Infection Control in Nursing Practice: Hand Hygiene, PPE & HAI Prevention

Infection Control in Nursing Practice

Infection control is a fundamental nursing responsibility and a frequently tested NCLEX topic. Healthcare-associated infections (HAIs) affect millions of patients annually and are largely preventable through proper nursing practice.

Hand Hygiene

Hand hygiene is the single most effective measure to prevent HAIs. Use alcohol-based hand sanitizer (ABHS) for routine hand hygiene unless hands are visibly soiled. ABHS is effective against most pathogens but is not effective against C. difficile spores or norovirus. Use soap and water for these organisms and when hands are visibly contaminated. The five moments for hand hygiene are: before patient contact, before aseptic procedures, after body fluid exposure risk, after patient contact, and after touching patient surroundings. Perform hand hygiene for at least 20 seconds with soap and water or until hands are dry with ABHS.

Personal Protective Equipment (PPE)

Donning sequence: hand hygiene, gown, mask or respirator, eye protection, gloves. Doffing sequence: gloves, eye protection, gown, mask or respirator, hand hygiene. The doffing sequence is critical because contaminated PPE must be removed in the correct order to prevent self-contamination. Remember that gloves come off first (most contaminated) and the mask comes off last (least contaminated on the outside). Perform hand hygiene after removing each item if hands become contaminated.

Healthcare-Associated Infections

Central Line-Associated Bloodstream Infection (CLABSI): Use central line bundles including hand hygiene, maximal barrier precautions during insertion, chlorhexidine skin preparation, optimal catheter site selection, and daily assessment of line necessity. Catheter-Associated Urinary Tract Infection (CAUTI): Insert only when indicated, use aseptic technique, maintain a closed drainage system, and remove as soon as possible. Surgical Site Infection (SSI): Administer prophylactic antibiotics within one hour before incision, maintain normothermia, and use proper wound care technique.

Sterile Technique

A sterile field is considered contaminated if it becomes wet, if anything unsterile touches it, or if you turn your back to it. Maintain a one-inch border around the field as unsterile. Practice with our clinical nursing flashcards and infection control topics.