When apositive biological indicator (BI)is detected, the immediate response is toretest the sterilizerusing another BI to confirm results. This helps distinguish between a true sterilization failure and a defective BI.
* TheCBIC Study Guideadvises:
"If there is no indication of abnormalities, then the sterilizer should be tested again in three consecutive cycles using paired biological indicators from different manufacturers." Immediate recall is reserved for implant loads or confirmed sterilization failure.
* Incorrect responses:
* A. Check employee techniquemay be appropriate later but not as a first step.
* B. Informing risk managerorC. Notifying patientsoccurs only after confirmation of failure.
References:
CBIC Study Guide, 6th Edition, Chapter 10 - Sterilization Monitoring
APIC Text, 4th Edition, Chapter 106 - Sterile Processing

Requiring influenza vaccination as acondition of employmenthas consistently been shown to be the most effective method to increase compliance among healthcare personnel.
* TheAPIC/JCR Workbookrecommends this as a gold standard:
"Some organizations have adopted policies requiring annual vaccination as a condition of employment unless medically contraindicated".
* CDC and APIC also support this method for maximizing coverage and protecting vulnerable populations.
References:
APIC/JCR Workbook, 4th Edition, Chapter 10 - Occupational Health Issues APIC Position Paper: Influenza Vaccination Should Be a Condition of Employment for Healthcare Personnel

The correct answer is D, "staff education related to loaner instrument reprocessing has occurred," as this is the infection prevention process that should be ensured when a surgeon is beginning a new procedure requiring loaner instruments within the next two weeks. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, loaner instruments-those borrowed from external sources for temporary use-pose unique infection prevention challenges due to potential variability in reprocessing standards and unfamiliarity among staff. Ensuring that staff are educated on proper reprocessing protocols (e.g., cleaning, sterilization, and handling per manufacturer instructions and AAMI ST79) is critical to prevent healthcare- associated infections (HAIs) (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This education should cover the specific requirements for loaner instruments, including documentation and verification of sterilization, and should occur proactively before the instruments are used to ensure competency and compliance.
Option A (items arrive in time for immediate use steam sterilization) is a logistical consideration, but it does not address the infection prevention process itself; timely arrival is necessary but insufficient without proper reprocessing validation. Option B (instruments are able to be used prior to the biological indicator results) is unsafe, as biological indicators are essential to confirm sterilization efficacy, and using instruments before results are available violates infection control standards. Option C (the planning process takes place after the instruments have arrived) is impractical, as planning (e.g., coordinating with vendors, assessing reprocessing needs) must occur in advance to ensure readiness and safety, not as a reactive step.
The focus on staff education aligns with CBIC's emphasis on preparing healthcare personnel to handle loaner instruments safely, reducing the risk of contamination and ensuring patient safety (CBIC Practice Analysis,
2022, Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs).
This proactive measure is supported by AAMI and CDC guidelines, which stress the importance of training for reprocessing complex or unfamiliar devices.
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment; Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs. AAMI ST79:2017, Comprehensive guide to steam sterilization and sterility assurance in health care facilities.

Postoperative infections in clean surgical operations, defined by the Centers for Disease Control and Prevention (CDC) as uninfected operative wounds with no inflammation and no entry into sterile tracts (e.g., gastrointestinal or respiratory systems), are influenced by various perioperative factors. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes identifying and mitigating risk factors in the "Prevention and Control of Infectious Diseases" domain, aligning with CDC guidelines for surgical site infection (SSI) prevention. The question focuses on identifying a procedure not documented as a contributor to SSIs, requiring an evaluation of evidence-based risk factors.
Option C, "The use of iodophors for preoperative scrubs," has not been documented to contribute to the development of postoperative infections in clean surgical operations. Iodophors, such as povidone-iodine, are antiseptic agents used for preoperative skin preparation and surgical hand scrubs. The CDC's "Guideline for Prevention of Surgical Site Infections" (1999) and its 2017 update endorse iodophors as an effective method for reducing microbial load on the skin, with no evidence suggesting they increase SSI risk when used appropriately. Studies, including those cited by the CDC, show that iodophors are comparable to chlorhexidine in efficacy for preoperative antisepsis, and their use is a standard, safe practice rather than a risk factor.
Option A, "Prolonged preoperative hospital stay," is a well-documented risk factor. Extended hospital stays prior to surgery increase exposure to healthcare-associated pathogens, raising the likelihood of colonization and subsequent SSI, as noted in CDC and surgical literature (e.g., Mangram et al., 1999). Option B,
"Prolonged length of the operations," is also a recognized contributor. Longer surgical durations are associated with increased exposure time, potential breaches in sterile technique, and higher infection rates, supported by CDC data showing a correlation between operative time and SSI risk. Option D, "Shaving the site on the day prior to surgery," has been documented as a risk factor. Preoperative shaving, especially with razors, can cause microabrasions that serve as entry points for bacteria, increasing SSI rates. The CDC recommends avoiding shaving or using clippers immediately before surgery to minimize this risk, with evidence from studies like those in the 1999 guideline showing higher infection rates with preoperative shaving.
The CBIC Practice Analysis (2022) and CDC guidelines focus on evidence-based practices, and the lack of documentation linking iodophor use to increased SSIs-coupled with its role as a preventive measure-makes Option C the correct answer. The other options are supported by extensive research as contributors to SSI development in clean surgeries.
References:
* CBIC Practice Analysis, 2022.
* CDC Guideline for Prevention of Surgical Site Infections, 1999, updated 2017.
* Mangram, A. J., et al. (1999). Guideline for Prevention of Surgical Site Infection. Infection Control and Hospital Epidemiology.

Surveillance is a critical tool in infection prevention and control, used to monitor disease trends and guide public health responses. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the "Surveillance and Epidemiologic Investigation" domain, which aligns with the Centers for Disease Control and Prevention (CDC) "Principles of Epidemiology in Public Health Practice" (3rd Edition, 2012).
The question describes a process of collecting and analyzing indicators to signal an increase in community illness, requiring identification of the appropriate surveillance type among the options provided.
Option C, "Syndromic," is the correct answer. Syndromic surveillance involves monitoring non-specific health indicators or symptoms (e.g., fever, respiratory complaints, or gastrointestinal issues) that may precede a formal diagnosis, aiming to detect potential outbreaks or increases in community illness early. The CDC defines syndromic surveillance as the real-time or near-real-time collection, analysis, and interpretation of health-related data to provide actionable information, often in collaboration with public health agencies. This approach uses data from sources like emergency department visits, over-the-counter medication sales, or absenteeism reports to identify trends before laboratory confirmation, making it well-suited to the described scenario of signaling community illness increases.
Option A, "Passive," involves healthcare providers or laboratories reporting cases to public health authorities on a voluntary or mandatory basis without active prompting (e.g., routine notifiable disease reporting). While passive surveillance contributes to baseline data, it is less proactive and not specifically designed to signal early increases in illness, making it less fitting. Option B, "Active," entails public health officials actively seeking data from healthcare facilities or providers (e.g., calling to confirm cases during an outbreak). This is more resource-intensive and typically used for specific investigations rather than ongoing community trend monitoring, which aligns better with syndromic methods. Option D, "Targeted," refers to surveillance focused on a specific population, disease, or event (e.g., monitoring TB in a high-risk group). The scenario's broad focus on community illness indicators does not suggest a targeted approach.
The CBIC Practice Analysis (2022) and CDC guidelines highlight syndromic surveillance as a key strategy for early detection of community-wide health threats, often involving collaboration with public health agencies. Option C best matches the described activity of analyzing indicators to signal illness increases, making it the correct choice.
References:
* CBIC Practice Analysis, 2022.
* CDC Principles of Epidemiology in Public Health Practice, 3rd Edition, 2012.
* CDC Syndromic Surveillance Systems, 2020.