Infection Control and PPE
Key Takeaways
- Standard Precautions apply to every resident because blood, body fluids, secretions, excretions, non-intact skin, and mucous membranes can transmit infection.
- Hand hygiene is required before resident contact, after resident contact, after glove removal, after contamination, and before clean care.
- Gloves reduce exposure but never replace hand hygiene; contaminated gloves can spread organisms from one task or resident to another.
- Contact Precautions usually require gown and gloves, droplet precautions add a mask, and airborne precautions require respirator-level protection such as an N95.
Infection Control Is Built Into Every Task
The Prometric Idaho outline lists infection prevention and control within Promotion of Safety. That placement matters: infection control is not a separate skill used only in isolation rooms. It is part of bathing, feeding, toileting, transfers, linen changes, vital signs, and equipment cleaning.
Standard Precautions apply to every resident. Treat blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes as potentially infectious. Use gloves when contact with those materials is possible, but remember the glove rule: gloves protect only when used for the right task and changed at the right time.
Hand Hygiene Decisions
Use hand hygiene before touching a resident, before clean care, after touching a resident, after touching contaminated surfaces, after contact with body fluids, after removing gloves, before eating, and after using the restroom. Alcohol-based hand rub is useful when hands are not visibly soiled. Soap and water is needed when hands are visibly dirty, after restroom use, before eating, and when facility policy requires it for spore-forming organisms such as C. diff.
A CNA should think in moments rather than schedules. Do not wash once at the start of the hour and rely on that. Clean your hands when the task changes from dirty to clean, from one resident to another, or from contaminated equipment back to the resident.
PPE and Transmission-Based Precautions
Transmission-Based Precautions add barriers when the resident's condition calls for them. Follow the sign on the room, the care plan, and nurse instructions.
| Precaution type | Common spread pattern | Typical CNA protection |
|---|---|---|
| Standard | Every resident, every time | Hand hygiene plus task-based gloves, gown, mask, or eye protection |
| Contact | Touch and contaminated surfaces | Gown and gloves for room entry or direct care per policy |
| Droplet | Larger respiratory droplets | Surgical mask near the resident, plus eye protection if splash risk exists |
| Airborne | Tiny particles that remain suspended | Fit-tested N95 or higher respirator and special room controls |
Put PPE on before exposure. Remove it without touching contaminated fronts. A safe doffing pattern is gloves first, then gown, then eye protection, then mask or respirator last, followed by hand hygiene. If your hands become contaminated during removal, clean them before continuing.
Clean Equipment, Linens, and Sharps
Clean equipment before it moves to another resident. Keep clean supplies away from soiled surfaces. Roll soiled linen inward, hold it away from your uniform, and place it directly in the proper hamper. Never shake linens because that can spread organisms into the air.
Sharps go directly into an approved sharps container. Do not recap, bend, break, hand-carry, or pass an exposed needle. Even though routine injections are outside CNA scope, CNAs may encounter lancets, insulin supplies, or resident-used sharps and must protect themselves and others.
Reporting Infection Risks
Report fever, new cough, drainage, diarrhea, rash, worsening wound appearance, redness around a device, cloudy urine, and sudden confusion. Also report if you are ill. Idaho skilled nursing rules require staff illness to be reported so the facility can prevent transmission to residents. The CNA's infection-control job is simple but strict: clean hands, correct barriers, clean equipment, safe disposal, and fast reporting.
Which actions show correct infection-control practice during a CNA shift?
Select all that apply
A resident is on Contact Precautions and the CNA needs to reposition them in bed. Which PPE choice best matches that situation?