Safety and Infection Control

Hand hygiene is the single most effective way to prevent the spread of infection; perform it before and after patient contact and after removing gloves.

Wash hands with soap and running water when caring for patients with C. diff, because alcohol-based rubs do not kill spores.

Apply standard precautions to all patients at all times, treating blood and body fluids as potentially infectious.

Alcohol-based hand rubs are appropriate when hands are not visibly soiled and for most organisms other than spores.

Contact precautions (e.g., MRSA, VRE) require a gown and gloves for direct care and contact with the patient's environment.

Droplet precautions require a surgical mask within about 3-6 feet of the patient (e.g., influenza, pertussis).

Airborne precautions (e.g., tuberculosis) require a fit-tested N95 or higher respirator and a negative-pressure room with the door closed.

Don PPE in the order: gown, mask/respirator, goggles/face shield, gloves.

Doff PPE starting with the most contaminated item: gloves, then goggles/face shield, then gown, then mask/respirator, followed by hand hygiene.

Under OSHA 29 CFR 1910.1030, never recap contaminated needles by hand; dispose of sharps immediately in a puncture-resistant, labeled container.

Replace sharps containers before they overfill (about two-thirds to three-quarters full); never empty or reuse them.

Treat all blood and body fluids as potentially infectious for HIV, hepatitis B, and hepatitis C.

Remove a contaminated isolation gown so the front and sleeves (most contaminated areas) do not touch clothing, then roll it inward.

Lift with the legs: bend at the knees and hips, keep the back straight, hold the load close, and avoid twisting.

Reduce fall risk by keeping the bed in its lowest position, the call light within reach, non-slip footwear on, and pathways clear.

Raise the bed to hip height for care to protect the back, and return it to the lowest position when finished.

Respond promptly to call lights and provide adequate lighting to prevent falls.

In a fire, follow RACE: Rescue, Alarm, Confine, Extinguish or Evacuate; operate an extinguisher with PASS: Pull, Aim, Squeeze, Sweep.

For an unresponsive, non-breathing patient, activate the emergency response system immediately and begin CPR if trained.

Use restraints only as a last resort after less restrictive alternatives fail, and only with a provider's order.

Monitor restrained patients frequently and release the restraint at least every 2 hours for circulation, toileting, and repositioning; tie to the non-movable bed frame with a quick-release knot.