Infection prevention and control
This domain tests whether you apply precautions to every patient and escalate correctly when a transmissible pathogen is suspected. Items ask about hand hygiene moments, isolation type, correct personal protective equipment order, and post-exposure action.
Standard precautions
Apply to all patients regardless of diagnosis. Hand hygiene is the single most effective measure: alcohol-based rub for visibly clean hands, soap and water when hands are soiled and for spore-formers such as Clostridioides difficile and norovirus.
The five moments for hand hygiene
Before touching a patient, before a clean or aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching the patient's surroundings.
Personal protective equipment
Don in the order gown, mask or respirator, eye protection, gloves; remove in the order gloves, gown, eye protection, mask, with hand hygiene at each step and always at the end.
Transmission-based precautions
- Contact: MRSA, C. difficile, scabies, extended-spectrum beta-lactamase producers. Single room or cohort, dedicated equipment.
- Droplet: influenza, pertussis, meningococcal disease, mumps. Surgical mask, about one metre distance.
- Airborne: tuberculosis, measles, varicella. Negative-pressure room, FFP3 or N95 respirator, and notification of staff immunity status.
Decontamination
Spaulding classification: critical items enter sterile tissue and require sterilisation; semicritical items contact mucosa and need high-level disinfection; non-critical items touch intact skin and need cleaning plus low-level disinfection.
Worked example
A patient with a chronic cough, night sweats and weight loss is admitted before tuberculosis is excluded. Reasoning: the risk is airborne, so the nurse places the patient in a negative-pressure room with the door closed, wears an FFP3 respirator, and ensures the patient wears a surgical mask when transferred, rather than relying on a surgical mask alone.
Exposure and stewardship
Wash a needlestick without squeezing, report immediately, and start post-exposure assessment within hours. Escalate overuse of broad-spectrum antibiotics; review lines and catheters daily.