What are the recommended infection control procedures when caring for a patient?

Recommended Infection Control Procedures When Caring for Patients

Implement rigorous hand hygiene before and after every patient contact, wear appropriate personal protective equipment (PPE) based on exposure risk, use new gloves for each patient, and maintain proper sharps safety protocols to prevent healthcare-associated infections and protect both patients and healthcare workers.

Hand Hygiene: The Foundation of Infection Control

Hand hygiene represents the single most critical infection control measure, yet remains one of the most challenging to achieve consistent compliance 1.

Key hand hygiene protocols:

• Perform hand hygiene before and after treating each patient - this is non-negotiable 1
• Wash hands with soap and water when visibly soiled or contaminated with blood or potentially infectious material 1
• Use alcohol-based hand rub when hands are not visibly soiled - this is equally effective and more convenient 1
• Always perform hand hygiene before donning gloves and immediately after removing gloves 1
• After touching any objects likely contaminated with blood, saliva, or respiratory secretions 1

Critical hand hygiene considerations:

• Keep fingernails short with smooth, filed edges to allow thorough cleaning and prevent glove tears 1
• Do not wear artificial fingernails or extenders when having direct contact with high-risk patients (intensive care units, operating rooms) 1
• Avoid hand or nail jewelry that compromises glove fit and integrity 1
• Use hand lotions to prevent skin dryness, but ensure compatibility with antiseptic products and glove materials 1

Personal Protective Equipment (PPE): Barrier Protection

Glove protocols:

• Wear medical gloves whenever potential exists for contacting blood, saliva, other potentially infectious material (OPIM), or mucous membranes 1
• Use a new pair of gloves for each patient - never reuse gloves between patients 1
• Remove gloves promptly after use and wash hands immediately to prevent microorganism transfer 1
• Replace torn, cut, or punctured gloves immediately and wash hands before regloving 1
• Never wash, disinfect, or sterilize gloves for reuse 1
• Use puncture- and chemical-resistant utility gloves when cleaning instruments or performing housekeeping tasks involving blood or OPIM 1

Masks, eye protection, and face shields:

• Wear a surgical mask and eye protection with solid side shields or a face shield during procedures likely to generate splashing or spattering of blood or body fluids 1
• Change masks between patients or during treatment if the mask becomes wet 1
• Clean and disinfect reusable facial protective equipment between patients 1

Protective clothing:

• Wear protective clothing (gown, laboratory coat, or uniform) that covers personal clothing and skin likely to be soiled with blood, saliva, or OPIM 1
• Change protective clothing if visibly soiled or immediately if penetrated by blood or infectious fluids 1
• Remove all barrier protection (gloves, mask, eyewear, gown) before departing the work area 1

Sharps Safety and Needlestick Prevention

Critical sharps protocols to prevent occupational exposure:

• Place used disposable syringes, needles, scalpel blades, and sharp items in appropriate puncture-resistant containers located as close as feasible to the area of use 1
• Never recap used needles using both hands or any technique directing the needle point toward any body part 1
• Do not bend, break, or remove needles before disposal 1
• If recapping is necessary (between multiple injections), use only a one-handed scoop technique or mechanical device designed for holding the needle cap 1
• Identify and select devices with engineered safety features annually as they become available 1

Postexposure management:

• Follow CDC recommendations immediately after percutaneous, mucous membrane, or nonintact skin exposure to blood or potentially infectious material 1

Special Considerations for High-Risk Procedures

For surgical procedures, perform surgical hand antisepsis before donning sterile surgeon's gloves using either antimicrobial soap and water, or soap and water followed by alcohol-based surgical hand-scrub product with persistent activity 1. Wear sterile surgeon's gloves for all oral surgical procedures 1.

For procedures involving highly pathogenic infectious diseases, endotracheal intubation should be performed by the most skilled person available wearing full PPE including eye protection, in an environment with minimum 15 air changes per hour 2.

Common Pitfalls and How to Avoid Them

The compliance challenge: Hand hygiene compliance remains the most intractable problem in infection control despite being the simplest measure 3. Making alcohol-based hand rub readily available at point of care significantly improves compliance 3.

Glove misuse: Healthcare workers often develop a false sense of security with gloves, forgetting that gloves do not replace hand hygiene. Always wash hands before donning and immediately after removing gloves 1.

Artificial nails: These harbor microorganisms and are strongly contraindicated in high-risk patient care settings 1.

PPE removal sequence: Improper removal of contaminated PPE can lead to self-contamination. Always remove gloves first, then perform hand hygiene before removing other PPE 1.

These evidence-based infection control procedures, when implemented consistently, significantly reduce healthcare-associated infections and protect both patients and healthcare workers from infectious disease transmission 4, 5.