Infection prevention and control: It’s in your hands
Pat, a registered nurse, is working a 12-hour night shift on the orthopedic unit where she has worked for the past 20 years. She knows that hand hygiene is the most effective way of preventing the transmission of health care-associated infections to patients, staff, and visitors in all health-care settings.
Mrs. Johnson, who is 80 years old, was admitted to the unit at 10 a.m. She was scheduled to have her surgery today for a fractured hip and has been fasting since her arrival. However, her surgery time was delayed to tomorrow morning. Pat is caring for Mrs. Johnson on the night shift. In preparation for surgery tomorrow and as per physician’s orders, Mrs. Johnson will need to begin fasting at midnight. Pat goes to Mrs. Johnson’s room to offer her something to eat. Mrs. Johnson requests a sandwich, or toast with peanut butter and jam.
What is expected of Pat according to the infection prevention and control standards?
According to CARNA’s Infection Prevention and Control Standards (2019), Pat has a responsibility and accountability to implement infection prevention and control interventions and activities. She is expected to:
- use and apply evidence-informed measures and best practices that prevent and control transmission of microorganisms
- ensure ethical and safe client care by reducing the transmission of infection
- provide safe, competent and ethical nursing care in the assessment, prevention, treatment, and control of infection, and,
- meet her professional obligations for infection prevention and control.
What does Pat do?
Pat refers to the CARNA’s Guidelines for Hand Hygiene (2016), and is reminded that hand hygiene is performed in accordance with the following four key moments:
- Before contact with a patient or patient’s environment (e.g. donning personal protective equipment (PPE), entering an examination room, providing patient care).
- Before a clean or aseptic procedure (e.g. wound care, handling intravenous devices, handling food, preparing medications).
- After exposure or risk of exposure to blood and/or body fluids (e.g. hands visibly soiled, after removal of gloves).
- After contact with a patient or patient’s environment (e.g. doffing PPE, leaving examination room, after handling patient care equipment).
According to CARNA’s Guidelines for Hand Hygiene (2016), hand hygiene is performed "after contact with a patient or patient’s environment". As a result, Pat uses the alcohol-based hand rub from the dispenser located by the door as she leaves the patient room and proceeds to the patient kitchen to prepare Mrs. Johnson’s food. Pat is aware that while alcohol-hand based rubs (ABHRs) are appropriate in some situations, hand hygiene using soap and water is required:
- During food preparation
- when hands are visibly soiled with food, dirt, blood, body fluids and/or a buildup of ABHR
- following glove removal when providing care for patients with diarrhea and/or vomiting
As a result, Pat performs hand hygiene using soap and water before handling the food she prepares for Mrs. Johnson.
Disclaimer: Our case studies are fictional educational resources. While we strive to make the scenarios as realistic as possible, any resemblance to actual people or events is coincidental.