Infection Control
Concepts you must understand
Think in terms of the chain of infection: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host. Every technique you are tested on breaks one link. Hand hygiene is the single most important action: use soap and water when hands are visibly soiled and for Clostridioides difficile and norovirus, because alcohol does not kill spores; otherwise an alcohol-based rub is acceptable. Perform hand hygiene before resident contact, before and after glove use, after touching body fluids or contaminated items, and between residents.
Know Standard Precautions - treat all blood and body fluids as infectious and use gloves, gown, mask, and eye protection based on the task. Transmission-based precautions add Contact (gown and gloves, e.g., C. diff, MRSA), Droplet (mask, e.g., influenza), and Airborne (N95 respirator, negative-pressure room, e.g., tuberculosis). Remove PPE carefully: gloves first, then goggles, gown, and mask last, with hand hygiene after. Clean from clean to dirty - clean the least contaminated area first, and never use the same cloth for the perineal area and the face.
Traps in questions
Gloves do not replace handwashing. Do not wear gloves in the hallway, answer a phone, or touch a doorknob with contaminated gloves. Never share razors, toothbrushes, or other personal items. Do not assume an isolation sign means you can skip the resident's care.
Rule of thumb
Clean hands, then clean gloves; dirty to clean; one resident, one set of gloves.
Worked example: A resident has C. diff diarrhea. The tempting answer is "use alcohol rub after care." The correct answer is soap and water, gown and gloves on entry, and hand hygiene with soap and water on exit because alcohol does not destroy spores.