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Don appropriate personal protective equipment (PPE) based on the patient’s signs and symptoms and indications for isolation precautions.
Perform hand hygiene with soap and water or use an alcohol-based hand sanitizer immediately after removing all PPE.undefined#ref4">4
Avoid physical contact with the patient before donning appropriate PPE.1
Infection prevention and control measures help to ensure the protection of patients in a range of settings who may be vulnerable to acquiring an infection both in the general community and when receiving care because of health problems.
Infection-control practices that reduce and eliminate sources of infection transmission help to protect patients and health care team members from disease. The health care team member is responsible for educating the patient about infection control. Knowledge of the infectious process, disease transmission, and critical-thinking skills associated with use of aseptic techniques and barrier protection is essential for both health care team members and patients.
Droplet transmission is a form of contact transmission when some form of infectious agent is transmitted by droplet route (direct or indirect contact). However, in contrast to contact transmission, respiratory droplets carrying infectious pathogens transmit infection when they travel directly from the infectious person’s respiratory tract (e.g., coughing, sneezing, talking) to the recipient’s susceptible mucosal surfaces, generally over short distances.4
Health care team members working with patients who have an illness that can be transmitted via droplet route (e.g., influenza) should don a mask when within 1.8 to 3 m (6 to 10 ft) of the patient or upon entry into the patient’s room.4 The difference between droplet precautions and airborne precautions is related to the size of the particle. With droplet-transmitted pathogens, the particle is greater than 5 micrometers4 and does not hang suspended in air. Airborne-transmitted pathogens are less than 5 micrometers and are able to hang suspended in the air for long periods of time. Airborne precautions require special air handling and ventilation.4
Standard precautions, or tier one precautions, are used based on the assumption that every patient is potentially infected or colonized with a transmissible organism. Standard precautions are primary for preventing infection transmission and apply to contact with blood, bodily fluids, nonintact skin, mucous membranes, equipment or surfaces contaminated with potentially infectious materials.
Respiratory hygiene and cough etiquette should be used by any person entering a health care facility with signs of respiratory infection (e.g., cough, congestion, rhinorrhea, increased production of respiratory secretions). Key elements of respiratory hygiene include proper hand hygiene, covering the mouth and nose with a tissue when coughing or sneezing, coughing or sneezing into the elbow, wearing a mask, and properly discarding used tissues.
Health care team members must participate in and practice rigorous training of current PPE recommendations, which include the systematic donning and doffing of PPE. Once in the isolation room, PPE must remain in place and worn correctly. A breach may include skin exposure, a needlestick, or a tear in the PPE. Removing or adjusting PPE while in the procedure room increases the risk of contamination. The doffing process is a time of high risk, and a systematic procedure must be followed.1
Rationale: Donning a gown properly prevents the transmission of infection and provides protection if the patient has excessive drainage or discharge.
Rationale: Donning eye protection properly reduces the risk of exposure to microorganisms that may occur from splashing fluids.
Rationale: This prevents contamination of the outside of the biohazard bag.
At the completion of the procedure, ensure that all choking hazards (e.g., syringe caps, port caps, adhesive bandages, bits of tape, twist-off caps from saline bullets) are removed from the patient’s linens and placed in the appropriate receptacle.
If hands become contaminated during glove removal, or any other step in the PPE doffing procedure, immediately perform hand hygiene.
Rationale: Properly removing gloves prevents contact with the contaminated gloves’ outer surface.
Rationale: The outside of the eye protection is contaminated. Handling as described allows removal without contaminating hands.
Rationale: The front of the gown and sleeves are contaminated. Removing the gown as described prevents contact with the contaminated front of the gown.
Do not touch the outer surface of the mask.
Rationale: The front of the mask is contaminated. Touching only the elastic or mask strings protects ungloved hands from contamination. Untying the bottom mask string first prevents the top part of the mask from falling down over the health care team member’s uniform.
Centers for Disease Control and Prevention (CDC). (n.d.). Sequence for putting on personal protective equipment (PPE). Retrieved April 1, 2020, from https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf
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