CIC Exam Dumps - CBIC Certified Infection Control Exam

To determine the infection rate per 100 procedures for total hip replacements, use the following formula:

Thus, the correct answer is B. 2.9 per 100 procedures.

CBIC Infection Control Reference

The methodology of calculating SSI rates aligns with guidelines from the National Healthcare Safety Network (NHSN) and standardized infection ratio (SIR) models used for hospital-specific SSI rates​.

The CDC and FDA have identified duodenoscopes as high-risk devices due to inadequate reprocessing, leading to MDRO transmission​.

The first priority is enhancing reprocessing protocols and ensuring strict compliance with manufacturer instructions.

CBIC Infection Control References:

APIC Text, "Endoscope Reprocessing and Infection Risk," Chapter 10​.

When an outbreak of infectious disease is suspected, the first step is to conduct an epidemiologic investigation. This begins with characterizing the outbreak by person, place, and time to establish patterns and trends. This approach, known as descriptive epidemiology, provides critical insights into potential sources and transmission patterns.

Step-by-Step Justification:

Identify Cases and Patterns:

The infection preventionist should analyze patient demographics (person), locations of cases (place), and onset of symptoms (time). This helps in defining the outbreak scope and potential exposure sources​.

Create an Epidemic Curve:

An epidemic curve helps determine whether the outbreak is a point-source or propagated event. This can indicate whether the infection is spreading person-to-person or originating from a common source​.

Compare with Baseline Data:

Reviewing historical data ensures that the observed cases exceed the expected norm, confirming an outbreak​.

Guide Further Investigation:

Establishing basic epidemiologic patterns guides subsequent actions, such as laboratory testing, environmental sampling, and surveillance​.

Why Other Options Are Incorrect:

B. Increase surveillance facility-wide for additional cases:

While enhanced surveillance is important, it should follow the initial characterization of the outbreak. Surveillance without a defined case profile may lead to misclassification and misinterpretation​.

C. Contact the laboratory to confirm stool identification results:

Confirming lab results is essential but comes after defining the outbreak's characteristics. Without an epidemiologic link, testing may yield results that are difficult to interpret​.

D. Form a tentative hypothesis about the potential reservoir for this outbreak:

Hypothesis generation occurs after sufficient epidemiologic data have been collected. Jumping to conclusions without characterization may result in incorrect assumptions and ineffective control measures​.

CBIC Infection Control References:

APIC Text, "Outbreak Investigations," Epidemiology, Surveillance, Performance, and Patient Safety Measures​.

APIC/JCR Infection Prevention and Control Workbook, Chapter 4, Surveillance Program​.

APIC Text, "Investigating Infectious Disease Outbreaks," Guidelines for Epidemic Curve Analysis​.

Coliform bacteria are indicators of fecal contamination in water, making them a critical measure of water safety. Hepatitis A is a virus primarily transmitted via the fecal-oral route, often through contaminated food or water.

Step-by-Step Justification:

Fecal Contamination and Hepatitis A:

Hepatitis A virus (HAV) spreads through ingestion of water contaminated with fecal matter. High coliform counts indicate fecal contamination and increase the risk of HAV outbreaks​.

Use of Coliforms as Indicators:

Public health agencies use total coliforms and Escherichia coli (E. coli) as primary indicators of water safety because they signal fecal pollution​.

Waterborne Transmission of Hepatitis A:

Hepatitis A outbreaks have been traced to contaminated drinking water, ice, and improperly treated wastewater. Coliform detection signals a need for immediate action​.

Why Other Options Are Incorrect:

B. Pseudomonads:

Pseudomonads (e.g., Pseudomonas aeruginosa) are environmental bacteria but are not indicators of fecal contamination.

C. Legionella:

Legionella species cause Legionnaires' disease through inhalation of contaminated aerosols, not through fecal-oral transmission.

D. Acinetobacter:

Acinetobacter species are opportunistic pathogens in healthcare settings but are not indicators of waterborne fecal contamination.

CBIC Infection Control References:

APIC Text, "Water Systems and Infection Control Measures"​.

APIC Text, "Hepatitis A Transmission and Waterborne Outbreaks"​.

The correct answer is C, "results of biologic indicators are unavailable prior to use of the item," as this is the primary reason immediate use steam sterilization (IUSS) is not recommended for implantable items requiring immediate use. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, IUSS is a process used for sterilizing items needed urgently when no other sterile options are available, typically involving a shortened cycle (e.g., flash sterilization). However, for implantable items—such as orthopedic hardware or prosthetic devices—ensuring absolute sterility is critical due to the risk of deep infection. Biologic indicators (BIs), which contain highly resistant spores to verify sterilization efficacy, require incubation (typically 24-48 hours) to confirm the kill, but IUSS does not allow time for BI results to be available before the item is used (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This lack of immediate verification poses a significant infection risk, making IUSS inappropriate for implants, as per AAMI ST79 standards.

Option A (the high temperature may damage the items) is a consideration for some heat-sensitive materials, but modern IUSS cycles are designed to minimize damage, and this is not the primary reason for the restriction on implants. Option B (chemical indicators may not be accurate at high temperatures) is incorrect, as chemical indicators (e.g., color-changing strips) are reliable at high temperatures and serve as an immediate check, though they are not a substitute for BIs. Option D (the length of time is inadequate for the steam to penetrate the pack) is not the main issue, as IUSS cycles are optimized for penetration, though the shortened time may be a secondary concern; the unavailability of BI results remains the decisive factor.

The focus on biologic indicator results aligns with CBIC’s emphasis on ensuring the safety and sterility of reprocessed medical devices, particularly for high-risk implantable items (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). This recommendation is supported by AAMI and CDC guidelines, which prioritize BI confirmation for implants to prevent healthcare-associated infections (AAMI ST79:2017, CDC Sterilization Guidelines, 2019).

Evaluating the effectiveness of a program to reduce central-line associated bloodstream infections (CLABSIs) in an intensive care unit (ICU) requires identifying the most direct and relevant measure of success. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes outcome-based assessment in the "Performance Improvement" and "Surveillance and Epidemiologic Investigation" domains, aligning with the Centers for Disease Control and Prevention (CDC) guidelines for infection prevention. The primary goal of a CLABSI reduction program is to decrease the occurrence of these infections, with secondary benefits including reduced length of stay, costs, and resource use.

Option B, "A 25% reduction in the incidence of CLABSIs over 6 months," is the best demonstration of effectiveness. The incidence of CLABSIs—defined by the CDC as the number of infections per 1,000 central line days—directly measures the program’s impact on the targeted outcome: preventing bloodstream infections associated with central lines. A 25% reduction over 6 months indicates a sustained decrease in infection rates, providing clear evidence that the intervention (e.g., improved insertion techniques, maintenance bundles, or staff education) is working. The CDC’s "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017) and the National Healthcare Safety Network (NHSN) protocols prioritize infection rate reduction as the primary metric for assessing CLABSI prevention programs.

Option A, "A 25% decrease in the length of stay in the ICU related to CLABSIs," is a secondary benefit. Reducing CLABSI-related length of stay can improve patient outcomes and bed availability, but it is an indirect measure dependent on infection incidence. A decrease in length of stay could also reflect other factors (e.g., improved discharge planning), making it less specific to program effectiveness. Option C, "A 30% decrease in total costs related to treatment of CLABSIs over 12 months," reflects a financial outcome, which is valuable for justifying resource allocation. However, cost reduction is a downstream effect of decreased infections and may be influenced by variables like hospital pricing or treatment protocols, diluting its direct link to program success. Option D, "A 30% reduction in the use of antibiotic-impregnated central catheters over 6 months," indicates a change in practice but not necessarily effectiveness. Antibiotic-impregnated catheters are one prevention strategy, and reducing their use could suggest improved standard practices (e.g., chlorhexidine bathing), but it could also increase infection rates if not offset by other measures, making it an ambiguous indicator.

The CBIC Practice Analysis (2022) and CDC guidelines emphasize that the primary measure of a CLABSI prevention program’s success is a reduction in infection incidence, as it directly addresses patient safety and the program’s core objective. Option B provides the most robust and specific evidence of effectiveness over a defined timeframe.

The correct answer is C, "Reviewing principles of adult learning," as this activity will best prepare a newly hired infection preventionist to present information at the facility’s orientation program. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, effective education delivery, especially for healthcare professionals during orientation, relies on understanding adult learning principles (e.g., andragogy), which emphasize learner-centered approaches, relevance to practice, and active participation. Reviewing these principles equips the infection preventionist (IP) to design and deliver content that addresses the specific needs, experiences, and motivations of the audience—such as new staff learning infection control protocols—enhancing engagement and retention (CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs). This preparation ensures the presentation is tailored, impactful, and aligned with the goal of promoting infection prevention behaviors.

Option A (observing other departments’ orientation presentations) can provide insights into presentation styles or facility norms, but it is less focused on the IP’s specific educational role and may not address the unique content of infection prevention. Option B (meeting with the facility’s leadership) is valuable for understanding organizational priorities and gaining support, but it is more about collaboration and context-setting rather than direct preparation for presenting educational material. Option D (administering tuberculin skin tests to orientees) is a clinical task related to TB screening, not a preparatory activity for designing or delivering an educational presentation.

The focus on reviewing adult learning principles aligns with CBIC’s emphasis on evidence-based education strategies to improve infection control practices among healthcare personnel (CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competency 4.2 - Evaluate the effectiveness of educational programs). This approach enables the IP to effectively communicate critical information, such as hand hygiene or isolation protocols, during the orientation program.

Therapeutic antimicrobial agents should ideally be pathogen-directed to minimize resistance, side effects, and treatment failure. Once the causative pathogen and its antimicrobial susceptibilities are known, the most narrow-spectrum, effective agent should be used.

Why the Other Options Are Incorrect?

A. The infecting agent is unknown – Empiric therapy may be necessary initially, but definitive therapy should be based on pathogen identification.

B. The patient's illness warrants treatment prior to culture results – This applies to empiric therapy, but not to definitive antimicrobial selection.

C. The patient’s symptoms suggest likely pathogens – Clinical presentation guides empiric treatment, but definitive therapy should follow culture and susceptibility testing.

CBIC Infection Control Reference

APIC emphasizes the importance of selecting antimicrobials based on pathogen identification and susceptibility testing to prevent antimicrobial resistance​.