Infection Control, Patient Safety, and Clinical Governance
Core concepts
Infection control questions test standard precautions applied to every patient. Know hand hygiene (the WHO five moments), personal protective equipment, safe sharps handling, and the decontamination cycle: cleaning, disinfection, sterilisation, and storage. Understand the Spaulding classification - critical items (sterilise), semicritical items (sterilise or high-level disinfection), and non-critical items (clean and disinfect).
Learn the principles of sterilisation: autoclave cycles, monitoring with physical, chemical, and biological indicators, and the importance of validated cycles and record-keeping. Understand single-use items and the rules on reprocessing. Know the management of a sharps injury or bloodborne exposure: immediate first aid, reporting, risk assessment, post-exposure prophylaxis, and follow-up.
Patient safety and governance
Know the elements of clinical governance: audit, incident reporting, complaints, risk management, continuing professional development, and evidence-based practice. Understand the importance of record-keeping, consent documentation, and duty of candour. Learn how to handle a never event and the role of root cause analysis.
Traps
- Using a disinfectant where sterilisation is required.
- Relying on chemical indicators alone without biological monitoring.
- Failing to report a sharps injury or delaying post-exposure assessment.
- Treating governance as paperwork rather than a system for learning from incidents.
Worked example
A hygienist sustains a needlestick from a patient with unknown bloodborne status. Rule of thumb: encourage bleeding, wash with soap and water, do not suck the wound, report immediately, and arrange risk assessment and post-exposure prophylaxis within hours, not days.