An infection control clinical nurse specialist is conducting unannounced surveillance rounds across multiple high-acuity medical-surgical units. Which of the following observed actions by the healthcare team represent a breach in infection control protocols that requires immediate intervention? Select all that apply.
- An unlicensed assistive personnel (UAP) performs hand hygiene using an alcohol-based hand rub after changing the soiled linens of a client with a confirmed *Clostridioides difficile* infection.Cevap
- BA registered nurse wears a fit-tested N95 respirator, face shield, isolation gown, and gloves while performing endotracheal suctioning on a client admitted with respiratory syncytial virus (RSV).
- CA transport technician places a standard surgical mask over the face of a client with suspected pulmonary tuberculosis prior to transporting the client through the hospital corridors.
- A nurse delegates the task of educating a visiting family member on the proper sequence for doffing contact precaution personal protective equipment (PPE) to a certified nursing assistant (CNA).Cevap
- A charge nurse places a client with active, uncrusted varicella-zoster lesions into a private protective environment (PE) room equipped with positive-pressure airflow.Cevap
- FA nurse removes their isolation gown and gloves inside the room of a client on airborne precautions, performs hand hygiene, exits the room, and then removes their N95 respirator in the hallway.
Cevap
The actions requiring immediate intervention are: using alcohol-based rub for C. difficile, delegating family PPE education to a UAP, and placing a varicella-zoster client in a positive-pressure room.
The actions requiring intervention are breaches of safety: 1) *C. difficile* spores are not eradicated by alcohol-based rubs; hand hygiene must be performed with soap and water to physically remove spores. 2) Client and family teaching is a core RN responsibility that cannot be delegated to a UAP/CNA. 3) Varicella-zoster requires Airborne precautions, which necessitates a negative-pressure Airborne Infection Isolation Room (AIIR). Placing this client in a positive-pressure room actively blows contaminated air into the hospital corridor, endangering others.
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Anahtar Kavram
Standard and transmission-based precautions require synthesizing knowledge of pathogen transmission routes, environmental airflow controls, appropriate PPE escalation for aerosol-generating procedures, and strict adherence to RN delegation scopes.