Safety, Infection Control, and Emergency Procedures
Standard precautions
Treat every resident's blood and body fluids as infectious. Perform hand hygiene before and after resident contact and after removing gloves; wash with soap and water when hands are visibly soiled and when caring for a resident with C. difficile, because alcohol gel does not kill spores. Don PPE in order: gown, mask, goggles, gloves. Remove in order: gloves, goggles, gown, mask - the mask comes last and is handled by the ties, never the front.
Transmission-based precautions
Contact (MRSA, VRE, scabies, C. diff): gown and gloves with dedicated equipment. Droplet (influenza, pertussis, mumps): mask within about three feet. Airborne (TB, measles, varicella, disseminated shingles): fit-tested N95 respirator and a negative-pressure room.
Emergencies
Fire: RACE - Rescue, Alarm, Contain, Extinguish. Extinguisher: PASS - Pull, Aim, Squeeze, Sweep. Seizure: protect the head, move objects away, do not restrain or put anything in the mouth, time it, and turn the resident on the side afterward. Choking: abdominal thrusts for a conscious adult. CPR is 30 compressions to 2 breaths at 100-120 per minute, at least 2 inches deep. Bleeding: direct pressure with gloved hands, then report.
Environment
Keep the call light within reach, bed low and locked, floor dry, side rails only as ordered, restraints only as ordered. Never leave a resident alone on a toilet or in a shower.
Traps
Hand hygiene for C. diff, the doffing order, and restraining a seizing resident are classic distractors.
Rule of thumb
Clean your hands, then ask: what is the most likely way this resident could be hurt in the next five minutes?