Task #1 When and how to conduct hand washing.
What does the learner do?
Defines “hand hygiene” and
identifies when to wash
hands.
What does the learner
need to know to do this
step?
When to wash hands.
A. When hands are visibly
dirty or contaminated with
proteinaceous material or
are visibly soiled with
blood or other body fluids,
wash hands with either a
non-antimicrobial soap and
water or an antimicrobial
soap and water.
B. If hands are not visibly
soiled, use an alcoholbased hand rub for
routinely decontaminating
hands in all other clinical
situations. Alternatively,
wash hands with an
antimicrobial soap and
water in all clinical
situations.
C. Decontaminate hands
before having direct
contact with patients.
D. Decontaminate hands
before donning sterile
gloves.
E. Decontaminate hands
before inserting indwelling
urinary catheters,
peripheral vascular
catheters, or other invasive
devices that do not require
a surgical procedure.
F. Decontaminate hands
What cues inform the learner
that there is a problem, the step
is done, or a different step is
needed?
Defines “hand hygiene”:
A general term that applies to
either hand washing, antiseptic
handwash, antiseptic hand rub, or
surgical hand antisepsis.
The following cues indicate that
the learner has completely the
task:
A. When decontaminating hands
with an alcohol-based hand rub,
apply product to palm of one
hand and rub hands together,
covering all surfaces of hands and
fingers, until hands are dry.
B. When washing hands with
soap and water, wet hands first
with water, apply an amount of
product recommended by the
manufacturer to hands, and rub
hands together vigorously for at
least 15 seconds, covering all
surfaces of the hands and fingers.
Rinse hands with water and dry
thoroughly with a disposable
towel. Use towel to turn off the
faucet. Avoid using hot water,
because repeated exposure to hot
water may increase the risk of
dermatitis.
C. Liquid, bar, leaflet or
powdered forms of plain soap are
acceptable when washing hands
with a non-antimicrobial soap and
water. When bar soap is used,
after contact with a
patient’s intact skin (e.g.,
when taking a pulse or
blood pressure, and lifting
a patient).
soap racks that facilitate drainage
and small bars of soap should be
used.
G. Decontaminate hands
after contact with body
fluids or excretions,
mucous membranes, nonintact skin, and wound
dressings if hands are not
visibly soiled.
H. Decontaminate hands if
moving from a
contaminated-body site to a
clean-body site during
patient care.
I. Decontaminate hands
after contact with
inanimate objects
(including medical
equipment) in the
immediate vicinity of the
patient.
J. Decontaminate hands
after removing gloves.
K. Before eating and after
using a restroom, wash
hands with a nonantimicrobial soap and
water or with an antimicrobial soap and water.
Task #2 How to properly handle linen.
What does the learner do?
List the guidelines for
What does the learner need
to know to do this step?
Linen and equipment will be
What cues inform the
learner that there is a
problem, the step is done, or
a different step is needed?
Learner explains when to use
handling linen and equipment.
separated into “clean” and
“dirty,” or contaminated,
categories.
personal protective equipment
when handling linen and
equipment.
Guidelines for handling linen
and equipment include:
1. Wearing gloves when
handling soiled linens.
2. Holding and carrying dirty
linen away from you.
3. Not shaking dirty linens or
clothes.
4. Placing linen and
equipment in proper
containers.
5. Not touching the inside of
disposal containers, etc.
Learner demonstrates the
proper guidelines when
handling linen and equipment.
Task #3 When and how to use personal protective equipment (PPE) gloves as a barrier for
bodily fluids.
What does the learner do?
Defines personal protective
equipment, and is able to
demonstrate the proper
method of donning and
removing non-surgical gloves
in a non-sterile environment.
What does the learner need
to know to do this step?
Gloves are used to prevent
contamination of healthcare
personnel hands when;
1) anticipating direct contact
with blood or body fluids,
mucous membranes, non-intact
skin and other potentially
infectious material;
2) having direct contact with
patients who are colonized or
infected with pathogens
transmitted by the contact route
handling or touching visibly or
potentially contaminated
patient care equipment and
environmental surfaces.
Gloves can protect both
patients and healthcare
What cues inform the
learner that there is a
problem, the step is done, or
a different step is needed?
The learner employs safe
work practices when donning
and removing gloves as a
PPE.
Cue 1. Learner demonstrates
proper donning and removal
of gloves.
Cue 2. Learner employs safe
work practices before donning
and after the removal of the
gloves.
SAFE WORK PRACTICES
1. Keep hands away from face
Work from clean to dirty
2. Limit surfaces touched
personnel from exposure to
infectious material that may be
carried on hands.
Non-sterile disposable medical
gloves made of a variety of
materials (e.g., latex, vinyl,
nitrile) are available for routine
patient care. The selection of
glove type for non-surgical use
is based on a number of
factors, including the task that
is to be performed, anticipated
contact with chemicals and
chemotherapeutic agents, latex
sensitivity, sizing, and facility
policies for creating a latexfree environment. For contact
with blood and body fluids
during non-surgical patient
care, a single pair of gloves
generally provides adequate
barrier protection.
During patient care,
transmission of infectious
organisms can be reduced by
adhering to the principles of
working from “clean” to
“dirty”, and confining or
limiting contamination to
surfaces that are directly
needed for patient care. It may
be necessary to change gloves
during the care of a single
patient to prevent crosscontamination of body sites. It
also may be necessary to
change gloves if the patient
interaction also involves
touching portable computer
keyboards or other mobile
equipment that is transported
from room to room.
Discarding gloves between
3. Change gloves when torn
or heavily contaminated.
4. Gloves disposed of in
closed patient trash
receptacle.
5. Perform hand hygiene prior
to donning and after removal
of gloves.
patients is necessary to prevent
transmission of infectious
material. Gloves must not be
washed for subsequent reuse
because microorganisms
cannot be removed reliably
from glove surfaces and
continued glove integrity
cannot be ensured.
When gloves are worn in
combination with other PPE,
they are put on last. Gloves
that fit snugly around the wrist
are preferred for use with an
isolation gown because they
will cover the gown cuff and
provide a more reliable
continuous barrier for the arms,
wrists, and hands. Gloves that
are removed properly will
prevent hand contamination.
Hand hygiene following glove
removal further ensures that
the hands will not carry
potentially infectious material
that might have penetrated
through unrecognized tears or
that could contaminate the
hands during glove removal.
DONNING PPE
GLOVES
■ Use non-sterile for isolation
■ Select according to hand size
■ Extend to cover wrist of
isolation gown.
(See figure 1)
Figure 1.
REMOVING PPE
Remove PPE at doorway
before leaving patient room or
in anteroom.
GLOVES
■ Outside of gloves are
contaminated!
■ Grasp outside of glove with
opposite gloved hand; peel off
■ Hold removed glove in
gloved hand
■ Slide fingers of ungloved
hand under remaining glove at
wrist (see figure 2).
Figure 2.
Task #4 When and how to clean / disinfect equipment between patients.
What does the learner do?
Discuss Transmission-Based
Precautions and Respiratory
Hygiene & Cough Etiquette.
What does the learner need
to know to do this step?
A combination of measures
designed to minimize the
transmission of respiratory
pathogens via droplet or
airborne routes in healthcare
What cues inform the
learner that there is a
problem, the step is done, or
a different step is needed?
When the learner successfully
demonstrates the components
of Respiratory Hygiene/Cough
etiguette.
settings.
The components of
Respiratory Hygiene/Cough
Etiquette are 1) covering the
mouth and nose during
coughing and sneezing, 2)
using tissues to contain
respiratory secretions with
prompt disposal into a notouch receptacle, 3) offering a
surgical mask to persons who
are coughing to decrease
contamination of the
surrounding environment, and
4) turning the head away from
others and maintaining spatial
separation, ideally >3 feet,
when coughing. These
measures are targeted to all
patients with symptoms of
respiratory infection and their
accompanying family
members or friends beginning
at the point of initial encounter
with a healthcare setting.
References:
Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-Care
Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee
and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR 2002; 51 (No. RR-16),
pp. 1-56.
Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices
Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of
Infectious Agents in Healthcare Settings (p. 50-51)
Wegner, S. Hartman Publishing Inc., n.d., PowerPoint, Infection Control, Chapter 6 SNAC-04