Infection Control
What you must understand
Hand hygiene is the single most important infection control measure. Wash with soap and water when hands are visibly soiled, after using the toilet, before eating, and when caring for a resident with C. difficile (alcohol rub does not kill spores). Use alcohol-based rub otherwise. Perform hand hygiene before and after every resident contact, before and after gloves, and after touching blood, body fluids, or contaminated equipment. Gloves do not replace hand hygiene.
Standard precautions apply to every resident: treat all blood and body fluids as potentially infectious. Wear gloves for contact with blood, urine, stool, secretions, non-intact skin, and mucous membranes; add a gown, mask, and eye protection when splashing is likely. Order for donning PPE: gown, mask, goggles, gloves. Order for removing: gloves, goggles, gown, mask - hand hygiene after.
Transmission-based precautions add to standard precautions. Contact precautions (MRSA, C. diff, scabies) require gown and gloves and dedicated equipment. Droplet precautions (influenza, pertussis) require a mask within a few feet. Airborne precautions (tuberculosis, measles, shingles) require an N95 respirator and a negative-pressure room; the resident stays in the room with the door closed.
Other essentials: do not shake soiled linen - roll it inward and bag it at the point of use; never share razors or other personal items; clean shared equipment between residents; place sharps in the puncture-proof container without recapping; for a needlestick, wash with soap and water and report immediately.
Traps the exam sets
- Using alcohol rub for a C. diff resident - wrong; wash with soap and water.
- Removing gloves and moving on without washing hands.
- Double-bagging everything, or carrying soiled linen through the hallway against your body.
Rule of thumb
If it is wet and it is not yours, wear gloves - and wash your hands after the gloves come off.