Infection Control: Breaking the Chain
What you must understand
The chain of infection has six links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Break any one link and infection stops. Hand hygiene is the strongest break available to you - before and after every resident contact, before and after gloves, after touching equipment, and after removing PPE.
PPE order matters. Donning: gown, mask or respirator, goggles or face shield, gloves last. Doffing: gloves first, then goggles, then gown, then mask last, with hand hygiene immediately after.
Standard precautions assume every resident's blood and body fluids are infectious. Transmission-based precautions add to that: contact (MRSA, C. difficile, scabies), droplet (influenza, pertussis), and airborne (tuberculosis, measles, varicella) - airborne requires a fit-tested N95 and a negative-pressure room.
Traps
- Reaching for alcohol-based hand rub when hands are visibly soiled, or when caring for a resident with C. difficile or norovirus. Alcohol does not kill spores; wash with soap and water.
- Treating gloves as a substitute for hand hygiene.
- Wearing PPE into the hallway or leaving an airborne-precaution door propped open.
- Sharing razors, toothbrushes, or nail clippers.
- Confusing cleaning (removing visible soil) with disinfection (killing most pathogens) and sterilization (killing all organisms).
Rule of thumb
If it is wet and it is not yours, treat it as infectious: gloves for the contact, hand hygiene the moment the gloves come off, and never shake soiled linen or set it on the floor.