DANB ICE common mistakes
DANB ICE · Understand the traps and how to avoid them.
Wearing the same gloves from one patient to the next, or handling charts, phones, or clean supplies with contaminated gloves, then removing gloves without performing hand hygiene.
Gloves are treated as a complete substitute for hand hygiene rather than a task-specific barrier.
What to do instead
Perform hand hygiene before donning and immediately after doffing gloves; change gloves between patients and whenever torn or contaminated; never touch clean items with contaminated gloves.
Using alcohol-based hand rub when hands are visibly soiled or after contact with a patient known to have C. difficile or norovirus.
Alcohol rub is remembered as the default hand-hygiene method, overlooking situations where soap and water are required.
What to do instead
Use soap and water when hands are visibly soiled and after contact with spore-forming organisms such as C. difficile; reserve alcohol-based rub for routine hand hygiene when hands are not visibly soiled.
Doffing PPE in an order that touches the contaminated outside of gloves, gown, or face protection with bare hands or clean clothing.
The sequence is memorized as a list without applying the contaminated-to-clean principle.
What to do instead
Remove gloves first, then eye/face protection, then gown, then mask or respirator last; perform hand hygiene immediately after; practice the sequence until the contaminated-to-clean logic is automatic.
Recapping needles with two hands, bending or breaking needles, or carrying uncapped syringes before disposal.
Expedience and habit override sharps-safety rules during clinical scenarios.
What to do instead
Dispose of sharps immediately in a rigid container at the point of use; never bend or break needles; if recapping is unavoidable, use a one-handed scoop technique or a safety device.
Placing a surface barrier over a visibly contaminated surface without cleaning and disinfecting first, or reusing a barrier between patients.
Barriers are mistaken for a substitute for cleaning and disinfection.
What to do instead
Clean and disinfect the surface before applying a barrier; change barriers between patients and whenever torn, loose, or soiled; remember barriers do not replace routine cleaning and disinfection.
Wiping a surface and immediately drying it, or mixing disinfectant by estimate rather than by the label dilution, so the required contact time is not met.
A surface that looks wet is assumed to be disinfected, and label contact time is overlooked.
What to do instead
Preclean the surface, apply the disinfectant so it stays wet for the full label contact time, allow it to air dry, and use the exact dilution with test strips where required.
Placing instruments with visible blood, tissue, or cement directly into a sterilizer or high-level disinfectant without cleaning first.
The sterilant or disinfectant is assumed to penetrate bioburden and kill everything.
What to do instead
Clean instruments before disinfection or sterilization, inspect them for visible debris, and use ultrasonic cleaning or an automated washer per manufacturer instructions; do not process until visibly clean.
Choosing a disinfection or sterilization method by the instrument name rather than by the Spaulding classification and the manufacturer's validated instructions.
Candidates memorize lists of instruments instead of classifying by the type of tissue contact.
What to do instead
Classify each item as critical, semicritical, or noncritical based on contact with sterile tissue, intact mucosa, or intact skin; then select the required process and confirm the manufacturer's validated method.
Treating a chemical indicator as proof of sterilization, skipping biological indicators, or failing to state the response to a positive biological indicator.
Physical, chemical, and biological monitoring are conflated into one general idea of checking the sterilizer.
What to do instead
Use physical monitors, chemical indicators, and biological indicators for their distinct purposes; run biological indicators per manufacturer and policy, including every load with implants; a positive biological indicator means stop use, recall affected loads, and follow the facility's recall procedure.
Confusing OSHA requirements with CDC guidance, such as thinking the hepatitis B vaccine may be charged to the employee or that the exposure control plan does not need annual review.
Study sources blend enforceable regulations with recommendations, so candidates cannot distinguish legal requirements from best practice.
What to do instead
Tag each fact by source: OSHA bloodborne pathogens requirements include a free hepatitis B vaccine within 10 working days of assignment, an exposure control plan reviewed at least annually, a sharps injury log, post-exposure medical evaluation, and training at hire and annually; CDC guidance and state dental board rules are separate.