A nurse is caring for a 22-year-old patient with acute hepatitis B infection who has a history of intravenous drug use. Which nursing intervention is the highest priority to prevent transmission to healthcare workers and other patients?

For a patient with acute hepatitis B, the highest priority is preventing bloodborne transmission. Implement Standard Precautions for all patient contact. Add Contact Precautions specifically to manage blood and body fluid spills or contamination.

• Hand Hygiene: Perform immediately before and after patient contact, and after removal of gloves.
• Personal Protective Equipment (PPE): Wear gloves when anticipating contact with blood, body fluids, mucous membranes, or non-intact skin. Use a gown, mask, and eye protection if splashes or sprays are expected.
• Sharps Safety: Dispose of all needles and sharps in puncture-resistant containers without recapping. This is critical given the patient's history of intravenous drug use.
• Environmental Cleaning: Clean and disinfect surfaces and equipment that may be contaminated with blood or body fluids using an EPA-registered hospital disinfectant.
• Patient Placement: A private room is recommended if the patient has poor hygiene or extensive bleeding that may contaminate the environment. A negative pressure room is not required.
• Post-Exposure Management: If an exposure occurs, immediately wash the site. Report per facility protocol. For an unvaccinated exposed person, HBIG and the HBV vaccine series should be initiated within 24 hours.

Educate the patient on modes of transmission and the importance of not sharing personal items like razors or toothbrushes. Ensure household contacts and sexual partners are screened and vaccinated.