Hand Hygiene Knowledge Assessment Questionnaire

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Hand Hygiene Knowledge Assessment Questionnaire - Quiz

The Hand Hygiene Knowledge Assessment Questionnaire from the Institute for Healthcare Improvement (IHI) presents a series of seven true–false and multiple choice questions focused on these areas. Use this questionnaire to periodically survey clinical staff about their knowledge of key elements of hand hygiene.
For more information on hand hygiene and infection prevention, please visit the Deb Group blog and sign-up for weekly updates.


Questions and Answers
  • 1. 

    In which of the following situations should hand hygiene be performed? A. Before having direct contact with a patient B. Before inserting an invasive device (e.g., intravascular catheter, foley catheter) C. When moving from a contaminated body site to a clean body site during an episode of patient care D. After having direct contact with a patient or with items in the immediate vicinity of the patient E. After removing gloves

    • A.

      B and E

    • B.

      A, B and D

    • C.

      B, D and E

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    Hand hygiene should be performed in all of the mentioned situations. Before having direct contact with a patient, hand hygiene is important to prevent the transmission of any microorganisms. Before inserting an invasive device, hand hygiene is necessary to reduce the risk of introducing pathogens into the patient's body. When moving from a contaminated body site to a clean body site during patient care, hand hygiene is crucial to prevent cross-contamination. After having direct contact with a patient or with items in the immediate vicinity of the patient, hand hygiene is necessary to remove any potentially harmful microorganisms. Finally, after removing gloves, hand hygiene is important to ensure that any remaining pathogens are eliminated.

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  • 2. 

    If hands are not visibly soiled or visibly contaminated with blood or other proteinaceous material, which of the following regimens is the most effective for reducing the number of pathogenic bacteria on the hands of personnel?

    • A.

      Washing hands with plain soap and water

    • B.

      Washing hands with an antimicrobial soap and water

    • C.

      Applying 1.5 ml to 3 ml of alcohol-based hand rub to the hands and rubbing hands together until they feel dry

    Correct Answer
    C. Applying 1.5 ml to 3 ml of alcohol-based hand rub to the hands and rubbing hands together until they feel dry
    Explanation
    The most effective regimen for reducing the number of pathogenic bacteria on the hands of personnel, when hands are not visibly soiled or contaminated, is applying 1.5 ml to 3 ml of alcohol-based hand rub to the hands and rubbing them together until they feel dry. This is because alcohol-based hand rubs have been proven to effectively kill a wide range of bacteria and viruses, including those that cause infections. Washing hands with plain soap and water is also effective, but may not be as convenient or readily available in certain situations. Washing hands with an antimicrobial soap and water may be unnecessary and can contribute to the development of antibiotic resistance.

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  • 3. 

    How are antibiotic-resistant pathogens most frequently spread from one patient to another in health care settings?

    • A.

      Airborne spread resulting from patients coughing or sneezing

    • B.

      Patients coming in contact with contaminated equipment

    • C.

      From one patient to another via the contaminated hands of clinical staff

    • D.

      Poor environmental maintenance

    Correct Answer
    C. From one patient to another via the contaminated hands of clinical staff
    Explanation
    Antibiotic-resistant pathogens are most frequently spread from one patient to another via the contaminated hands of clinical staff. This is because healthcare workers may come into contact with these pathogens while caring for an infected patient and then transmit them to another patient if proper hand hygiene practices are not followed. Airborne spread resulting from coughing or sneezing, patients coming in contact with contaminated equipment, and poor environmental maintenance can also contribute to the spread of antibiotic-resistant pathogens, but they are not the most frequent modes of transmission in healthcare settings.

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  • 4. 

    Which of the following infections can be potentially transmitted from patients to clinical staff if appropriate glove use and hand hygiene are not performed?

    • A.

      Herpes simplex virus infection

    • B.

      Colonization or infection with methicillin-resistant Staphylococcus aureus

    • C.

      Respiratory syncytial virus infection

    • D.

      Hepatitis B virus infection

    • E.

      All of the above

    Correct Answer
    E. All of the above
    Explanation
    If appropriate glove use and hand hygiene are not performed, all of the mentioned infections can potentially be transmitted from patients to clinical staff. Herpes simplex virus infection can be transmitted through direct contact with the virus, colonization or infection with methicillin-resistant Staphylococcus aureus can be transmitted through contact with contaminated surfaces or objects, respiratory syncytial virus infection can be transmitted through respiratory droplets, and hepatitis B virus infection can be transmitted through contact with infected blood or body fluids. Therefore, all of the above infections can be transmitted if proper precautions are not taken.

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  • 5. 

    Clostridium difficile (the cause of antibiotic-associated diarrhea) is readily killed by alcohol-based hand hygiene products.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Alcohol-based hand hygiene products are not effective in killing Clostridium difficile, the cause of antibiotic-associated diarrhea. Clostridium difficile is a spore-forming bacterium that can survive in the environment for long periods of time and is resistant to many disinfectants, including alcohol. Therefore, alternative disinfection methods, such as using bleach or hydrogen peroxide-based products, are recommended to effectively eliminate Clostridium difficile.

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  • 6. 

    Which of the following pathogens readily survive in the environment of the patient for days to weeks? A. E. coli B. Klebsiella spp. C. Clostridium difficile (the cause of antibiotic-associated diarrhea) D. Methicillin-resistant Staphyloccus aureus (MRSA) E. Vancomycin-resistant enterococcus (VRE)

    • A.

      A and D

    • B.

      A and B

    • C.

      C, D, E

    • D.

      All of the above

    Correct Answer
    C. C, D, E
    Explanation
    Pathogens that readily survive in the environment of the patient for days to weeks are Clostridium difficile (the cause of antibiotic-associated diarrhea), Methicillin-resistant Staphyloccus aureus (MRSA), and Vancomycin-resistant enterococcus (VRE). E. coli and Klebsiella spp. may not survive as long in the patient's environment. Therefore, the correct answer is C, D, E.

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  • 7. 

    Which of the following statements about alcohol-based hand hygiene products is accurate?

    • A.

      They dry the skin more than repeated handwashing with soap and water

    • B.

      They cause more allergy and skin intolerance than chlorhexidine gluconate products

    • C.

      They cause stinging of the hands in some providers due to pre-existing skin irritation

    • D.

      They are effective even when the hands are visibly soiled

    • E.

      They kill bacteria less rapidly than chlorhexidine gluconate and other antiseptic containing soaps

    Correct Answer
    C. They cause stinging of the hands in some providers due to pre-existing skin irritation
    Explanation
    Alcohol-based hand hygiene products can cause stinging of the hands in some providers due to pre-existing skin irritation. This means that individuals who already have irritated or sensitive skin may experience discomfort or a stinging sensation when using these products. It is important to note that this statement does not imply that all individuals will experience this reaction, but rather that it is a possibility for some people.

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