Patient Safety and Infection Control
Core concepts
Patient safety rests on a small set of high-yield systems: correct patient identification (two identifiers, never the room number), hand hygiene as the single most effective infection-prevention measure, and the chain of infection (infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host). Know standard precautions apply to every patient regardless of diagnosis, while transmission-based precautions (contact, droplet, airborne) add to-not replace-standard precautions. Familiarize yourself with personal protective equipment order (don on gown, mask, goggles, gloves; remove gloves first, then goggles, gown, mask, with hand hygiene after). Understand sterile technique, surgical asepsis, and which procedures require it (catheter insertion, wound care, IV starts).
Traps in questions
Distinguish isolation type by disease: airborne (tuberculosis, measles, varicella) needs a negative-pressure room and N95; droplet (influenza, pertussis, meningococcal) needs a mask and private room; contact (C. difficile, MRSA, scabies) needs gown and gloves with dedicated equipment. A frequent trap is choosing "wear a mask" for a contact-precaution organism or forgetting hand hygiene with soap and water for C. difficile (alcohol rub does not kill spores). Another trap: confusing a susceptible host factor with a mode of transmission. Fall prevention, restraint use, and safe patient handling also appear here-remember restraints require a provider order, time-limited renewal, and frequent assessment.
Rule of thumb
When a question describes a new organism or uncertain diagnosis, default to standard precautions plus the most protective additional precaution until confirmed. For any isolation question, ask: How does this organism leave the body and enter the next person? That answer picks the precaution.
Worked example
A patient with suspected pulmonary TB is admitted. Correct action: place in an airborne infection isolation room with negative pressure, wear an N95 respirator, and keep the door closed-standard precautions still apply for body fluids.