Hands are excellent reservoirs for organisms to transfer from one thing to another. Performing hand hygiene before and after each patient encounter is a National Patient Safety Goal. Additionally, to help reduce microorganisms being transferred, nails should be kept clean, short, and well manicured. Know your health organization's policy on nail care.
It is standard practice that when entering a room one washes or gels their hands, and repeats when exiting the room. This helps block the spread of infection and keeps it isolated in the room. If someone has C. difficile it is required to wash hands with soap and water as the alcohol gel does not kill this organism.
Typical alcohol-based hand soap contains at least 60% alcohol and does not require any rinse after use. Do not use alcohol-based hand rub when hands are visibly soiled, feel dirty, or after caring for a patient with C. difficile.
It is important for the healthcare worker to wash his or her hands when they are visibly soiled. Rub hands vigorously for at least 15 seconds. Friction allows for transient organisms to be removed from the hands.
PPE is specialized clothing or equipment used to protect the patient and provider from transmitting organisms from one place to another. Required PPE will depend on the task to be performed and what infectious agent the patient could have. It is important to know your hospital’s policy on the proper use and disposal of PPE.
A gown is used for all patients that are on contact precautions or when contact with body fluid is anticipated. The gown creates a barrier between the staff member’s skin and uniform and the infectious organism. This helps prevent the organism from transmitting onto the staff uniform.
Masks are used during invasive procedures when respiratory secretions are present or when the patient is on Droplet or Respiratory Precaution. Staff members caring for a patient with possible tuberculosis are required to wear a N95 mask. Being “fit tested” by the organization is required before using these masks.
Goggles or face shields are used when splashes or spraying of bodily fluid can occur. Face shields are also used with patients that are in Droplet Precaution.
Gloves are an essential part of standard precautions. Even though gloves are being worn, it is still necessary to wash or gel hands before and after a patient encounter. Ask the patient about Latex allergies and confirm that the proper gloves are being used.
Gather needed supplies before entering the room. Then don needed PPE. Make sure all PPE fits and is securely tied, placing gloves on last. Remove gloves first by pulling them off by the cuff and turning them inside out.
To eliminate accidental needle sticks and comply with OSHA regulation, place any used sharps/needles in a puncture-resistant container immediately after use. A container should be present in every room. Never carry used sharps out of a patient’s room.
Educate the patient and family members on proper cough/sneeze etiquette. Have the patient cover his or her nose/mouth when coughing or sneezing and dispose of used tissues properly. Place a surgical mask on a non-compromised respiratory patient when the patient is out of the room. Keep a 3 feet distance between you and a patient that is coughing.
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