7.2 Infection Control & Standard Precautions
Key Takeaways
- Standard precautions apply to every patient regardless of diagnosis: hand hygiene, gloves, and personal protective equipment (PPE) whenever contact with blood or body fluids is possible.
- Alcohol-based hand rub is preferred for routine hygiene, but soap and water are mandatory after caring for patients with Clostridioides difficile (C. diff) or norovirus because alcohol does not kill those spores.
- Don PPE in the order gown, mask, eye protection, gloves; doff in the order gloves, eye protection, gown, mask to avoid self-contamination.
- Airborne precautions for tuberculosis (TB), measles, and varicella require an N95 respirator and a negative-pressure private room; droplet precautions require a surgical mask within about 3 to 6 feet.
- After a bloodborne pathogen exposure, wash the site immediately, report it, and seek post-exposure evaluation without delay.
Standard Precautions: The Baseline for Everyone
Standard precautions are the minimum infection-prevention practices applied to every patient in every setting, whether or not an infection is suspected. They treat all blood, body fluids, secretions, non-intact skin, and mucous membranes as potentially infectious.
Core components: hand hygiene, gloves and other personal protective equipment (PPE) when exposure is possible, safe injection and sharps practices, respiratory hygiene, and proper handling of contaminated equipment and linens.
Hand Hygiene
- Alcohol-based hand rub is the preferred method for routine hand hygiene when hands are not visibly soiled — it is faster and more effective against most organisms.
- Soap and water are mandatory when hands are visibly soiled and after caring for patients with Clostridioides difficile (C. diff) or norovirus. These pathogens form spores that alcohol does not kill; mechanical washing is required to physically remove them.
Transmission-Based Precautions
Layered on top of standard precautions when a specific organism is known or suspected.
| Precaution Type | Example Conditions | Key PPE / Room |
|---|---|---|
| Contact | C. diff, methicillin-resistant Staphylococcus aureus (MRSA), open draining wounds | Gown and gloves; dedicated equipment |
| Droplet | Influenza, pertussis, bacterial meningitis | Surgical mask within ~3 to 6 feet; private room preferred |
| Airborne | Tuberculosis (TB), measles (rubeola), varicella (chickenpox) | N95 respirator; negative-pressure private room with door closed |
Memory hook for airborne: My (measles) Chicken (varicella) Tea (TB) requires an N95.
Donning and Doffing PPE (Tested Sequence)
The order matters because it minimizes self-contamination.
Donning (putting ON): gown -> mask or respirator -> eye protection -> gloves.
Doffing (taking OFF): gloves -> eye protection -> gown -> mask or respirator.
The principle: remove the most contaminated items first (gloves), and remove the mask last, after leaving the patient's room, since it protected your airway throughout.
Bloodborne Pathogen Exposure Protocol
If a PTA sustains a needlestick or mucous-membrane exposure to blood or body fluids:
- Wash the site immediately with soap and water; flush mucous membranes or eyes with water or saline.
- Report the exposure to a supervisor right away — do not wait until the end of the shift.
- Seek post-exposure evaluation promptly so testing and, if indicated, post-exposure prophylaxis can begin within the effective time window.
- Document the incident per facility policy.
The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard requires employers to make this evaluation available at no cost to the employee.
Place the steps of doffing (removing) personal protective equipment (PPE) in the correct sequence to minimize self-contamination.
Arrange the items in the correct order
A PTA finishes treating a patient with confirmed Clostridioides difficile (C. diff) colitis. Which hand hygiene method is required?