Patient Safety and Infection Control
The Chain of Infection
Interrupting transmission requires understanding the chain: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host. Standard precautions apply to every patient regardless of diagnosis: hand hygiene, gloves, gown, mask and eye protection based on anticipated exposure, safe sharps handling, and respiratory hygiene.
Transmission-Based Precautions
Know the categories and the diseases that anchor them. Contact precautions for multidrug-resistant organisms, Clostridioides difficile, and scabies. Droplet precautions for influenza, pertussis, and meningococcal disease. Airborne precautions for tuberculosis, measles, and varicella, requiring a fit-tested respirator and negative-pressure room. Hand hygiene remains the single most effective measure; alcohol-based rub is preferred except with C. difficile or visibly soiled hands, where soap and water is required.
General Safety
Fall prevention (risk screening, bed height, call light, nonskid footwear, toileting schedules), restraint use as a last resort with ordered time limits and monitoring, safe patient handling, identification with two identifiers, and medication safety including high-alert drugs.
Traps
Questions may describe a patient on airborne precautions and offer a surgical mask as correct - it is not. Another trap is applying precautions only after a diagnosis is confirmed, when empiric precautions are indicated. Also watch for hand hygiene timing errors, such as removing gloves and skipping hand hygiene.
Rule of Thumb
Match the precaution to the transmission route, not to the severity of illness. When unsure, standard precautions plus the most protective plausible route until confirmed.