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1. Demonstrate the 7 steps of hand washing in correct sequence?

1) Palm to palm
2) In-between fingers
3) Back of hands
4) Base of thumb
5) Back of fingers
6) Finger nails
7) Wrists
2. What are the 5 moments of Hand hygiene?
1. Before touching a patient
2. Before clean / aseptic procedure
3. After body fluid exposure risk
4. After touching a patient
5. After touching patient surrounding.
3. What are the different HAI’S / Quality indicators?
I. HAI (Hospital Acquired Infections)
1. UTI (Urinary Tract Infection)
2. BSI (Blood Stream Infection)
3. VAE (Ventilator Associated Event) (VAP)
4. SSI (Surgical Site Infection)

II. Total 58 quality indicators are used in the hospital, which is distributed in
Ward, Dialysis, ICU, OT, Laboratory, Radiology, IT, Pharmacy etc...
Staff should be aware about their departmental quality indicators.

4. What is the immediate management of NSI/BBFE and to whom do you report


such injuries?
Note: All NSI/BBFE should be reported to HIC department (Ext No: 1990)
Report to nursing office (Ext No: 1408) or causality medical officer for further management after 5pm
to 9 am / holidays.

Needle Stick Injury (NSI) management Blood & Body fluid Exposure(BBFE)
management
Do not squeeze. Wash affected area with soap and water.

Hold under running water until blood stop. For eyes – Irrigation with normal saline/water.

For mouth– Spit out fluid immediately.


Hand wash with liquid soap and water. - Rinse the mouth thoroughly using water.

Check the source patient serology (for e.g. HIV, Hepatitis B).
Report incident to In-charge and HIC department for further management.

5. Demonstrate – how you will clean Blood & Body fluid spill?
Step 1: Put caution board, if spillage is large.
Step 2: Get blood spill kit to the spot.
Step 3: Put paper on the spill
Step 4: Prepare isochlor 2% solution – (2gm/1lit)
Step 5: Wear all PPE 1) first wear shoe cover
2) Use Sterillium
3) Then wear all remaining PPE
Step 6: Pour isochlor solution on the paper, pour slightly in excess.
Step 7: Then wait for 5 minutes
Step 8: Discard the paper as infected waste
Step 9: Wipe the area again with isochlor & paper till all visible blood is removed,
repeat as many times as necessary.
Step 10: Hand wash with wearing the gloves with soap and water and then
immerse the gloves in isochlor solution for 5 minutes in the blood spill
box.
Step 11: Rinse the gloves under running water and keep for dry.
Step 12: Remove all PPE and discard in yellow bag.
Step 13: Wash the hands with liquid soap and water.
Note: In case of large spill (more than 10ml), wear all PPE and wipe the spill with plain paper
to remove as much fluid as possible. Then follow the above procedure.
6. Demonstrate – how you will handle accidental mercury spill?
1) Put caution board
2) Get mercury spillage kit to the spot
3) Wear all PPE
4) With the help of card boards collect all visible mercury at one place aspirate
with the syringe and put it into the container.
5) Place the torch on the floor and rotate it at 360° angle and collect the visible
mercury with the help of sticking plaster and discard it in yellow plastic
bag.
6) All waste generated during the mercury spillage should be discarded in yellow
bag and label it as mercury spillage waste & sent it to bio- medical
department.
7) Hand wash with wearing the gloves with soap & water and keep for dry.
8) Wipe apron and goggles with soap & water keep for dry. Remaining
PPE discard in yellow bag
9) Wash hands with liquid soap & water.
7. What are the different colors of Bio –medical waste segregation?
Yellow :– Infectious dressing waste, human anatomical waste, plaster casts.
Red :– Infectious & Non- infectious plastic waste
White: - General waste
Glass waste
Transparent container – Sharps.
8. How you will prepare the site – before giving injection or inserting IV line?
- Use 70% alcohol (spirit) for cleaning the site from centre to periphery and wait
for 30 seconds.
9. what are the 6 components of NABH safe I Program
1) Access assessment and continuity of care
2) Care of patients
3) Management of medications
4) Patient rights & education
5) Hospital infection control
6) Continuous Quality improvement

10. Tell me the “wound care” guidelines?


1 Surgical Wound Types:
1) Clean wound – No signs of infection / inflammation e.g.; skin, eye, vascular system
(Hernia, lymphoma, ganglion).
2) Clean contaminated wound: e.g. surgical wounds, post – op infected cases, abscess.
3) Contaminated wound: e.g. gunshot injury.
4) Dirty contaminated: where there is exposure to feacal mass, open fistulas, RTA cases.

2 Management:
1. Clean wound: clean with Betadine 10%.
2. Wound surroundings to be cleaned with spirit and keep dry.
3. Further management – surgical intervention
4. Minor and Major.
3 Contaminated Wound:
1. Wound surface 1st to be cleaned with Betadine 10%.
2. Internal wound cleaned by H₂O₂ / Saline.
3. Removal of slough (Debridement, +dressing vac +Hydrogen)
4. Send pus for culture & sensitivity .
5. Antibiotics according to culture & sensitivity report.
4 Dirty Contaminated Wound:
1. Proper irrigation with saline.
2. Betadine 10%/H₂0₂ / saline cleaning.
3. Inj. TT/TT Immunoglobulin.
4. Adequate hydration –I.V. fluids/ PCV transfusion.
5. Antibiotics.
6. Prepare patient for wound debridement ± # Stabilization, ± dressing.
11. What are the different isolation precaution/ Nursing barriers?

Contact Droplet Airborne


Gloves Mask Respirator
Gown Gown Gown

1. Hand washing & gloving.


2. Personal Protective equipments.
3. Patient care equipment & articles cleaning and disinfection.
4. Linen & laundry management.
5. Routine & terminal cleaning.
6. Patient placement.
7. Transport of infected patients.
12. Tell me the care bundle practices for preventing UTI, Phlebitis and SSI?
UTI
Insertion bundle
1) Hand hygiene. 4) Aseptic technique while connecting

2) Aseptic technique. catheter to urine bag.


3) Use of antiseptic. 5) Use sterile lubricant.
Maintenance bundle
1) Hand hygiene
2) Daily meatal care
3) Secure catheter
4) Bag below the level of bladder
5) Bag does not touch floor
6) Check for obstruction

13. Enumerate care bundle Practices for preventing VAP and CLABSI?
VAP
1)
Hand hygiene 2) Head end elevation
3) Oral care 4) Inj. PPI (Proton pump inhibitor)
5) DVT prophylaxis 6) ETT cuff pressure
7) Change filter 8) Suctioning done
CLABSI

Insertion bundle Maintenance bundle


1) Hand hygiene 1) Hand hygiene
2) Sterile Precautions (PPE) 2) Scrub the hub
3) Aseptic technique 3) Dressing
4) Perform skin antisepsis 4) Flushing done
5) Change of IV set

14.Explain – how the linen should be segregated? (Categories/ labeling /transporting)


2 Categories
1) Soiled
2) Unsoiled.
Soiled Linen: - The linen which is contaminated with blood and body fluids.
Soiled linens are segregated in yellow plastic bag, tie the bag & labeled as
soiled linen, date &name of ward /ICU
Unsoiled linen: - The linen which is not contaminated with blood and body fluids.
Unsoiled linens are segregated in the hamper bags.
1. Demonstrate the 7 steps of hand washing in correct sequence
2. What are the 5 Moments of Hand hygiene
3. What are the different HAIs/ Quality Indicators
4. What is the immediate management of NSI & TO whom do you report such
injuries
5. Demonstrate – how you will clean Blood & Body fluid spill
6. Demonstrate – How you will handle accidental mercury spill
7. What are the different colors of Bio medical waste segregation
8. How you will prepare the site – before giving injection or inserting iv line
9. What are the 6 components of NABH Safe I Program
10.How – you will dispose the BBF from Suction jars/ urine bags/ blood
Tubes& Plates (lab)
11.Tell me the “WOUND CARE” Guidelines
12.What are the different isolation precautions/ Nursing barriers
13.Tell me the “Care Bundle practices” for preventing UTI, Phlebitis, SSI (All staff)
14.Enumerate Care Bundle practices for preventing VAP, CLABSI,
SEPSIS (ICU Staff)
15.Explain – how the linen should be segregated (3 categories/Labeling/ transporting)
16.How the liquid waste should be disinfected at source, like Suction jars etc
17.Has your department prepared antibiotic policy/standard treatment guidelines
18.Are all staff oriented on antibiotic policy and are 05% IPD/OPD prescriptions
audited by your internal designated department staff
19.Enumerate the infusion management guidelines
20.Explain the order of draw for blood collection
21.Explain – 1) HAPU guidelinesoi
2) Sepsis management guidelines
3) Tracheostomy and sterile suctioning guidelines.
4) Enteral feeding guidelines

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