Question

A client is on contact isolation due to a MSRA abscess. The charge nurse observes all of the following nursing activities. Which nursing activity fails to safely protect others from the client? The nurse: A. washes hands after removing gloves. B. does not wear gloves when changing the bed. C. does not wear a gown when checking the IV level. D. covers the client with a sheet when being transported to \(x\)-ray.

Short answer

Option B fails to safely protect others because the nurse did not wear gloves when changing the bed.

Step-by-step solution

- Understand Contact Isolation

Contact isolation is used to prevent the spread of infectious diseases that are spread by direct or indirect contact with the patient or the patient's environment. It usually involves using gloves, gowns, and masks.

- Evaluate Each Nursing Activity

Assess each provided activity to determine if it meets contact isolation precautions.

- Analyze Option A

Option A: The nurse washes hands after removing gloves. This action is correct as hand hygiene is crucial after removing gloves to prevent the spread of infection.

- Analyze Option B

Option B: The nurse does not wear gloves when changing the bed. This action fails to protect others, as MSRA can be spread through contact with contaminated surfaces and not wearing gloves while changing the bed can lead to contamination.

- Analyze Option C

Option C: The nurse does not wear a gown when checking the IV level. This action is generally acceptable, provided that the nurse does not have direct contact with the patient’s skin or any contaminated materials.

- Analyze Option D

Option D: The nurse covers the client with a sheet when being transported to x-ray. This action is correct as covering the patient helps to prevent the spread of infection during transport.

- Identify the Incorrect Action

Based on the analysis, Option B is the incorrect action because the nurse failed to wear gloves, which is essential to prevent the spread of infection in a contact isolation scenario.

Key concepts

Hand Hygiene

Hand hygiene is one of the most crucial practices in preventing the spread of infections in healthcare settings. Proper hand hygiene involves washing hands with soap and water or using an alcohol-based hand sanitizer. It should be performed
- before and after touching a patient
- after removing gloves
- before performing any aseptic task. Washing hands after removing gloves ensures that any potential contaminants left on the hands after taking off the gloves are eliminated

MSRA Infection Control

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that is resistant to several antibiotics. Because of its resistance, controlling its spread in a healthcare environment is critical. Patients with a MRSA infection are often placed in contact isolation. Key elements for controlling MRSA include:

- Wearing gloves and gowns when entering the patient’s room

- Using dedicated or disposable equipment for the patient

- Proper disposal of contaminated materials.

Staff should also carry out frequent hand hygiene and environmental cleaning.

Nursing Protective Measures

Nursing protective measures aim to safeguard patients, staff, and visitors from infection. General protective measures include:

- Using personal protective equipment (PPE) like gloves, masks, gowns, and face shields

- Following transmission-based precautions, such as contact, droplet, and airborne precautions

- Cleaning and disinfecting surfaces and equipment effectively

- Educating patients and visitors about infection prevention. Nurses should always perform a risk assessment to decide the appropriate level of protection required for each situation.

Infection Prevention Protocols

Infection prevention protocols are designed to minimize the risk of spreading infections within healthcare environments. These protocols encompass a variety of practices, some of which are:

- Adopting standard precautions like hand hygiene and the use of personal protective equipment

- Implementing transmission-based precautions based on the type of infection

- Ensuring proper patient placement and cohorting

- Conducting regular training and education for healthcare workers. Adhering to these protocols helps in reducing the incidence of healthcare-associated infections (HAIs) and ensures a safer environment for both patients and healthcare providers.