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Apex Nursing

Reference — Infection Control

Standard Precautions and PPE Reference

Isolation precautions are organized in two tiers. Standard Precautions are applied to every patient, every time — they are the foundation of infection prevention. Transmission-Based Precautions are layered on top when a specific pathogen requires it. This reference covers standard precautions in depth, PPE selection by task and tier, and hand hygiene — the practices every nurse must internalize.

Educational use only. This reference supports learning and clinical practice. Always follow your institution's infection control policies, which may exceed CDC minimum standards. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.

PPE Selection by Precaution Tier

TierApplies WhenMinimum PPERoom
StandardEvery patient, every encounterGloves, gown, mask/eye protection (when splash risk)Any
ContactDirect/indirect contact transmission riskGloves + Gown (on entry)Private room preferred
DropletLarge respiratory droplet transmission riskSurgical mask (on entry or within 3–6 ft)Private room preferred; door may remain open
AirborneAirborne particle (≤5 µm) transmission riskFit-tested N95 respirator (or PAPR)AIIR — negative pressure, door closed at all times

Transmission-based precautions are always in addition to — not instead of — standard precautions. For condition-specific precaution assignments, see Common Isolation Guidelines.

Standard Precautions — Core Elements

Standard precautions apply to every patient, every time, regardless of known infection status. They are based on the premise that all blood, body fluids, secretions, excretions, non-intact skin, and mucous membranes are potentially infectious.

Hand Hygiene

The single most important measure in preventing healthcare-associated infections. Required before and after every patient contact — even when gloves are worn.

Gloves

Wear when contact with blood, body fluids, secretions, excretions, mucous membranes, or non-intact skin is anticipated. Change between tasks. Perform hand hygiene after removal — gloves are not a substitute for hand hygiene.

Gown

Wear when splashing of clothing with blood or body fluids is anticipated, or when direct contact with a contaminated environment is likely.

Mask and Eye Protection / Face Shield

Wear during procedures likely to generate splashing or spraying of blood or body fluids (suctioning, irrigation, bronchoscopy, wound irrigation). A mask alone protects mucous membranes; a face shield also protects eyes.

Safe Injection Practices

One needle, one syringe, one patient — no exceptions. Do not re-enter multi-dose vials with used needles. Use safety-engineered sharps devices. Dispose immediately in puncture-resistant containers.

Respiratory Hygiene / Cough Etiquette

Applies at triage and throughout care. Offer masks to symptomatic patients. Instruct patients to cover coughs and sneezes. Perform hand hygiene after contact with respiratory secretions.

Patient Care Equipment

Handle soiled equipment in a manner that prevents exposure to skin, mucous membranes, and clothing. Clean and disinfect or sterilize reusable equipment before use on another patient.

Hand Hygiene — When and How

WHO 5 Moments for Hand Hygiene

  1. Before touching a patient
  2. Before a clean or aseptic procedure
  3. After body fluid exposure risk
  4. After touching a patient
  5. After touching patient surroundings

Alcohol-Based Hand Rub (ABHR)

  • Preferred for most situations — faster and less skin-damaging than soap
  • Apply to all surfaces of hands; rub until dry (20+ seconds)
  • Effective against most bacteria and viruses
  • Not effective against C. difficile spores or norovirus

Soap and Water Required When:

  • Hands are visibly soiled
  • Before eating
  • After using the restroom
  • After caring for patients with C. difficile
  • After potential norovirus exposure

PPE Donning and Doffing Order

Donning (Putting On)Doffing (Removing)
  1. Hand hygiene
  2. Gown
  3. Mask or respirator
  4. Eye protection / face shield
  5. Gloves (over gown cuffs)
  1. Gloves (most contaminated — pull away from body)
  2. Hand hygiene
  3. Eye protection / face shield (handle by straps only)
  4. Gown (roll away from body)
  5. Hand hygiene
  6. Mask or respirator (handle by ties/straps only)
  7. Hand hygiene

Doffing is the highest-risk step — self-contamination most commonly occurs during removal. Treat all outer surfaces of used PPE as contaminated. Never touch the face of a used mask.

Related Resources

Standards & sources

Fact-checked Jun 21, 2026

This page is written to align with CDC / HICPAC · Infectious Diseases Society of America (IDSA) / SHEA. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →