NCLEX Infection Control and Safety: Isolation Precautions, Hand Hygiene and Patient Safety Priorities

Why Infection Control Dominates NCLEX Safety Questions

Safety and Infection Control accounts for 9-15% of the NCLEX-RN exam. Questions range from hand hygiene technique to selecting correct PPE to room assignment priorities.

Hand Hygiene: The #1 Patient Safety Intervention

Use Soap and Water (NOT alcohol rub) for: C. difficile (alcohol does NOT kill spores!), visibly soiled hands, after restroom use.

Alcohol-Based Hand Rub is appropriate before/after every patient contact when hands are not visibly soiled, before putting on gloves, after removing gloves.

Isolation Precautions Master Chart

Airborne Precautions

Diseases (Mnemonic MTV): Measles, TB, Varicella (Chickenpox), disseminated Herpes Zoster.

PPE: N95 respirator + gown + gloves. Room: Negative pressure private room, door CLOSED.

Droplet Precautions

Diseases: Influenza, Mumps, Rubella, Pertussis, Meningococcal meningitis, RSV, COVID-19 (routine).

PPE: Surgical mask within 3 feet + gown + gloves. Door may remain open.

Contact Precautions

Diseases: MRSA, VRE, C. diff, scabies, impetigo, norovirus.

PPE: Gown + gloves upon room entry.

Donning and Doffing PPE Order

Donning (Put On): Gown, Mask/Respirator, Goggles, Gloves.

Doffing (Remove — Most Contaminated First): Gloves, Goggles, Gown, Mask — perform hand hygiene after each step!

National Patient Safety Goals (NPSGs)

• Use 2 patient identifiers before any procedure
• Read-back all verbal/phone orders
• Label all medications and reconcile medication lists
• Reposition patients every 2 hours for pressure injury prevention
• Fall risk assessment, non-slip footwear, call light within reach