Infection Control & Prevention in Nursing: Best Practices

Chain of Infection

Breaking any link prevents disease transmission:

1. Infectious Agent: Bacteria, virus, fungus, parasite
2. Reservoir: Where the pathogen lives (human, animal, environment)
3. Portal of Exit: How it leaves (respiratory, GI, blood, skin)
4. Mode of Transmission: How it spreads
5. Portal of Entry: How it enters a new host
6. Susceptible Host: Person at risk for infection

Standard Precautions (Use for ALL patients)

• Hand hygiene: Before and after every patient contact
• Gloves: When touching blood, body fluids, mucous membranes
• Gown: When clothing may become contaminated
• Mask/Eye protection: When splashing is anticipated
• Sharps safety: No recapping needles
• Respiratory hygiene/Cough etiquette: Cover coughs, offer masks
• Safe injection practices: One needle, one syringe, one patient

Transmission-Based Precautions

Contact Precautions

For: MRSA, VRE, C. diff, scabies, wound infections

• Private room or cohorting
• Gown and gloves for all contact
• Dedicated equipment
• C. diff special note: Use soap and water (not alcohol hand sanitizer)

Droplet Precautions

For: Influenza, pertussis, meningitis, strep pharyngitis

• Private room (door may be open)
• Surgical mask within 3-6 feet
• Patient wears mask during transport

Airborne Precautions

For: Tuberculosis, measles, chickenpox, COVID-19 (aerosolized)

• Airborne infection isolation room (AIIR): negative pressure
• N95 respirator or PAPR
• Door must remain closed
• Patient wears surgical mask during transport

Hand Hygiene

When to Perform (WHO 5 Moments)

1. Before touching a patient
2. Before clean/aseptic procedure
3. After body fluid exposure risk
4. After touching a patient
5. After touching patient surroundings

Alcohol-Based vs. Soap and Water

• Alcohol-based: Preferred for most situations
• Soap and water: C. diff, norovirus, visibly soiled hands

Sterile Technique

• 1-inch border around sterile field is contaminated
• Never turn your back on a sterile field
• Keep sterile items above waist level
• Moisture = contamination
• When in doubt, consider it contaminated

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