Infection Control
Infection control is part of Safety and Infection Control for RN candidates and Safety and Infection Control for PN candidates, and the reasoning is the same for both. You need to match each disease to the right precautions, put on and take off PPE safely, and protect vulnerable clients. This topic keeps it practical.
Key facts
- Hand hygiene is the single most important way to prevent infection.
- Contact precautions: C. difficile, MRSA and scabies. Use soap and water for C. difficile.
- Droplet precautions: influenza, pertussis and bacterial meningitis. Wear a surgical mask.
- Airborne precautions: tuberculosis, measles and varicella. Use an N95 respirator and a negative-pressure room.
- A common donning order is gown, mask or respirator, goggles, then gloves.
- Gloves usually come off first when removing PPE, followed by goggles and gown. Take the mask off last, after leaving the room.
Standard and transmission-based precautions
Standard precautions apply to every client and assume that any body fluid could be infectious. Transmission-based precautions are added according to how the organism spreads: by contact, droplet or air.
Memory aids can help, but focus on the route. Organisms that spread through the air need a respirator and a special room. Droplets travel a short distance and need a mask. Contact organisms need a gown and gloves.
PPE and hand hygiene
Alcohol-based hand rub works for most situations. Use soap and water when hands are visibly soiled and for C. difficile, because alcohol does not kill its spores.
Remove PPE carefully to avoid contaminating yourself, and perform hand hygiene after removing it.
Protecting vulnerable clients
Clients with neutropenia need protective measures: strict hand hygiene, no fresh flowers or standing water, and prompt reporting of fever.
When assigning rooms, do not place an immunocompromised client with a client who has an active infection.
Devices and infection risk
Central lines, urinary catheters and ventilators all carry infection risk. Aseptic technique, removing devices once they are no longer needed, and site checks all reduce harm.
Report signs of infection such as fever, redness, drainage, cloudy urine or rising white cell counts.
Practice: 3 original questions
1. Which precautions does a client with suspected pulmonary tuberculosis need?
Answer and rationale
Correct: C. TB spreads through the air. It requires an N95 respirator and a negative-pressure room.
2. Which hand hygiene method is best after caring for a client with C. difficile?
Answer and rationale
Correct: B. Alcohol does not kill C. difficile spores. Washing with soap and water removes them physically.
3. When removing PPE, which item is usually removed first?
Answer and rationale
Correct: C. Gloves are the most contaminated item and are generally removed first, following facility policy.
Related Nurseclex guides
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