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Difficulty: MediumStandard and Transmission-Based Precautions

A registered nurse is observing an unlicensed assistive personnel (UAP) provide care for a client who is on enteric contact precautions due to an active *Clostridioides difficile* (*C. difficile*) infection. Which action by the UAP requires immediate intervention by the nurse?

  1. A
    Doffing the disposable gown and gloves inside the client's room near the doorway.
  2. B
    Disinfecting the client's overbed table using a bleach-based sporicidal wipe.
  3. Cleansing hands with an alcohol-based antiseptic rub immediately after removing gloves.Answer
  4. D
    Placing the client's soiled bed linens directly into a fluid-resistant laundry bag inside the room.

Answer

The UAP using an alcohol-based hand rub after providing care requires immediate intervention because *C. difficile* spores are not destroyed by alcohol.
The action of cleansing hands with an alcohol-based antiseptic rub requires immediate intervention. *Clostridioides difficile* is a spore-forming bacterium. Alcohol-based hand sanitizers are not sporicidal and will not eliminate the pathogen from the hands. The nurse must intervene to ensure the UAP washes their hands with soap and water, which mechanically removes the spores down the sink drain.

Step-by-Step Solution

1
Identify the pathogen and the specific isolation precautions required.
The client has *C. difficile*, which requires enteric contact precautions.
Understanding the pathogen's mode of transmission dictates the necessary infection control measures.
2
Evaluate each of the UAP's actions against enteric contact precaution guidelines.
Doffing PPE in the room, using bleach wipes, and bagging linens in the room are all correct procedures. Using an alcohol-based hand rub is incorrect.
To identify which action violates infection control protocols and requires immediate correction.
3
Determine the physiological rationale for the intervention.
*C. difficile* forms hardy spores that must be physically removed from the hands using friction, soap, and water. Alcohol sanitizers do not destroy these spores.
Safe nursing practice requires understanding the clinical rationale behind hand hygiene methods.

Key Concept

Enteric contact precautions specifically require handwashing with soap and water because alcohol-based sanitizers are ineffective against spore-forming organisms like *Clostridioides difficile*.
Estimated Time:1m 0s
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Topics

Standard and Transmission-Based Precautions

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