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Test 7: Surveillance and outbreak investigation

  1. Surveillance can best be described as:
    • A method to track infections in a healthcare facility
    • A way to record the numbers of patients attending a primary care clinic
    • A way to record how many sterile packs are being stored in an operating theatre
    • Random data collection with no specific purpose.
  2. The purpose of conducting surveillance for healthcare-associated infection is:
    • To keep the facility manager satisfied
    • To establish infection rates before implementing an IPC intervention
    • To give the IPC practitioner something to do when infection is not a problem
    • To identify which areas of a healthcare facility are the dirtiest.
  3. Surveillance for healthcare-associated infection should be conducted by:
    • Only the IPC practitioner
    • A team of people with the relevant skills
    • The microbiology service
    • The data manager.
  4. Surveillance programmes for healthcare-associated infection should be conducted at:
    • Community level
    • Facility, provincial or national level
    • Individual pathogen level
    • Individual patient level.
  5. Healthcare-associated infection surveillance programmes require:
    • Large amounts of money to implement
    • Standardised surveillance definitions
    • A microbiologist to interpret the findings
    • A biostatistician to analyse the data.
  6. A disadvantage of conducting continuous surveillance is:
    • That it is very time-consuming
    • It does not allow for comparison of changes over time
    • It cannot identify outbreaks
    • It is not useful for establishing baseline infection rates.
  7. Point prevalence surveillance studies:
    • Require ongoing, continuous data collection for specific infections
    • May not be repeated periodically
    • Require more resources than continuous surveillance
    • Provide a snapshot of disease burden at one point in time.
  8. The following IPC indicators are an outcome measure:
    • The percentage of staff that receive an annual influenza vaccination
    • The healthcare-associated infection rate
    • The hand hygiene compliance rate
    • The percentage of surgical patients receiving antibiotic prophylaxis on time.
  9. Data on healthcare-associated infection are usually presented as a:
    • Proportion
    • Percentage
    • Rate
    • Numerator.
  10. Healthcare-associated infection rates in low-income countries are:
    • Lower than in high-income countries
    • Similar to high-income countries
    • Higher than high-income countries
    • Not known.
  11. A commonly used definition of an outbreak is:
    • One or more linked cases with the same symptoms
    • More than four linked cases with similar symptoms
    • More cases in a population than expected
    • A rapidly spreading type of infectious disease.
  12. In outbreak terminology a vehicle is defined as:
    • A non-living intermediary that can transmit pathogens, e.g. food
    • A living intermediary that can transmit pathogens, e.g. ticks
    • The site where a pathogen grows and multiplies
    • A motorised form of transport that can translocate pathogens, e.g. mosquitoes on aeroplanes.
  13. In outbreak terminology, an epidemic is defined as:
    • The usual or expected level of disease in an area
    • Disease levels greater than normally expected, more prolonged/widespread than outbreaks
    • A disease that has spread to all regions of the world
    • The study of the epidemiology of infectious diseases.
  14. Outbreaks are usually recognised by:
    • Conducting point prevalence surveys
    • Reports in the media of people dying under mysterious circumstances
    • Reports from clinicians or the laboratory of an increased frequency of a particular disease
    • Analysing data on notifiable diseases on an annual basis.
  15. The main purpose of outbreak investigation is to:
    • Identify the source of the illness and guide efforts to stop the outbreak
    • Find someone to blame for the spread of the outbreak
    • Train healthcare workers about public health programmes
    • Help the local government to prioritise service upgrades, e.g. water, sanitation.
  16. Six babies develop diarrhoea on the neonatal ward. The first step in outbreak investigation is:
    • To draw up a line list and Gantt chart
    • To send stool samples to microbiology and virology laboratories
    • To call an urgent meeting with paediatrics, infection control and facility management
    • To agree on a case definition for the outbreak.
  17. The immediate control measures needed in an outbreak are:
    • The formation of an outbreak response team
    • Development of a case definition
    • Alerting of all possible role players
    • Reinforcement of IPC measures.
  18. In outbreak investigation, a line list is used to:
    • Keep track of all staff who were in contact with the disease-affected patients
    • Record details of all patients who meet the outbreak case definition
    • Track patient movements within a healthcare facility
    • Record which specimens have been sent to the laboratory for each patient.
  19. When the outbreak has been successfully contained, the outbreak team should:
    • Congratulate each other on a job well done
    • Inform the facility manager or communicable disease officer
    • Prepare and distribute a report summarising their findings and recommendations
    • Tell the laboratory to destroy all the samples/specimens.
  20. The role of the IPC practitioner in outbreak investigation is:
    • To act as the spokesperson and liaise with the media
    • To co-ordinate evaluation of relevant IPC policies and implement IPC control measures
    • To take responsibility for leading the outbreak team
    • To provide clinical care to people affected by the outbreak.