A nurse is caring for a patient with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in the intensive care unit. Which infection control measure should the nurse implement first when entering the patient's room?
1Put on gloves and gown before entering the room✓ 정답
2Place a surgical mask on the patient
3Ensure the patient's room door remains open for monitoring
4Administer prescribed antibiotics immediately upon entry
해설
For MRSA pneumonia on contact precautions, donning gloves and gown before entering the room is the first priority to prevent transmission via direct or indirect contact. Other options are either patient-specific interventions or compromise infection control.
Clinical Judgment
This question assesses infection control priorities. The key is to identify the first action a healthcare worker must take before entering the room when Contact Precautions are applied for a patient with MRSA pneumonia. MRSA is primarily transmitted through direct contact (patient's skin or contaminated surfaces) or indirect contact (healthcare worker's hands or contaminated equipment). Therefore, the top priority measure to protect the healthcare worker and prevent transmission of the pathogen to other patients is to put on appropriate personal protective equipment (PPE)before entering the room. Option 1 accurately reflects this principle.
Memory Tip:
Remember Contact Precautions PPE as Contact = Cover up (gown and gloves). "Put them on before you go in!"
KR vs US:
The basic principles of Contact Precautions (gown and gloves) are the same in both Korea and the US. However, the US CDC guidelines emphasize more standardized and rigorous protocols for multidrug-resistant organisms like MRSA, with systematic education on the correct sequence for donning and doffing PPE. While Korea is also strengthening its infection control standards, compliance in practice may vary between facilities.
임상 시나리오
Clinical Practice Guide
Contact precautions protocol for managing patients infected/colonized with multidrug-resistant organisms such as MRSA:
1. Perform hand hygiene before entering the patient room.
2. Don personal protective equipment (PPE): gown and gloves are essential. If there is a risk of splashing from patient secretions, consider eye protection and a mask as well.
3. When leaving the patient room: remove gloves and gown inside the room and dispose of them properly, then perform hand hygiene before exiting through the door.
Caution:
In SATA (Select All That Apply) questions that ask for the "first" thing to do, you must choose one based on temporal precedence and the principle of safety (protecting healthcare workers and preventing infection spread) among all necessary actions. "Administering antibiotics" or "putting a mask on the patient" are important interventions, but entering the patient room without protecting oneself is not the correct sequence.
핵심 개념
Methicillin-resistant Staphylococcus aureus — Methicillin-resistant Staphylococcus aureus (and other beta-lactam antibiotics). It is a multidrug-resistant bacterium that can cause infections in both hospitals and community settings.
Contact Precautions — Contact precautions. Infection control measures implemented for pathogens that can be transmitted through direct contact (skin-to-skin) or indirect contact (contaminated object surfaces). The key points are wearing personal protective equipment (gown, gloves) and using dedicated equipment.
Personal Protective Equipment — Personal protective equipment. Equipment worn by healthcare workers to prevent exposure to infectious agents. Includes gowns, gloves, masks, face shields, eye protection, etc.
Healthcare-Associated Infection — Healthcare-associated infection. An infection that occurs while a patient is hospitalized or receiving treatment at a medical facility. MRSA is one of the major causative pathogens.
Transmission-Based Precautions — Transmission-based precautions. In addition to standard precautions, infection control measures implemented based on the transmission route (contact, droplet, airborne) of known or suspected pathogens. Contact precautions are one of them.