Infection Prevention and Control in Healthcare Settings
Domain 3 covers preventing healthcare-associated infections through standard and transmission-based precautions, hand hygiene, environmental cleaning, sterilization, surveillance, and occupational exposure control. Expect questions on the chain of infection, PPE, isolation, multidrug-resistant organisms, and OSHA bloodborne pathogens requirements.
Core rules
- Standard precautions apply to all patients: hand hygiene, gloves, gown, mask/eye protection based on exposure risk, safe injection practices, and respiratory hygiene.
- Transmission-based precautions include contact for MRSA, VRE, C. difficile, and scabies; droplet for influenza, pertussis, and meningococcus; airborne for tuberculosis, measles, and varicella.
- Perform hand hygiene before and after patient contact and after glove removal. Alcohol-based rub is preferred for routine hand hygiene but not effective against C. difficile spores; use soap and water.
- PPE sequence: don gown, mask or respirator, eye protection, then gloves; remove gloves first, then eye protection, gown, and mask or respirator; hand hygiene last.
- Clean and disinfect shared equipment and follow disinfectant contact time. Sterile processing requires monitoring of cycles and storage integrity.
Worked example
A patient with C. difficile has frequent incontinence. Place on contact precautions, use gown and gloves for room entry, dedicate equipment, clean with an EPA-registered sporicidal disinfectant at the labeled contact time, and perform hand hygiene with soap and water. Alcohol rub alone would leave spores on hands.
Traps
Do not use alcohol rub after C. difficile care. Do not wear the same gloves for multiple patients. Do not confuse droplet and airborne precautions; TB requires an N95 respirator and negative-pressure room, not a surgical mask.