Infection Control
Core concepts
Infection control questions test the chain of infection (infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host) and how each link is broken. Master the CDC/OSHA framework: standard precautions apply to all patients regardless of diagnosis; transmission-based precautions (contact, droplet, airborne) add to standard precautions for known infections. Know the difference between disinfection (kills most pathogens on surfaces), sterilization (destroys all microorganisms including spores), and antisepsis (applied to living tissue).
Practical workflow
Understand hand hygiene as the single most important measure - alcohol-based rub for routine, soap and water when hands are visibly soiled or after C. difficile exposure. Know PPE sequencing: don gloves last, remove gloves first, then eyewear, mask, and perform hand hygiene. Recognize critical items (penetrate tissue - must be sterile, e.g., surgical instruments), semicritical (contact mucous membranes - high-level disinfection minimum, e.g., mirrors), and noncritical (intact skin - low-level disinfection). Know spore testing for autoclaves (biological indicator weekly) and that ultrasonic cleaners do not sterilize.
Traps
Expect distractors that suggest a patient's known status changes whether you wear gloves - standard precautions apply universally. Watch for confusing disinfectant with sterilant. Another trap: assuming an autoclave pouch indicator strip proves sterility; only a biological spore test verifies the cycle. Also know that needle recapping with two hands is prohibited - use a scoop or one-handed technique or a sharps container device.
Rule of thumb
If an item touches broken skin or enters the body, it must be sterile. If it touches intact skin only, clean and low-level disinfect.