Infection Prevention, Safety, and Quality in Maternity Care
What this domain tests
This domain tests standard precautions, hand hygiene, aseptic technique, sharps safety, waste segregation, and quality improvement in maternity units. The exam expects infection-control decisions that protect mothers, newborns, and staff.
Core rules
- Perform hand hygiene according to the WHO five moments: before touching a patient, before clean or aseptic procedures, after body-fluid exposure, after touching a patient, and after touching patient surroundings.
- Use alcohol-based hand rub for routine hand hygiene when hands are not visibly soiled; use soap and water when hands are visibly soiled or after exposure to spore-forming organisms such as Clostridioides difficile.
- Wear gloves, gown, mask, and eye protection according to the risk of blood or body-fluid exposure. Gloves do not replace hand hygiene.
- Use aseptic technique for intravascular access, urinary catheterisation, and perineal repair. Use single-use items and sterile packs.
- Do not recap needles; dispose of sharps immediately in a puncture-resistant container. Report needlestick injuries promptly and follow post-exposure prophylaxis protocol.
- Separate clinical and domestic waste. Clean and disinfect reusable equipment. Audit infection rates and hand-hygiene compliance.
Worked example
A midwife sustains a needlestick after drawing blood. She should wash the wound with soap and water, allow bleeding, report immediately, and undergo risk assessment for hepatitis B, hepatitis C, and HIV. Post-exposure prophylaxis depends on the source and her immune status. Document the incident and attend follow-up.
Traps that cost marks
Wearing gloves is not a substitute for hand hygiene. Alcohol hand rub is not effective against spores. Do not recap needles. Do not use the same tourniquet without cleaning between patients. Do not ignore a cluster of postpartum infections; report it as a possible quality or safety issue.
Key points
- The WHO five moments structure hand hygiene.
- Alcohol hand rub is used when hands are not visibly soiled.
- Gloves do not replace hand hygiene.
- Sharps are disposed of immediately without recapping.
- Needlestick injuries require immediate reporting and risk assessment.
- Infection clusters require audit and incident reporting.