General Discussion

1️⃣ Five Moments of Hand Hygiene (WHO Guidelines)

Hand hygiene is the single most effective way to prevent the spread of infection. Perform hand hygiene:

1. Before touching a patient

2. Before clean/aseptic procedures

3. After body fluid exposure/risk

4. After touching a patient

5. After touching patient surroundings

2️⃣ Proper Handwashing (40–60 seconds)

Use when hands are visibly soiled or after contact with potentially infectious material.

Steps (about 40–60 seconds):

1. Wet hands with water

2. Apply enough soap to cover all hand surfaces

3. Rub palm to palm

4. Right palm over left dorsum and vice versa

5. Palm to palm with fingers interlaced

6. Backs of fingers to opposing palms with fingers interlocked

7. Rotational rubbing of left thumb clasped in right palm and vice versa

8. Rotational rubbing of clasped fingers in palm

9. Rinse hands thoroughly

10. Dry with a single-use towel

11. Use towel to turn off tap

3️⃣ Proper Hand Rubbing with Alcohol-Based Rub (20–40 seconds)

Use when hands are not visibly dirty

1. Apply a palmful of product

2. Follow the same rubbing steps as above, skipping water/soap

3. Continue until hands are dry — do not wipe off

4️⃣ Transmission-Based Precautions

Used in addition to Standard Precautions when specific infections are suspected/confirmed.

🫁 Airborne Precautions

Acronym: My Chicken Hez TB

• Measles

• Chickenpox (Varicella)

• Herpes zoster (disseminated)

• Tuberculosis

Measures:

• N95 respirator

• Negative pressure room

• Limit patient movement

💧 Droplet Precautions

Acronym: SPIDERMAN

• Sepsis

• Pertussis

• Influenza

• Diphtheria (pharyngeal)

• Epiglottitis

• Rubella

• Mumps / Meningitis (Neisseria)

• Adenovirus

Measures:

• Surgical mask within 1–2 meters

• Eye protection if risk of splash

• Limit patient transport

🖐️ Contact Precautions

Acronym: MRS WEE

• Multidrug-resistant organisms (MRSA, VRE)

• Respiratory infections (RSV, parainfluenza)

• Skin infections (scabies, impetigo)

• Wound infections

• Enteric infections (C. difficile)

• Eye infections (conjunctivitis)

Measures:

• Gloves and gown on entry

• Dedicated equipment

• Enhanced cleaning

5️⃣ Standard Precautions — Applied to all patients

• Hand hygiene before/after every patient contact

• Use of PPE (gloves, masks, eye protection) as needed

• Respiratory hygiene/cough etiquette

• Safe injection practices

• Proper handling of linens and waste

• Environmental cleaning

6️⃣ Chain of Infection

To prevent infection, break the chain at any point:

1. Infectious Agent — Bacteria, viruses, fungi

2. Reservoir — Where the agent lives (people, equipment, water)

3. Portal of Exit — How it leaves (cough, blood, wounds)

4. Mode of Transmission — Contact, droplet, airborne

5. Portal of Entry — Mouth, nose, mucous membranes, broken skin

6. Susceptible Host — Person with low immunity

7️⃣ Role of the CNA in IPAC

• Perform proper hand hygiene and use PPE appropriately

• Follow isolation precautions correctly

• Clean and disinfect patient equipment

• Report any signs of infection to the nurse (e.g., redness, swelling, drainage)

• Educate patients/families on hygiene practices

8️⃣ Vital Signs to Monitor if Infection is Suspected

• Temperature (fever may indicate infection)

• Pulse (tachycardia may be present)

• Respiration rate (may increase with fever or respiratory infection)

• Blood pressure (may drop in severe sepsis)

• Oxygen saturation (especially in respiratory infections)

• Pain score (localized or generalized discomfort)