Infection Prevention and Control
Infection control questions are grounded in the chain of infection and standard precautions. Standard precautions apply to all patients regardless of diagnosis: hand hygiene, gloves, gown, mask/eye protection based on risk, safe sharps handling, and safe waste disposal.
Hand hygiene: The WHO five moments - before patient contact, before an aseptic task, after body-fluid exposure risk, after patient contact, after contact with patient surroundings. Alcohol-based rub is preferred for routine hand hygiene when hands are not visibly soiled; soap and water is required for C. difficile and visible soiling.
Personal protective equipment: Don before contact, remove safely (gloves first, hand hygiene last). Do not wear the same gloves between patients.
Transmission-based precautions:
- Contact: MRSA, C. difficile, scabies - gown and gloves, dedicated equipment.
- Droplet: influenza, meningococcal meningitis - surgical mask, distance.
- Airborne: tuberculosis, measles, varicella - N95 respirator and negative-pressure room.
Sharps and spills: Never recap needles; dispose immediately in a puncture-resistant container. Follow spill protocols and report exposures promptly.
Antimicrobial stewardship: use antibiotics appropriately; complete prescribed courses; prevent resistance through hand hygiene and isolation.
Traps
- Choosing droplet when airborne precautions are required (TB, measles).
- Using alcohol rub when soap and water is indicated (C. difficile).
- Wearing gloves as a substitute for hand hygiene.
- Forgetting to clean shared equipment between patients.
Rule of thumb
Ask how does this organism spread? Airborne needs N95 and negative pressure; droplet needs a mask and distance; contact needs gown, gloves and dedicated equipment - and hand hygiene always comes last.