NCLEX Review Guide: Fundamentals - Infection Control & Safety, Nurse/Workplace Safety

Standard Precautions

• Hand hygiene is the single most important measure to prevent healthcare-associated infections and must be performed before and after every patient contact. Use alcohol-based hand rub for 15-20 seconds or soap and water for 40-60 seconds when hands are visibly soiled.
• Personal Protective Equipment (PPE) includes gloves, gowns, masks, and eye protection used based on anticipated exposure to blood, body fluids, secretions, and excretions. PPE must be donned before entering patient room and doffed in proper sequence to prevent contamination.
• Safe injection practices require using sterile, single-use disposable needles and syringes for each injection and accessing medication vials with new needle/syringe. Never reuse needles or syringes between patients or for the same patient.

Transmission-Based Precautions

Donning PPE (Putting On)

1. Perform hand hygiene
2. Put on gown (tie at neck and waist)
3. Put on mask or respirator
4. Put on eye protection if needed
5. Put on gloves (extend over gown cuffs)

Doffing PPE (Removing)

1. Remove gloves (avoid touching outer surface)
2. Remove gown (roll inside-out)
3. Perform hand hygiene
4. Remove eye protection
5. Remove mask/respirator (handle by straps only)
6. Perform final hand hygiene

Needlestick and Sharps Safety

• Never recap needles using the two-handed technique; use one-handed scoop method if recapping is absolutely necessary. Dispose of sharps immediately in puncture-resistant containers at point of use.
• Use safety-engineered devices when available, including retractable needles, needleless systems, and safety syringes to prevent accidental exposures. Activate safety features immediately after use.
• Report all needlestick injuries immediately to employee health and follow post-exposure prophylaxis protocols including baseline testing and potential antiviral therapy.

Body Mechanics & Ergonomics

• Use proper lifting techniques: bend knees, keep back straight, lift with legs, and avoid twisting motions while lifting. Get help for patients over 35 pounds or use mechanical lift devices.
• Mechanical lift devices should be used for dependent patients to prevent nurse injury and maintain patient dignity. Never attempt manual lifting of total-care patients without adequate assistance.

Common Pitfalls

Quick Check - Test Yourself

• ☐ I can list the 5 moments of hand hygiene
• ☐ I know the correct PPE donning and doffing sequence
• ☐ I can differentiate between contact, droplet, and airborne precautions
• ☐ I understand proper sharps disposal and needlestick injury protocol
• ☐ I know when to use mechanical lifting devices vs manual lifting