Quiz 5: Infection control considerations for healthcare facility design

Please choose the one, most correct answer to each question or statement.

1. The most important consideration when designing a new healthcare facility is:
   • The budget available for the project
   • The disease profile of the local community
   • The community’s stated service needs
   • The existing facilities available in the area.
2. Infection control practitioners should be involved in healthcare facility design because:
   • They can advise on design elements to reduce healthcare-associated infection (HAI)
   • They will have to work in the facility once built
   • They know better than clinicians what is required for a new building
   • They are required by law in all countries to be involved in all building projects.
3. Infection control practitioners should be involved in healthcare facility design:
   • Just before the ward is opened to admit new patients
   • Just before the building or renovation work starts
   • After the approved plans have been received from the architect
   • When the ideas for the building or renovation are first being discussed.
4. Infection control practitioners should advise on the following aspects:
   • Resuscitation and clinical equipment needed
   • The colour of the walls and floors
   • Isolation rooms, ventilation, layout and fittings
   • The admission criteria for patients to the new ward/area.
5. Beds in the general wards should be separated by at least:
   • 2.5 metres (centre of bed to centre of next bed)
   • 3.0 metres (edge of bed to edge of next bed)
   • 3.5 metres (centre of bed to centre of next bed)
   • 2.5 metres (edge of bed to edge of next bed).
6. In general wards, at least one dedicated handwash basin should be provided:
   • For every bed
   • For every two beds
   • For every four beds
   • For every six beds.
7. The common route/s for infection transmission in clinics include:
   • Respiratory
   • Respiratory and contact
   • Faeco-oral
   • Inoculation.
8. The highest risk of infection in dental clinics is from:
   • Blood-borne viruses
   • Bacteria
   • Gastro-intestinal viruses
   • Prions.
9. Isolation rooms:
   • Should make up at least 30% of all hospital beds
   • Should always be mechanically ventilated under positive pressure
   • Do not need en suite bathrooms
   • Function to separate infectious patients from susceptible patients.
10. Operating theatres:
    • Should be mechanically ventilated under negative pressure
    • Should be kept at temperatures between 24 and 28 °C
    • May routinely sterilize their own surgical equipment in the theatre
    • Should have well-demarcated ‘clean’ and ‘sterile’ zones.
11. Intensive care units (ICU):
    • Do not require isolation rooms as the beds are far apart
    • Should have a minimum of 2.5 metres space between beds
    • Require at least one handwash basin for every six ICU beds
    • Should regularly train their staff on hand hygiene and aseptic technique.
12. Accident and emergency units:
    • Do not require isolation rooms/bays
    • Should have sharps containers within easy reach of every bed/bay
    • Must have negative pressure ventilation
    • Are not high-risk areas for needlestick injuries.
13. Patients in burns wards:
    • Are not at particularly high risk of infection
    • Acquire infections mostly by respiratory transmission
    • Acquire infections by contact with staff, equipment and the environment
    • Should all be placed under protective isolation.
14. Neonatal wards require:
    • One isolation room for every 30 beds
    • Disease screening protocols for mothers admitted to kangaroo care units
    • Handwash basins next to every cot/incubator
    • Specialised environmental disinfection of all surfaces.
15. Milk preparation areas:
    • Are a high-risk area for microbial contamination of infant feeds
    • Can store milk in fridges together with medication and foodstuffs
    • Can prepare feeds up to 48 hours in advance
    • Can use low-level disinfection for babies’ bottles and teats.
16. With regard to expressed breastmilk (EBM):
    • The risk of HIV or hepatitis transmission through breastmilk is low
    • Mothers may express, label and store the EBM themselves
    • EBM should be stored at 4–6 °C and used within 24 hours
    • Pasteurisation is not needed for pooled EBM.
17. Mortuary workers:
    • Do not require personal protective equipment since corpses do not transmit infections
    • Are at risk of penetrating injuries, mucosal splashes and infection with respiratory pathogens
    • Are not required to change out of their personal clothing before coming on duty
    • Are not required to shower before coming off duty.
18. Ambulance staff:
    • Should try to establish any infection transmission hazards before transporting a patient
    • Should wear surgical masks when transporting patients with pulmonary TB
    • Should ask patients with pulmonary TB to wear N95 respirators when inside the ambulance
    • May use alcohol handrub to decontaminate hands covered in blood or mucus.
19. Hospital kitchens:
    • Staff require only routine pre-employment health checks
    • Require the same personal protective equipment as the clinical staff
    • May prepare raw and cooked food in the same area
    • Require an uninterrupted supply of hot and cold water.
20. Support services staff:
    • Are at lower risk for pathogen exposure than clinical staff
    • Should receive pre-employment hepatitis B immunisation
    • Are not required to wear personal protective equipment
    • Are not required to undergo training in infection prevention and control.