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Difficulty: MediumStandard and Transmission-Based Precautions

A practical nurse (PN) is emptying a surgical drain for a client on contact precautions due to a multidrug-resistant wound infection. During the task, the PN's right glove tears, and the client's purulent drainage visibly soils the PN's bare hand. Which sequence of actions must the PN take immediately?

  1. Remove the gloves, wash hands thoroughly with soap and water, and don a new pair of gloves before resuming the task.Answer
  2. B
    Place a second clean glove directly over the torn glove to establish an immediate double barrier.
  3. C
    Wipe the soiled hand with an antimicrobial wipe and quickly apply a fresh glove to the right hand.
  4. D
    Carefully finish emptying the drain using only the intact left hand, then remove all personal protective equipment (PPE).

Answer

Remove the gloves, wash hands thoroughly with soap and water, and don a new pair of gloves before resuming the task.
According to standard infection control protocols, if a protective barrier like a glove is breached and the skin is visibly soiled with blood or body fluids, the nurse must immediately stop the task, remove the gloves, and wash their hands with soap and water. Once the hands are properly decontaminated and dry, the nurse can don new gloves and safely resume client care.

Step-by-Step Solution

1
Recognize the personal protective equipment (PPE) breach.
The PN identifies that the glove is torn and the skin is visibly contaminated with infectious drainage.
Awareness of the breach is the first step in mitigating exposure to the multidrug-resistant organism.
2
Halt the procedure and remove the compromised PPE.
The PN steps back from the clean field and safely removes the torn gloves.
Continuing the task risks spreading the infectious material to other environmental surfaces or clean supplies.
3
Perform appropriate hand hygiene for visible soiling.
The PN washes hands thoroughly at the sink using soap, water, and friction.
Alcohol-based hand rubs are ineffective when hands are visibly soiled with organic material like blood or drainage; mechanical washing is required.
4
Don fresh PPE.
The PN puts on a new pair of clean gloves.
Re-establishing the contact precaution barrier is mandatory before touching the client or the drain again.

Key Concept

Standard and Contact Precautions: Managing PPE Breaches
Estimated Time:1m 0s
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Topics

Standard and Transmission-Based Precautions

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