HCA - Health Care Assistant Infection Prevention and Control Questions and Answers 2 — Questions and Answers
Question 1: What is the correct donning (putting on) order for personal protective equipment (PPE) when entering a contact precautions room?
- Gown first, then mask/eye protection, then gloves (Correct answer)
- Gloves first, then gown, then mask
- Mask first, then gloves, then gown
- Gown and gloves simultaneously, then mask
Correct answer: Gown first, then mask/eye protection, then gloves
The gown is donned first to protect clothing, then face protection, then gloves last so they cover the gown cuffs.
The correct PPE donning sequence (per BC IPAC and Ontario Public Health) is: 1) perform hand hygiene, 2) put on gown (tie at back), 3) put on mask or respirator and eye protection, 4) put on gloves (pulling cuffs over gown cuffs). This sequence ensures maximum coverage and prevents self-contamination. The doffing sequence is the reverse with hand hygiene performed after each step. Gloves first would leave gown cuffs exposed; donning simultaneously is unsafe.
Question 2: A resident has been diagnosed with Clostridioides difficile (C. diff). Which type of precautions are required?
- Contact precautions with dedicated equipment, private room if possible, and soap and water handwashing (not alcohol hand rub) (Correct answer)
- Droplet precautions only since C. diff spreads via respiratory secretions
- Standard precautions alone are sufficient for C. diff management
- Airborne precautions with N95 respirator
Correct answer: Contact precautions with dedicated equipment, private room if possible, and soap and water handwashing (not alcohol hand rub)
C. diff is transmitted via spores on surfaces; contact precautions and soap/water (which destroy spores) are required, as alcohol hand rub is ineffective.
C. difficile produces heat-resistant spores that survive on surfaces for months and are not destroyed by alcohol-based hand rubs. Soap and water physically removes spores. Contact precautions require gown and gloves for all room entries, dedicated equipment (stethoscope, blood pressure cuff), and a private room with dedicated bathroom if possible. Environmental cleaning with sporicidal agents (hypochlorite) is essential. These protocols are standard across BC and Ontario IPAC guidelines.
Question 3: What does 'point-of-care risk assessment' mean in infection prevention?
- Evaluating the likelihood of exposure to infectious materials before each task to determine which PPE is required (Correct answer)
- Conducting a formal audit of all rooms for infection risks at the start of each shift
- Assessing whether a resident is infectious before admitting them to the facility
- Checking the supply room for adequate PPE inventory before beginning work
Correct answer: Evaluating the likelihood of exposure to infectious materials before each task to determine which PPE is required
Point-of-care risk assessment is a brief evaluation before each task to determine appropriate PPE based on potential exposure.
Point-of-care risk assessment (PCRA) is a core IPAC practice in Canadian health care. Before each task, the HCA considers: Is there risk of splashing or contact with blood, body fluids, mucous membranes, or non-intact skin? What are the resident's current precautions? What PPE does this risk level require? This takes seconds but prevents unnecessary PPE use (resource conservation) or inadequate protection. PCRA training is embedded in BC and Ontario HCA IPAC curricula.
Question 4: Which of the following is correct regarding the handling of sharps (needles, lancets) in a care setting?
- Dispose of all sharps immediately in an approved sharps container at the point of use; never recap needles by hand (Correct answer)
- Recap needles carefully using two hands before disposing to prevent accidental needlesticks
- Sharps can be placed in a regular garbage bag if a sharps container is not immediately available
- Used lancets may be rinsed and reused for the same resident to reduce waste
Correct answer: Dispose of all sharps immediately in an approved sharps container at the point of use; never recap needles by hand
Immediate single-handed sharps disposal prevents needlestick injuries; recapping and improvised disposal are prohibited.
Needlestick injuries are a major occupational hazard, transmitting bloodborne pathogens (HIV, hepatitis B and C). Recapping with two hands creates the highest risk of needlestick injury. If recapping is unavoidable, the one-hand scoop technique is the only acceptable alternative. Sharps containers must be placed at the point of use and sealed when three-quarters full. Sharps never go in regular garbage or sharps reuse under any circumstances. Post-exposure protocols (immediate washing, reporting, blood work) must be followed for any needlestick.
Question 5: How should soiled linen be handled to prevent cross-contamination?
- Roll soiled linen away from your body, place it directly into a linen bag without shaking, and never place it on the floor or clean surfaces (Correct answer)
- Shake linen vigorously before placing in the hamper to remove loose debris
- Carry soiled linen against your uniform to the laundry area efficiently
- Stack soiled linen in the hallway temporarily if the linen hamper is full
Correct answer: Roll soiled linen away from your body, place it directly into a linen bag without shaking, and never place it on the floor or clean surfaces
Shaking soiled linen disperses pathogens into the air; direct bagging and avoiding contact with clean surfaces prevents transmission.
Soiled linen can harbour MRSA, C. diff spores, and other pathogens. Shaking releases bioaerosols. Correct handling: roll or fold with contaminated surface inward, hold away from uniform, place directly into an appropriately coloured linen bag. Never put on clean surfaces, floors, or in the hallway. Linen bags should not be overfilled and should be transported in a covered cart. After handling soiled linen, hand hygiene is mandatory. These practices are consistent with PIDAC guidelines from Ontario and BC IPAC standards.
Question 6: What is the 'chain of infection' and why is it important in HCA practice?
- A model of six links (agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host) showing how infection spreads; breaking any link prevents infection (Correct answer)
- A documentation chain showing how an infection is reported from HCA to physician
- A list of residents currently on isolation precautions in the facility
- A cleaning protocol for breaking down biofilm on medical equipment
Correct answer: A model of six links (agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host) showing how infection spreads; breaking any link prevents infection
Understanding the chain helps HCAs identify where interventions (hand hygiene, PPE, cleaning) break the transmission cycle.
The chain of infection model is foundational to IPAC education. The six links are: infectious agent (pathogen), reservoir (where it lives), portal of exit (how it leaves), mode of transmission (how it travels), portal of entry (how it enters the next host), susceptible host. HCA interventions target multiple links: hand hygiene targets the mode of transmission; PPE blocks the portal of entry; proper wound care seals portals of exit; vaccination reduces susceptible hosts. Understanding the model empowers proactive infection prevention.
HCA - Health Care Assistant Infection Prevention and Control Questions and Answers 2
What is the correct donning (putting on) order for personal protective equipment (PPE) when entering a contact precautions room?