Pat, a registered nurse, is working a 12-hour night shift on the orthopedic unit where she has worked for the past 20 years. She knows that hand hygiene is the most effective way of preventing the transmission of health care-associated infections to patients, staff, and visitors in all health-care settings.
Mrs. Johnson, who is 80 years old, was admitted to the unit at 10 a.m. She was scheduled to have her surgery today for a fractured hip and has been fasting since her arrival. However, her surgery time was delayed to tomorrow morning. Pat is caring for Mrs. Johnson on the night shift. In preparation for surgery tomorrow and as per physician’s orders, Mrs. Johnson will need to begin fasting at midnight. Pat goes to Mrs. Johnson’s room to offer her something to eat. Mrs. Johnson requests a sandwich, or toast with peanut butter and jam.
According to CARNA’s Infection Prevention and Control Standards (2019), Pat has a responsibility and accountability to implement infection prevention and control interventions and activities. She is expected to:
Pat refers to the CARNA’s Guidelines for Hand Hygiene (2016), and is reminded that hand hygiene is performed in accordance with the following four key moments:
According to CARNA’s Guidelines for Hand Hygiene (2016), hand hygiene is performed "after contact with a patient or patient’s environment". As a result, Pat uses the alcohol-based hand rub from the dispenser located by the door as she leaves the patient room and proceeds to the patient kitchen to prepare Mrs. Johnson’s food. Pat is aware that while alcohol-hand based rubs (ABHRs) are appropriate in some situations, hand hygiene using soap and water is required:
As a result, Pat performs hand hygiene using soap and water before handling the food she prepares for Mrs. Johnson.