Infection Prevention and Control
Infection Prevention and Control
This domain tests your ability to break the chain of infection in everyday care: hand hygiene, standard and transmission-based precautions, aseptic technique, safe injection practice, and environmental cleaning. Questions often ask which precaution applies to a specific organism and which PPE sequence is correct.
Core rules
- Chain of infection: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host. Interrupt any link.
- Standard precautions apply to all patients: hand hygiene, gloves when touching blood or body fluids, gown when splash risk, mask and eye protection when splash or spray risk.
- Transmission-based precautions add contact, droplet, or airborne measures. Contact: gown and gloves; droplet: surgical mask; airborne: fit-tested N95 or PAPR and negative-pressure room.
- Perform hand hygiene before patient contact, before aseptic tasks, after body-fluid exposure, after patient contact, and after touching patient surroundings.
- Clean gloves do not replace hand hygiene; remove gloves and perform hand hygiene.
- Aseptic technique protects sterile sites; clean technique is not sterile technique.
Worked example
A patient has profuse diarrhea and is suspected of Clostridioides difficile. The nurse places the patient in a private room, wears gown and gloves for every entry, and uses soap and water for hand hygiene after removing PPE. Alcohol-based rub is not used because C. difficile spores are not reliably killed by alcohol. The equipment is dedicated, and the room is cleaned with a sporicidal agent. If the patient also had active pulmonary tuberculosis, airborne precautions would be added with an N95 and negative-pressure room.
Traps
- Using alcohol rub after caring for a C. difficile patient.
- Wearing gloves into the hallway or using the same gloves for two patients.
- Choosing droplet precautions for varicella or measles (airborne).
- Doffing PPE in the wrong order and contaminating skin or clothes.