Empty Glove Box in a Contact Precautions Room
Mrs. Nguyen has Clostridioides difficile diarrhea and is on contact precautions. You are assigned to her and to three other residents on the same hall. You enter her room wearing gloves and a gown, help her to the toilet, and clean her perineum. As you finish, you notice the box of gloves in her room is empty and you need more from the supply cart in the hallway. Her roommate, Mr. Ellis, is sitting by the window and asks you to refill his water pitcher on your way out. A shared blood pressure cuff hangs on the wall between the two beds.
1. Walk through exactly what you do from the moment you notice the gloves are empty until you leave the room.
Read the worked answer
Contamination is the whole issue here.
- Remove the soiled gloves inside out without touching your skin, and drop them in the room's trash.
- Remove the gown inside the room, touching only the inside, and discard it in the designated hamper. Do not walk into the hall wearing it.
- Wash your hands with soap and water - not alcohol rub. C. difficile forms spores that alcohol does not kill; friction and running water remove them.
- Leave the room, close the door if policy requires, get gloves and a new gown from the hallway cart, and never touch the cart or doorknobs with soiled hands.
- Re-don gown and gloves before re-entering to finish her care, then doff PPE and wash hands again on exit.
If you cannot leave her safely, use the call system or ask a coworker to bring supplies to the door rather than walking out contaminated.
2. What do you do about Mr. Ellis's water pitcher and the shared blood pressure cuff?
Read the worked answer
Do not fill Mr. Ellis's pitcher on the way out. That would carry C. diff spores to him and to shared equipment.
- Finish Mrs. Nguyen's care, remove PPE, wash hands, and only then handle anything for Mr. Ellis with clean hands and clean equipment.
- The shared BP cuff should not be used between them. It should be dedicated to her room or cleaned with the facility's C. diff-appropriate disinfectant (typically bleach-based, using the label's wet contact time) before it touches another resident.
- Report both problems - the empty glove box and the shared equipment hanging between the beds - to the nurse so the room is restocked and the equipment issue is corrected.
- Mr. Ellis is not on precautions; he still needs his water and normal care, and he should not be exposed because of where equipment is stored.
3. Mrs. Nguyen's daughter arrives with her 4-year-old and starts to sit on the bed. What do you say and do?
Read the worked answer
Greet them warmly and set limits without shaming anyone.
- Explain that her mother has an infection that spreads easily from hands and surfaces, and that the nurse will explain it in more detail.
- Ask that the toddler wait in the hallway with another adult or visit another time - young children are at higher risk and put hands in their mouths.
- Ask the daughter to wash her hands before and after the visit, and to wear a gown and gloves if she helps with personal care.
- Do not disclose the specific diagnosis to other residents, visitors, or the child; only the resident and the care team share that information.
- If she refuses precautions, do not argue - get the nurse and document the visit per policy.