Safe and Effective Care Environment: Safety and Infection Control
Safety and Infection Control tests the PN's ability to prevent harm, apply precautions correctly, and respond to emergencies.
Precautions
- Standard precautions apply to all clients: hand hygiene before and after contact, gloves for body fluids, and gown, mask, and eye protection when splash is likely.
- Contact precautions require gown and gloves and dedicated equipment. For C. difficile, use soap and water because alcohol does not kill spores. Follow facility policy for MRSA and scabies.
- Droplet precautions require a mask for client and staff; examples include influenza, pertussis, and bacterial meningitis.
- Airborne precautions require an N95 respirator, a negative-pressure room, and a closed door; examples include tuberculosis, measles, and varicella.
Worked example
A client has watery diarrhea and suspected C. difficile. The PN places the client in a private room, wears gown and gloves, uses dedicated equipment, and performs hand hygiene with soap and water after care. Reasoning: C. difficile spores survive alcohol-based rub; soap and water physically removes spores. The PN also cleans shared equipment and teaches visitors to wash hands.
Other safety
Fall prevention includes a low bed, locked brakes, call light within reach, non-skid footwear, and hourly rounding. Restraints are a last resort and require a provider order, time limits, frequent circulation and skin checks, release and repositioning per policy, and never staff convenience. Fire response uses RACE: rescue, alarm, contain, evacuate or extinguish.
Traps
Wearing gloves instead of performing hand hygiene; using alcohol rub for C. difficile; applying restraints without an order; documenting restraint checks before performing them; leaving a client with dysphagia supine after meals.