Hand Hygiene: The Foundation of Patient Safety
Proper hand hygiene is the cornerstone of preventing the spread of infection within a healthcare setting. Before you even touch the door handle, you must perform this critical step. Hand hygiene can involve washing your hands with soap and water or using an alcohol-based hand sanitizer.
When to use soap and water
- If your hands are visibly soiled.
- After using the restroom.
- Before and after eating.
- When the patient has a suspected or confirmed C. difficile or norovirus infection, as alcohol sanitizers are not effective against these pathogens.
When to use alcohol-based sanitizer
- In all other situations, as it is often more effective and less damaging to the skin than frequent hand washing.
- After applying, rub your hands together for at least 20 seconds, ensuring all surfaces are coated and dry before proceeding.
Checking for Precautions and Donning PPE
Isolation precautions are put in place to protect the patient, staff, and other visitors from specific germs. A sign will be posted on the patient's door, clearly indicating any special requirements. You must read and follow these instructions carefully.
Understanding different precaution types
- Standard Precautions: These are for everyone and include hand hygiene and, if contact with body fluids is likely, the use of gloves, gown, and mask.
- Contact Precautions: A red or pink sign indicates a risk of spreading germs by touch. You will need to wear a gown and gloves, which should be donned before entering and discarded upon exiting the room.
- Droplet Precautions: An orange sign means germs can spread through respiratory droplets. You will need to wear a surgical mask, donned upon room entry.
- Airborne Precautions: A green sign indicates germs that can travel through the air. A special respirator mask, such as an N95, is required before entry. The door must also remain closed.
Practicing Professional Etiquette and Communication
Beyond infection control, a crucial part of patient care involves respectful and clear communication. This builds trust and ensures a positive patient experience.
The importance of the knock
Before you enter, knock and pause. This is a basic gesture of respect and gives the patient a moment of warning before a stranger enters their personal space. It is particularly important when curtains are drawn or the door is ajar.
The initial introduction and identification
- Introduce yourself: State your name and your role (e.g., "I'm [Your Name], a registered nurse").
- Identify the patient: Verify the patient's identity using two identifiers, such as their full name and date of birth. Do not use the room number for this purpose. This is a crucial step to ensure patient safety and prevent medical errors.
- Ask about preferences: Inquire about their preferred name and how they would like to be addressed.
The Bedside Safety Check and Environmental Scan
Before beginning any procedure, a quick environmental scan ensures the patient's safety and comfort.
Key items to check upon entry
- Bed position: Is the bed in its lowest position? This prevents falls when the patient attempts to get out of bed.
- Side rails: Are the appropriate side rails up to prevent a fall? Always follow facility policy.
- Call light: Is the call light within easy reach of the patient? This ensures they can get help when they need it.
- Necessary equipment: Check that any needed equipment, such as oxygen or suction, is working correctly and within reach.
The difference between visitor and staff protocol
| Action | Healthcare Staff | Visitors |
|---|---|---|
| Hand Hygiene | Before & after every interaction, even if gloves are used. | Upon entering & exiting the room. |
| Identification | Always identify the patient using two identifiers. | No identification needed, but should not visit if sick. |
| PPE | Don appropriate PPE based on posted precaution signs. | Follow instructions on signs and check with staff before entering. |
| Purpose | Explain the reason for your visit and procedure. | May be limited in number or time, especially during precautions. |
| Transport | Must follow strict protocols to limit patient movement. | Do not transport patients outside the room. |
Conclusion
Knowing what should you do before you enter a patient's room is a foundational aspect of providing safe, respectful, and high-quality healthcare. By prioritizing meticulous hand hygiene, adhering to all posted isolation precautions, and practicing courteous and effective communication, healthcare workers create a safer environment for everyone. These protocols protect against infection, build patient trust, and contribute to a more positive and therapeutic experience for the patient. Following these steps consistently is a non-negotiable part of professional care. You can find more comprehensive resources on this topic at the Centers for Disease Control and Prevention's Infection Control portal.
