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Standard precautions are used with blood, blood products, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes. This includes infection prevention practices that apply to all patients: hand hygiene; use of gloves, gown, mask, and face shield; respiratory hygiene/cough etiquette; and safe injection practices. The practice is determined by the extent of anticipated blood, body fluid, or pathogen exposure.
Practice Challenges
Challenge 1
HISTORY
Your patient is a 74-year-old male who was seen in the emergency department (ED) where he reported nausea, severe abdominal cramping, and diarrhea for the past couple of days. He was admitted to your unit with a diagnosis of dehydration.
HISTORY
Your patient is a 74-year-old male who was seen in the emergency department (ED) where he reported nausea, severe abdominal cramping, and diarrhea for
the past couple of days. He was admitted to your unit with a diagnosis of dehydration.
ASSESSMENT
Vital signs: Temperature = 38.4° C (101.2° F), Blood pressure = 114/76, Pulse = 104, Respiratory rate = 16. The patient reports weakness and syncope, especially when standing. His skin turgor is fair, while his oral mucous membranes appear pale and dry. The patient experienced a cerebrovascular accident 2 years ago that has left him with left-sided paralysis. He requires assistance to
reposition in bed, to transfer to a chair, and to perform self-hygiene care. The patient reports, "The last thing I ate before the diarrhea started was a salad with grilled chicken."
Do you have any concerns about infection control for this patient?
Please select from the options below. A. Yes B. No
You enter the room in full protective garb, adjust the patient's IV fluid infusion, provide him with a bedpan, reposition him after providing peri-care, empty and clean the bedpan, document the care you provide in the notebook, and move 10 feet away to the sink. You remove and dispose of all personal protective equipment. After appropriate handwashing, you pick up both the notebook and the pen, place them onto the designated counter, and then leave the room. Within 3 days, five patients and 14 staff members have infectious diarrhea.
PRACTICE CHALLENGE.
Considering the previous information, where did you fail to maintain
appropriate technique to prevent contact transmission of the Salmonella bacteria in this patient's stool?