surgical ANTT for this procedure?

   • A
     The procedure involves a large wound with multiple Key Parts and requires a large sterile field for safe management of the wound and equipment
     Correct answer
   • B
     Surgical ANTT is required because the wound has a surgically implanted device, which is classified as a Critical Device under the Spaulding Classification
   • C
     The patient has a known infection, which automatically requires Surgical ANTT regardless of procedure complexity
   • D
     Surgical ANTT is required only if the nurse has less than one year of clinical experience with wound care
   Explanation

   The choice between Standard and Surgical ANTT is driven by the complexity of the procedure, specifically, how many Key Parts and Key Sites are involved and how large or difficult they are to protect using non-touch technique alone. A large, complex wound involving a surgically implanted device is likely to expose an extensive wound bed (a large Key Site) and require the simultaneous management of multiple pieces of equipment (multiple Key Parts), which is difficult to achieve safely using only a General Aseptic Field and non-touch handling.

   In this situation, Surgical ANTT, using a large sterile field (Critical Aseptic Field), sterile gown, and sterile gloves, allows the practitioner to manage the wound and equipment directly and safely. The decision is based on the practical demands of the procedure itself, not on the patient's infection status, immune status, or the nurse's level of experience, none of which independently determine the ANTT type required.

2. Before performing a wound dressing change, which WHO Moment for Hand Hygiene applies?

   • A
     Moment 2 — before an aseptic task
     Correct answer
   • B
     Moment 5 — after contact with patient surroundings
   • C
     Moment 1 — before patient contact
   • D
     No specific Moment applies to wound care
   Explanation

   WHO Moment 2 is 'before an aseptic task.' A wound dressing change is an aseptic procedure because it involves direct contact with a wound (a Key Site) that provides a pathway for microorganisms to enter the body. Hand hygiene immediately before an aseptic task protects the patient from organisms transferred from the healthcare worker's hands. Moment 1 (before patient contact) may have occurred earlier when the nurse first approached the patient, but the specific moment preceding the aseptic component is Moment 2.

3. A nurse removes gloves after emptying a urinary catheter bag. Which WHO Moment applies immediately after glove removal?

   • A
     Moment 3 — after body fluid exposure risk
     Correct answer
   • B
     No Moment applies after removing gloves for this task
   • C
     Moment 4 — after patient contact
   • D
     Moment 1 — before patient contact
   Explanation

   Emptying a urinary catheter bag involves contact with urine — a body fluid. Moment 3 (after body fluid exposure risk) applies immediately after this procedure, even though gloves were worn. Gloves do not replace hand hygiene because they may have micro-perforations and because the glove removal process itself can transfer contamination to the hands. Hand hygiene must be performed immediately after glove removal following any procedure with body fluid exposure risk, regardless of whether the fluid was visibly present on the gloves.